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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601949
Report Date: 11/15/2023
Date Signed: 11/15/2023 04:00:53 PM

Document Has Been Signed on 11/15/2023 04:00 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
GREATER LA AC/SC, 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: 34DATE:
11/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Stephen Falla, Program ManagerTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection on 11/15/23. LPA arrived unannounced and met with Program Manager, Stephen Falla. The day program is licensed to serve a capacity of 60 participants, ages 18 and over, of which six (6) may be non-ambulatory.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools and inspected the following domains:
Infection Control: Staff are using appropriate hand hygiene and wearing gloves when necessary to assist participants. Staff are cleaning and disinfecting tables after each use. Company has additional cleaning service each week night. Facility keeps a sufficient amount of PPE supplies at the site.
Physical Plant & Environment Safety: The facility is a one story building that is comprised of 5 activity rooms, 3 Staff rooms, 1 office room, and 4 restrooms. There are no obstructions to the hallways. Activities are conducted primarily indoors. The hot water temperature for the bathrooms was measured within the range of 105-120 degrees F. Carbon monoxide and smoke combo detectors are interconnected. Disinfectants and cleaning supplies are properly stored and locked.
Operational Requirements: The day program is operating within its approval. There are currently 34 individuals participating in the program.
Food Service: There are emergency food supplies and snacks that are locked. Participants bring their own meals and snacks daily to the program. Perishable items can be stored in the refrigerator.
Incidental Medical & Dental: There are no clients who require health services or have a health condition that need to be monitored more carefully.
Disaster Preparedness: The facility has an Emergency Disaster Plan posted with contact numbers and at least 2 relocation sites. Emergency procedures are explained on the disaster plan. Earthquake and fire drills are conducted monthly and documented.

There are no deficiencies issued today. LPA will return another day to review staff and client files. An exit interview was held and a copy of this report is given to the Program Manager.
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2023
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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