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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601894
Report Date: 02/27/2023
Date Signed: 02/27/2023 11:07:14 AM

Document Has Been Signed on 02/27/2023 11:07 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:CLIMB, INC. - ARF 2FACILITY NUMBER:
198601894
ADMINISTRATOR:FILIMON GEBREMICHAEFACILITY TYPE:
735
ADDRESS:2298 W. MAIN STREETTELEPHONE:
(626) 289-5322
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY: 6CENSUS: 5DATE:
02/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Estrella Terry Del Mundo, AdministratorTIME COMPLETED:
11:10 AM
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Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection with the focus of the Infection Control domain. LPA arrived unannounced and Staff, Jovita Hernandez allowed entry. Administrator, Estrella Del Mundo, arrived shortly after to assist with the visit. The facility is licensed to serve a total of 6 adults, of which 1 may be non-ambulatory and 5 bedridden.

LPA toured the facility and observed the following:
* There are 5 Client bedrooms, 3 bathrooms, living room, dining room, and kitchen. The laundry area is located inside the 3rd bathroom with 2 showers.
* Staff are still conducting temperature and symptoms check upon arrival for staff and visitors. Clients are monitored daily for symptoms and temperature are documented.
* The company tests staff and clients twice a week.
* Proper COVID-19 signage are posted throughout the home.
* There are sufficient food supplies for 2 day perishable and a week of non-perishable at the facility.
* Disinfectants and cleaning solutions are locked in cabinets. Staff are disinfecting at least 2x/shift and more often for high touched surfaces.
* Knives and sharps are locked in the kitchen cabinet.
* Medications are centrally stored and locked in the dining room. LPA checked medications for 4 clients and they are being administered as prescribed.
* PPE supplies for at least 30 days are stored at the facility.
* LPA observed Staff wearing face masks properly during the visit.
* Facility has plan to mitigate the spread of the Coronavirus if any client is tested positive and still following the strictest guidance.

No deficiencies observed today. An exit interview was held and a copy of this report was given to Administrator Del Mundo.
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2023
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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