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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601949
Report Date: 11/18/2024
Date Signed: 11/18/2024 03:06:19 PM

Document Has Been Signed on 11/18/2024 03:06 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
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: 38DATE:
11/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Stephen Falla, Program ManagerTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection on 11/18/24. LPA arrived unannounced and explained the purpose of the visit to the Program Manager, Stephen Falla. The day program is licensed to serve 60 individuals, of which 6 may be non-ambulatory.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools to inspect the facility.
The day program is a single story building consisting of 5 activity rooms, 3 administrative rooms, 1 staff office, and 4 restrooms. Activities are held indoors and consumers are also taken into the community in small groups. There are no objects obstructing the walkways. Cleaning supplies are locked in the storage room. The smoke and carbon monoxide detectors are interconnected and operable. Extra snacks are observed and locked in the cabinet. The hot water temperature was measured within the required range of 105-120 degrees F. Facility is clean and disinfected daily.
LPA reviewed files for 4 Staff and 4 Clients. Staff files have the job application, health screening and TB results, background clearance, and on-going training. The client files have the admission agreement, physician's report with TB test results, consent forms, and the most current regional center's IPP report. Clients with helmets have physician's order to wear them.
Medications are centrally stored and only 3 of the clients are taking medication while at the day program. All 3 Clients' medications were reviewed and there were no discrepancies.
The Emergency Disaster Plan is posted with contact numbers and at least 2 relocation sites. Emergency procedures are explained on the disaster plan. Different emergency drills are conducted monthly and documented.

No deficiencies were issued today. An exit interview was held and a copy of this report was given to S. Falla.
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 11/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/18/2024
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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