198601685-12-20-2023-11-AS-PBUR-CYPN6J-20231220091113

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198601685
Report Date: 12/19/2023
Date Signed: 12/20/2023 09:13:49 AM

Document Has Been Signed on 12/20/2023 09:13 AM - 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 ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	A HEALTHIER CHOICE DAY PROGRAM		FACILITY NUMBER:	198601685
ADMINISTRATOR:	EBONY HARRIS		FACILITY TYPE:	775
ADDRESS:	693 S. LA BREA AVENUE		TELEPHONE:	(310) 672-0488
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90301
CAPACITY: 45		CENSUS: 17	DATE:	12/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Eduardo Martinez		TIME COMPLETED:	03:30 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	Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced required 1- year visit with the primary focus on Infection Control measures and using the new CARE Inspection Tool. Upon arrival at the facility, LPA Bunker conducted a risk assessment. Based on the assessment, the Adult Day Program is clear of COVID-19 infection. LPA was properly screened for COVID-19 symptoms and temperature was checked. LPA Bunker met with Program Director Eduardo Martinez and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved Mitigation Plan report and Infection Control Plan. There are currently seventeen (17) residents attending the Day Program today. The Day Program's annual fees are current. There are 12 Domains in the Infection Control Practices that will be observed and reviewed. Infection Control; Physical Plant & Environmental Safety; Operational Requirements; Staffing; Personnel Records-Training; Client Records-Incident Reports; Client Rights-Information; Food Service; Health-Related Services; Incidental Medical Services; Disaster Preparedness; and Emergency Intervention. "I will be using this tool and methods that have been developed to improve the efficiency and accuracy of the Department of Social Services' facility inspections." The Adult Day Program is located in single-story business buildings, operating hours are 8:30 A.M. until 2:30 P.M., 5 days a week Monday through Friday. All clients bring their own lunch or bring money to purchase lunch in the community. If clients forget their lunch the facility staff will provide emergency food for clients. See continued LIC809-C on page #2

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023

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 ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: A HEALTHIER CHOICE DAY PROGRAM	FACILITY NUMBER: 198601685
	VISIT DATE: 12/19/2023

NARRATIVE

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Continued LIC809-C page #2

Mr. Martinez and LPA Bunker toured the entire Adult Day Program inside and outside which consisted of the following: A receptionist area, 2 client restrooms, 1 staff restroom, a multi-purpose room in the rear of the building with a pull-up door, and an open and close door, with a quick release handle lock. The multi-purpose room is used as a lunch room, small groups, activities, arts and crafts. The main multi-purpose has a television area, fitness area, and activity area. There is a nurse's station/office area, an administrator's cubicle, and a parking lot.

All areas are in compliance. Each room is adequately equipped and furnished. The day program has posted current activity schedules, and each instructor develops and follows specific weekly lesson plans.

The last Fire/Emergency Drill was conducted on September 27, 2023. The staff in-service training was reviewed. The employee personnel files and client records are in a locked cabinet and were reviewed and appear to be in compliance. Mr, Martinez states staff was given training on dependent adult and elder abuse reporting. The day program currently has no clients on medication. The Adult Day Program does have a centrally stored locked cabinet in the nurse's office for medications. There are no personal/incidental monies handled by the day program staff. However, clients bring money for special field trips or activities when in the community.

Documents are posted as mandated. The following Title 22 regulated areas were audited and found to be in compliance: Carbon monoxide and smoke detectors were in compliance, the first aid kit was fully stocked with a manual, fire extinguishers were fully charged, restrooms were clean and operational, and toxic/sharp items were locked and inaccessible to clients. Hazardous items are inaccessible to clients. The day program grounds are free of debris/hazards.

See continued LIC809-C page 2

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023

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 ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: A HEALTHIER CHOICE DAY PROGRAM	FACILITY NUMBER: 198601685
	VISIT DATE: 12/19/2023

NARRATIVE

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Continued LIC809-C page 3

LPA Bunker observed the facility’s infection control practices, screening protocols for residents and visitors, sanitizer, visitor log, and thermometer at the Adult Day Program entrance. Logs of daily COVID-19 screening and temperature checks of clients and staff were available and updated. PPE supplies are readily available to staff, and an additional supply of Personal Protective Equipment (PPE) was observed. Sufficient liquid soap, paper goods, cleaning, and disinfecting supplies were observed. LPA observed staff wearing a face covering and social distancing.

LPA Bunker provided Program Director Eduardo Martinez with copies of the LIC809; LIC809-Cs; LIC809-D; LIC858; and LIC859

According to the California Code of Regulations, Title 22, Division 6, Chapter 3. LPA observed the following deficiency, the facility is being cited on the attached LIC809-D.

Appeal rights were issued and covered with the facility Program Director.

An exit interview was conducted.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 12/20/2023 09:13 AM - It Cannot Be Edited

Created By: Pamela Bunker On 12/19/2023 at 02:46 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: A HEALTHIER CHOICE DAY PROGRAM	FACILITY NUMBER: 198601685
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

82088(e)(1)

This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	82088 (e) (1) Fixtures, Furniture, Equipment, and Supplies: Based on observation temperature was tested in the client's restroom. The hot water temperature was measured and recorded at 150.02 degrees Fahrenheit, exceeding the standards set by Title 22 Regulations. Which poses an immediate health, safety, or personal rights risk to persons in care.
	POC Due Date: 12/20/2023
	Plan of Correction
1 2 3 4	The hot water temperature was measured and recorded at 150.02 degrees Fahrenheit. The Licensee agrees to adjust the hot water temperature to maintain a range between 105 and 120 degrees Fahrenheit. This adjustment must be completed by the Plan of Correction (POC) due date of 12/20/2023.

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:

Stephanie Cifuentes

LICENSING EVALUATOR NAME:

Pamela Bunker

LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023

LIC809 (FAS) - (06/04)

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