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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601949
Report Date: 10/10/2024
Date Signed: 10/10/2024 11:37:00 AM

Document Has Been Signed on 10/10/2024 11:37 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:OPARC SUMMIT SERVICES WESTFACILITY NUMBER:
198601949
ADMINISTRATOR/
DIRECTOR:		TOMINES, JONATHANFACILITY TYPE:
775
ADDRESS:355 S LEMON AVE STE GTELEPHONE:
(909) 598-8055
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY: 60CENSUS: 37DATE:
10/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Stephen Falla, Program ManagerTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Cynthia Chan conducted a case management visit regarding an incident report submitted to LPA on 9/26/24. LPA arrived unannounced and met with Program Manager, Stephen Falla. The purpose of the visit was explained.

On 9/26/24, LPA received an incident from the facility indicating Client #1 (C1) mentioned that Staff #1 (S1) took C1 to the park on the way home and inappropriately touched the client’s body parts. The date was unknown, however, C1 stated this incident occurred on a day when a house mate did not attend the program.

During the visit today, LPA conducted interviews with 3 Staff and obtained documents pertaining to Staff #1 and Client #1.

LPA will continue to gather information related to this incident. No deficiency was issued today. An exit interview was held, and a copy of this report was given to Mr. Falla.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2024
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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