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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602284
Report Date: 12/08/2022
Date Signed: 12/08/2022 02:22:41 PM

Document Has Been Signed on 12/08/2022 02:22 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: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: 97DATE:
12/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Samantha Lindsay - HR DirectorTIME COMPLETED:
02:35 PM
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Licensing Program Analyst (LPA) Luis Mora conducted an unannounced annual visit at the facility with focus on the infection control domain, medication and food review. LPA Mora met with Samantha Lindsay (HR Director) and explained the reason for the visit.

The facility is an Adult Day Program (ADP) licensed to serve 100 ambulatory and 5 non-ambulatory consumers ages 18 and over. 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 restroom and 3 class rooms and a staff restroom. For the left side of the wing, it includes 3 consumer classrooms, kitchen area, 2 storage rooms, men restroom and 2 unisex restrooms. There's a outside patio in between 2 wings.

LPA toured the facility with Dion Richardson and the following was observed: a total of 97 consumers were at the facility during the visit. The staff to client ratio is 1:3. The program site is clean, safe, sanitary and in good repair. All passageways are free from obstruction. Disinfectants and cleaning supplies are locked in a storage room and inaccessible to consumers. There are multiple fire extinguishers throughout the facility and are fully charged. 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. Restrooms were observed to be operational, clean, sanitary and free of odors. Restrooms' water temperature were tested between 109.6 and 116.6 degrees F, which is within the required 105 degrees F and 120 degrees F temperature. The program maintains a comfortable temperature throughout the facility. Food is not prepared at this facility. The clients are able to bring their own food and store the food in the facility's refrigerators. Facility has storage area/shelves for the consumers' personal belongings. The outdoor courtyard was equipped with shaded seating area accessible for consumers use. The last fire/emergency disaster drill was conducted on 05/17/2022 and earthquake drill on 07/25/2022. (CONTINUED TO LIC 809C)
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Luis Mora
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2022
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 2
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: JT BEHAVIOR MANAGEMENT INC
FACILITY NUMBER: 198602284
VISIT DATE: 12/08/2022
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Facility keeps medication for 8 consumers only in the nursing station and are inaccessible to the consumers. LPA reviewed medication for the 8 consumers and observed that medications were given as prescribed. LPA reviewed 10 consumers and 5 staff files, and observed no deficiencies.

Facility has 30 days supplies of Personal Protective Equipment in the storage room. Facility is following COVID-19 recommendations regarding screening visitors, staff, and clients. Covid-19 prevention signs are posted throughout the facility and hand-washing signs were observed in the bathrooms. Sufficient hand soap, hand sanitizer, and paper towels were observed.

Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report was provided.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Luis Mora
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022
LIC809 (FAS) - (06/04)
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