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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601949
Report Date: 03/08/2022
Date Signed: 03/08/2022 04:06:32 PM

Document Has Been Signed on 03/08/2022 04:06 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:OPARC SUMMIT SERVICES WESTFACILITY NUMBER:
198601949
ADMINISTRATOR:TOMINES, JONATHANFACILITY TYPE:
775
ADDRESS:355 S LEMON AVE STE GTELEPHONE:
(909) 598-8055
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY: 60CENSUS: 49DATE:
03/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Kathlene Parker, Program ManagerTIME COMPLETED:
04:20 PM
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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 met with Kathlene Parker, Program Manager. The purpose of the visit was explained. The day program is licensed to serve 60 ambulatory clients ages 18 and over, of which 6 may be non-ambulatory. The program is operating in person for 19 clients and also providing remote services.

LPA Chan toured the day program with the Program Manager.
* The one-story building is comprised of 8 program activity rooms, 3 staff offices, copy room, 4 restrooms (2 designated for female and 2 for male), kitchen area, locker area, and a maintenance storage room.
* There are no obstructions to the walkways nor any bodies of water.
* The day program does not utilize any sharp knives, only plastic utensils.
* Hand sanitizers are readily available around the facility.
* Disinfectants, cleaning solutions, and extra paper towels are stored and locked in a storage room.
* The hot water temperature is measured between 105-120 degree F.
* The fire extinguisher was last inspected on 4/21/21. The day program has the smoke/carbon monoxide detectors in each room.
* Snacks are provided to clients in individually wrap packages.
* The day program is currently following the COVID-19 recommendations. LPA observed signage posted for hand washing, social distancing, and mask reminders in each of the activity rooms and bathrooms.
* Adequate PPE supplies for at least 30 days are stored in the Program Manager's office.
* First Aid kit contains the required items.
* The day program is not currently administering medication to clients.

There are no deficiencies observed during the visit today. Exit interview conducted and a copy of this report and appeal rights were given.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2022
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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