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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601302
Report Date: 12/15/2023
Date Signed: 12/15/2023 02:30:02 PM

Document Has Been Signed on 12/15/2023 02:30 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
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:C-H ADULT DAY CENTER PROGRAMFACILITY NUMBER:
198601302
ADMINISTRATOR:BROWN, MARIETTAFACILITY TYPE:
775
ADDRESS:8026 E ALONDRA BLVDTELEPHONE:
(562) 630-8123
CITY:PARAMOUNTSTATE: CAZIP CODE:
90723
CAPACITY: 70CENSUS: 45DATE:
12/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:12 AM
MET WITH:Maricruz Salinas- SupervisorTIME COMPLETED:
02:45 PM
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Licensing Program Analysts (LPAs) Sanjay Vaid and Luis Mora conducted an unannounced Annual Required inspection to the above Adult Day Program (ADP). Upon arriving at the facility LPAs met with Supervisor Maricruz Salinas and informed her of the purpose of the visit. This facility is licensed as an Adult Day Care facility to serve seventy (70) Developmentally Disabled clients ages 18 and above, Eight (8) may be Non-Ambulatory. Supervisor Salinas stated that the facility has forty-five (45) clients enrolled in the program. Non-ambulatory clients attending the program are eight (8). Staff to Client ratio is one (1) staff to three (3) clients. The program operates within its conditions and limitations specified on the license, including the capacity limitation.

As part of the inspection, LPAs toured the facility inside and out, reviewed client and staff records, and medications. The property consists of one large building with tow reception areas, administration offices, three classrooms, two kitchens: one for client use and the other for staff use, client storage room, facility storage room, staff room with lockers. Facility walls and floors were in good condition, adequate lighting, fire extinguishers were properly charged. All toilets and hand washing facilities were well maintained, safe, sanitary and in operating condition. Additional equipment for physically handicapped clients is provided. Both kitchen areas were clean and well maintained. Refrigerators are available for client use to store their lunches. The program does not provide lunch but does provide snacks. ADP provides transportation for clients from place of residence to ADP and back.

Motor vehicles used to transport clients were maintained in safe operating condition. No pools and bodies of water are located within the facility. Disinfectants, cleaning solutions, poisons were inaccessible to clients. A comfortable temperature is maintained within facility. Hot water temperature was within Title 22 regulations (115 F). Fire drills are conducted monthly and the last one conducted was on 11/17/23. Disaster Plan was on file.
(continued to LIC 809-C)
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE: DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: C-H ADULT DAY CENTER PROGRAM
FACILITY NUMBER: 198601302
VISIT DATE: 12/15/2023
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Facility is ensuring that Care and Supervision necessary to meet the client's needs and all services specified in the admission agreements are being met. The staff provide clients with training in daily living skills, including grooming, personal hygiene, social skills, cooking and simple homemaking tasks, and opportunities to learn about the community. Clients are assisted with self-administration of medications by trained staff. Medications are kept safe, locked, and inaccessible to clients. Facility staff ensure that clients are kept clean and dry, and that the day program facility remains free of odors. The program administration develops, maintains, and implements written plans for orientation, continuing education, on-the-job training and development, supervision, and evaluation of all direct care staff. Client/ Staff files are current and in compliance. All staff are fingerprint cleared and associated to the facility. First aid kit with manual was checked and is complete. All program driver’s files reviewed have a valid driver's license on file. Documents are posted as mandated.


No Deficiencies cited.

Exit interview conducted and a copy of report was provided to Administrator Maxine Hartwell.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023
LIC809 (FAS) - (06/04)
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