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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602284
Report Date: 02/02/2022
Date Signed: 02/02/2022 05:30:39 PM

Document Has Been Signed on 02/02/2022 05:30 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:JT BEHAVIOR MANAGEMENT INCFACILITY NUMBER:
198602284
ADMINISTRATOR:TURNER, LEONARDFACILITY TYPE:
775
ADDRESS:8292 TELEGRAPH ROADTELEPHONE:
(213) 308-4489
CITY:DOWNEYSTATE: CAZIP CODE:
90240
CAPACITY: 105CENSUS: 93DATE:
02/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Leonard Turner TIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Christine Wong conducted an unannounced annual visit at the facility. LPA met with HR Director Samantha Lindsay and explained the reason for the visit and assisted LPA with the tour of the facility. Shortly after, the administrator Leonard Turner arrived.

The Day Program is licensed to serve 105 Ambulatory developmentally disabled adults ages 18- 59. During the today's visit, LPA used the infection control tool to evaluate the facility. LPA observed the physical plant and COVID-19 procedures. The facility does not provide transportation to the consumers. Consumers arrive to the facility with their own meals and snacks. The facility maintains emergency food supply and water. The facility is a one story building with 2 wings. The right side of the wing include lobby area, five offices, nursing station, quiet room, 2 storage rooms, staff lounge, isolation room with a bathroom and 3 class rooms and a staff bathroom. For the left side of the wing, it includes 3 client classrooms, kitchen area, 2 storage rooms, men bathroom and 2 unisex bathrooms. There's a outside patio in between 2 wings.
  • Bathrooms were observed to be operational, clean, sanitary and free of odors
  • Bathrooms water temperature were tested between 54 and 113.7 degrees F. At 9:20am, LPA observed on the left side of the wing, one of the unisex bathroom (across from classroom#3) and the hot water temperature was tested at 60 degrees F. And the staff bathroom on the right side of the wing was tested at 54 degrees F.
  • Disinfectants and cleaning supplies are locked in storage closet and inaccessible to clients.
  • First Aid Kit are stored at the nursing station and has all the required supplies which include consisting of thermometer, tweezers, scissors, antiseptic, bandages, gauze.
  • Smoke detectors and Carbon Monoxide detectors are working properly.
  • The building contains central air conditioning and heating.
  • Storage areas /shelves for resident personal belongings.
  • The outdoor courtyard was equipped with shaded seating area accessible for client use.
SUPERVISORS NAME: Christine Yee
LICENSING EVALUATOR NAME: Christine Wong
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: JT BEHAVIOR MANAGEMENT INC
FACILITY NUMBER: 198602284
VISIT DATE: 02/02/2022
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Facility is currently following COVID 19 recommendations regarding COVID 19 signs throughout the facility, disinfecting products are available in each room and facility is disinfected as much as needed, restrooms have sufficient soap, and signs, facility has an isolation room and a cart with PPE supplies, and PPE supplies are stored for more than 30 days.

According to the California Code of Regulations (Title 22, Division 6, Chapter 3) deficiencies were cited.

Exit interview conducted with Administrator Leonard Turner. A copy of the report and appeal rights were provided.
SUPERVISORS NAME: Christine Yee
LICENSING EVALUATOR NAME: Christine Wong
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022
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Document Has Been Signed on 02/02/2022 05:30 PM - It Cannot Be Edited


Created By: Christine Wong On 02/02/2022 at 09:57 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: JT BEHAVIOR MANAGEMENT INC
FACILITY NUMBER: 198602284

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82088(e)(1)

82088 Fixtures, Furniture, Equipment and Supplies(e) Faucets used by clients for personal care shall deliver hot water.
(1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observation,LPA observecd the staff bathroom hot water temperature on the right side of the wing was tested at 54 degrees F. and the unisex bathrom hot water temperature across from the classroom#3 was tested at 60 degrees F. which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2022
Plan of Correction
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The administrator will fix the hot water temperatue immediately and send the 7 days hot water log via email to LPA
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Christine Yee
LICENSING EVALUATOR NAME:Christine Wong
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2022


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