198602059-3-18-2025-28-AS-MGFS-DEVRWC-20250318132255

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198602059
Report Date: 03/18/2025
Date Signed: 03/18/2025 01:23:11 PM

Document Has Been Signed on 03/18/2025 01:23 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:	ABILITYFIRST - LAWRENCE L. FRANK CENTER		FACILITY NUMBER:	198602059
ADMINISTRATOR/ DIRECTOR:	PRIVITT, KELLY		FACILITY TYPE:	775
ADDRESS:	201 S KINNELOA AVE		TELEPHONE:	(626) 449-5661
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY: 36		CENSUS: 32	DATE:	03/18/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Lisa Duenas and Edward Frutis - Program Supervisors		TIME VISIT/ INSPECTION COMPLETED:	01:30 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Lisa Duenas and Edward Frutis and explained the reason for the visit. Michael Barkyoumb Program Director arrived shortly after.

This facility is licensed to serve a capacity of (36) Developmentally Disabled Ambulatory Adults, of which (8) may be Non-Ambulatory. Facility consists of (4) offices, (1) career office, (1) conference room, (2) staff lounges, (1) client activity room, (1) shared client/child activity room, (1) isolation room, (4) client bathrooms, 1 out of the 4 has client change room, a kitchen, a flex convert client/child room, (3) outdoor spaces.

The following CARE tool domains were reviewed during this visit:

Infection Control: Facility maintains an infection control plan last reviewed on 4/15/24. Staff were observed practicing safe hand washing. Hand sanitizing was observed throughout. Sanitizing materials were observed in each bathroom and changing station.

Physical Plant & Environmental Safety: LPA toured the facility with Edward Frutis and observed the facility is in good repair indoor and outdoor. Facility is operating within capacity. The center serves two shifts in which a total of 85 clients are enrolled. No large bodies of water were observed. Cleaning supplies and sharp materials were observed locked and inaccessible to clients. An isolation room was observed. Outdoor space is furnished, shaded, and accessible to clients. Passageways and exit areas were observed free of obstructions. Restrooms were observed clean, in good repair and water temperature was tested within 106.4 - 107.7 degrees F. which is within the required 105-120 degrees F.
Operational Requirements: A fire clearance was provided to the facility prior to licensing.
Staffing: Staff was available and with clients during the visit. Facility is vendorized through the Frank Lanterman Regional Center and are maintaining a 3:1 (client:staff) ratio.
(CONTINUED ON LIC 809C)

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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: ABILITYFIRST - LAWRENCE L. FRANK CENTER	FACILITY NUMBER: 198602059
	VISIT DATE: 03/18/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Personnel Records - Training: All staff records were available for review. Criminal background clearance was reviewed for all staff. Administrator has completed 20 hours of training within the last 24 months. Five staff files were reviewed which include health screenings, TB test clearance, personnel records, finger clearance, and yearly training. Each individual has received at least 8 hours of training or more within the last year.
Client Records - Incident Reports: All client records were available for review. Files were reviewed for 5 clients, which included medical assessments, admission agreement, individual service plan or needs and care plan, and TB test. 1 out of 5 clients did not have a TB test clearance on file.
Client Rights - Information: Clients rights were observed posted in the activity areas. No postural supports are used by staff or clients.
Food Service: Snacks and lunch bags were observed separated from chemicals and stored in the refrigerator and cupboards.
Health-Related Services: Staff have current CPR/First Aid certificates on file. Staff ensure that clients with incontinence are maintain clean and dry. Supplies were observed in changing rooms and in storage. Medications were reviewed for 3 clients. Medications are centralized stored and inaccessible to the clients. Parents consent was observed in clients files for medication. First aid kit was reviewed.
Incidental Medical Services: Facility does not currently serve any clients with restricted health conditions.
Disaster Preparedness: Emergency Disaster Plan LIC610D (12/21) was observed and last reviewed on 2/24/25. A contingency plan was observed. Last emergency drill was conducted on 3/11/25 for afternoon shift and 1/6/25 for morning shift and are conducted quarterly.
Emergency Intervention: Facility does not use restrains.

Technical violations were noted. No deficiencies were noted during this visit.

Exit interview was conducted with Michael Barkyoumb and technical violations were provided.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025

LIC809 (FAS) - (06/04)

Page: 2 of 4