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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601789
Report Date: 11/22/2022
Date Signed: 11/23/2022 09:00:16 AM

Document Has Been Signed on 11/23/2022 09:00 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:LC VOCATIONAL TRAINING CENTERFACILITY NUMBER:
198601789
ADMINISTRATOR:THERESA ZAROURFACILITY TYPE:
775
ADDRESS:1420 CLAREMONT BLVD., STE 205CTELEPHONE:
(909) 626-2900
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY: 30CENSUS: 7DATE:
11/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Program Director Johnny WinsserTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced annual inspection visit focused on Infection Control. LPA met with the Program Director Johnny Winsser and discussed the purpose of today's visit.

As a part of the inspection, LPA used the inspection tool, reviewed (4) client records, (4) staff files. This program consists of the following: a single-story building (located in a commercial site) with two (2) offices, one (1) large activity room, one (1) kitchenette, one (1) cafe room, and two (2) bathrooms. This program is equipped with surveillance cameras in the common areas. This program provides services for Developmentally Disabled Adults between the ages of 18 to 59. This program is licensed for (25) ambulatory clients and (5) non-ambulatory clients. There are a total of (17) clients participating in this program as a whole. At the time of visit (7) clients were present for in-person services. All rooms are clean and in good repair. LPA observed the following during inspection of adequate lighting present, plenty of storage space present. LPA observed there were toiletries accessible to clients. LPA observed the PPE supplies. Bathrooms were found to be within Title 22 regulation. Carbon monoxide detector and smoke detectors are operational. Fire extinguishers were fully charged and operational, toxins and cleaning supplies were locked and inaccessible to clients. Facility does not handle client medications. First aid kit was checked an in order. Outside grounds were toured and no bodies of water were observed. Requires posting were observed. Fire panel observed and last serviced on 4/27/22. Exits/ Walkways around the home were free of debris and hazards. LPA completed visit with the Inspection Tool focused on Infection Control.

No deficiencies cited on this visit and a copy of report was furnished
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Jose Villalobos
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2022
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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