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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600558
Report Date: 03/07/2024
Date Signed: 03/07/2024 04:11:24 PM

Document Has Been Signed on 03/07/2024 04:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:PALS EINDELIJK EL MONTEFACILITY NUMBER:
198600558
ADMINISTRATOR:GLORIA GALLEGOSFACILITY TYPE:
775
ADDRESS:11645 MCBEAN DR.TELEPHONE:
(626) 279-1064
CITY:EL MONTESTATE: CAZIP CODE:
91732
CAPACITY: 60CENSUS: 40DATE:
03/07/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Gloria GallegosTIME COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit and was greeted by Administrator Gloria Gallegos and explained the reason for the visit. The purpose of the visit is to complete the required inspection.
LPA Trueman toured the facility along with Administrator Gloria Gallegos today 03/07/2023 at 1:30 PM and the following was observed:
Facility contains : Front office, conference room, supervisor office, manager office, 2 activity rooms , 6 programming rooms, storage room, infirmary, 4 restrooms each with sink and toilet and a kitchen area.
Annual Inspection includes the following Domains:
Infection Control, Physical Plant and Environment Safety, Operational Requirements, Staffing, Personnel Records- Training, Client Rights Information, Client rights- Incident Reports, Food Service, Health Related Services, Incidental Medical Services, and Disaster Preparedness.
Interviews were conducted with 3 staff and all clients were not at the Day Program at time of visit..5 client files and 6 staff files were reviewed
All staff were cleared and associated.
Medication was administered per physician's directions for 1 client at the Program.
Signage for hand washing and proper sanitizing were posted. Staff have been trained in hand washing.
Direct care staff had a minimum of 8 hours of annual training,
Licensee maintained an individual admission agreement for each client.
Fire Clearance has been maintained.
Hot water temperature was measured between 105F and 120 F. meeting regulations.
Each client has personal rights free from corporal or unusual punishment, infliction of pain, humiliation, ridicule, coercion, threats, mental abuse, or other actions of a punitive nature.
Program site was clean, safe, sanitary, and in good repair at all times for the safety and well being of clients, employees and visitors.
No deficiencies.

Exit interview conducted.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Glenn Trueman
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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