198601527-9-15-2023-11-AS-EDAT-CVQ4UX-20230915192529

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198601527
Report Date: 09/15/2023
Date Signed: 09/15/2023 07:25:41 PM

Document Has Been Signed on 09/15/2023 07:25 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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	MONETA LEARNING CENTER		FACILITY NUMBER:	198601527
ADMINISTRATOR:	ANITA MATHARU		FACILITY TYPE:	775
ADDRESS:	21601 MONETA AVENUE		TELEPHONE:	(310) 782-9701
CITY:	CARSON	STATE: CA	ZIP CODE:	90745
CAPACITY: 32		CENSUS: 32	DATE:	09/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:54 AM
MET WITH:	Pat Ball		TIME COMPLETED:	12:35 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 09/15/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Executive Program Director Pat Ball and explained the purpose of today’s visit. The day program is licensed to operate for thirty-two (32) non-ambulatory ages 18 and over. The consumers are Harbor Regional Center clients. Currently, the program is conducting services though visual communications with consumers. The day program is a single-story structure located in a residential neighborhood. It consists of the following: administrative office, consultation area, conference room, physical activity room, arts and crafts room, controlled multi-sensory stimulation room(SPA), computer lab area, break room/kitchen area, laundry area, nurse's room, and two (2) designated restrooms. LPA and director toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected and had adequate lighting furnishings. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 115.3 F. A comfortable temperature of 70 degrees was maintained. LPA observed the day program to be sanitary and appropriately supplied at the time of visit. Storage room for cleaning supplies, toxins, and sharps objects were stored and not accessible to consumers. The kitchen was inspected and found all appliances were in working condition. Fire extinguishers were charged, smoke detectors and carbon monoxide were operable. The first Aid kit was adequately supplied. A landlne telephone was in working condition. Inspection Evaluation Report Continues on LIC 809-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: MONETA LEARNING CENTER	FACILITY NUMBER: 198601527
	VISIT DATE: 09/15/2023

NARRATIVE

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During this visit, LPA’s observed the day program's infection control practices. LPA observed screening protocols for visitors, staff, and consumers, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the program had a sufficient supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. Social distancing floor makings were observed throughout. The program has a dedicated isolation/quarantine room.

An audit of clients #1-#5 (C1-C5) service files and staff #1-#6 (S1-S6) personnel files was conducted. Interviews were conducted with (3) clients. The facility is current on Community Care Licensing annual dues.

Deficiency:
During an audit of personal files between 10:45am - 11:45am, LPA identified (4) out of (5) staff did not have current CPR/First Aid Certificates. Staff #1-#4 (S1-S4) had expired CPR/First Aid certificates dated 08/23/23.

According California Code of Regulations (Title 22, Division 6, Chapter 3), deficiencies were observed, and citations were issued (ref. LIC 9099-D).

An exit interview was conducted with Pat Ball and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/15/2023 07:25 PM - It Cannot Be Edited

Created By: Ernand Dabuet On 09/15/2023 at 12:12 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: MONETA LEARNING CENTER	FACILITY NUMBER: 198601527
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

82075(f)

Health-Related Services

(f) Staff responsible for providing direct care and supervision shall receive and maintain current training in first aid and cardiopulmonary resuscitation from persons qualified by agencies including, but not limited to, the American Red Cross. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on (record review)], the licensee did not comply with the section cited above. LPA identified (4) out of (5) staff did not have current CPR/First Aid Certificates. This violation which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/29/2023
	Plan of Correction
1 2 3 4	Program Director will adhere to Title 22 82075 and ensure that all direct staff have completed a current/valid CPR/First Aid for all personnel working with person's in care. Proof of correction must be sent to LPA Dabuet: ernand.dabuet@dss.ca.gov by POC date: 09/29/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Janae Hammond

LICENSING EVALUATOR NAME:

Ernand Dabuet

LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

LIC809 (FAS) - (06/04)

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