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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602284
Report Date: 12/20/2024
Date Signed: 12/20/2024 04:09:07 PM

Document Has Been Signed on 12/20/2024 04:09 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
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:JT BEHAVIOR MANAGEMENT INCFACILITY NUMBER:
198602284
ADMINISTRATOR/
DIRECTOR:		TURNER, LEONARDFACILITY TYPE:
775
ADDRESS:8292 TELEGRAPH ROADTELEPHONE:
(213) 308-4489
CITY:DOWNEYSTATE: CAZIP CODE:
90240
CAPACITY: 105CENSUS: 101DATE:
12/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Anthony Alvarez - SupervisorTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
NARRATIVE
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Licensing Program Analyst (LPAs) Luis De Leon, Mayra Cota, and LPM Adeline Ho conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Supervisor Anthony Sanchez, and the purpose of today’s visit was explained. LPA was granted access to the facility. Later, Dion Richardson (Program coordinator) arrived and assisted with facility walk-thru inspection. Director Leonard Turner joined in the middle of the walk-thru.

The facility is an Adult Day Program (ADP) licensed to serve 100 ambulatory and five (5) non-ambulatory consumers ages 18 and over. The facility is a one-story building with two (2) wings (south and North). The facility has a driveway that circles main building where clients safely board and get-off transportation vans. The facility does not own any vans for transportation. Transportation is available by third-party independent vans.

The south side of the wing include lobby area, five offices, nursing station, quiet room, two (2) storage rooms, staff lounge, wing has three (3) restrooms and three (3) classrooms and one (1) staff restroom. The north side of the wing includes three (3) consumer classrooms, kitchen area, two (2) storage rooms, men's restroom and two (2) unisex restrooms. There is also an outside patio in between both wings.

During the tour of the facility, it was observed that all walls/floors were cleaned and well maintained. The training/activity rooms were well ventilated and had adequate lightning. The kitchen and dining room are clean and well maintained, no sharps objects were observed as administrator explained that food service staff bring knives only for used during meals and they are taken back out. However, meals are not prepared on site, each client brings lunch from home. Staff only assist with cutting their meals for those with special food requirements. The facility will have snacks and meals available for clients who don’t bring lunch.

Report continues on 809-C.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Luis DeLeon
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: JT BEHAVIOR MANAGEMENT INC
FACILITY NUMBER: 198602284
VISIT DATE: 12/20/2024
NARRATIVE
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The bathrooms were all cleaned and well maintained. There were sufficient non-perishable foods that are used for snacks, and it was adequately stored. Facility has storage area/shelves for consumer to store belongings. The fire extinguishers were charged, smoke and carbon monoxide detectors were operation. Exits and Walkways around facility were free of debris and hazards. There are no bodies of water on premises observed. Toxins were locked and inaccessible to clients. The outdoor patio was equipped with a shaded seating area that is accessible to clients use.

As part of inspection, LPAs reviewed ten (10) client records and six (6) staff records. The last fire drill was conducted on 8/12/24. Clients/staffs files are current and in compliance. Staff responsible for direct care and supervisions have current first Aid and CPR. During review of staff roster sheet, it was observed that there are five (5) staff that were not associated to the facility. LPAs will assess an immediate penalty. The review of facility records found that an infection control plan was incomplete.

Facility keeps medications for thirteen (13) consumers only in the med station and are locked away from clients. Medications are centrally stored and in their original containers. The facility uses the Medication Administration Record (MAR) log to document medications given. Medications are administered as prescribed by the Physician.

Water temperature in all bathrooms were not within 105-120 degrees F. Water temperature in the bathrooms were:
South Wing: Bathroom 1: 99.6, Bathroom 2: 100.4, and Bathroom 3:103.4
North Wing: Bathroom 1:64.9, Bathroom 2:64.9, and Bathroom 3: 66.9

Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the 809D.

An exit interview was conducted, and a copy of this report was provided to Director Leonard Turner.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Luis DeLeon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 12/20/2024 04:09 PM - It Cannot Be Edited


Created By: Luis DeLeon On 12/20/2024 at 02:28 PM
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: 12/20/2024

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


This requirement is not met as evidenced by: Section 82088 (e)(1) 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 deliever to plumibing fixtures to atttain a hot water temperature of nto less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).
Deficient Practice Statement
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Based on LPAs observation Water temperature in all bathrooms were not within 105-120 degrees F. Water temperature in the bathrooms were: South Wing: Bathroom 1: 99.6, Bathroom 2: 100.4, and Bathroom 3:103.4
North Wing: Bathroom 1:64.9, Bathroom 2:64.9, and Bathroom 3: 66.9
POC Due Date: 12/23/2024
Plan of Correction
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Director will contract replacement of water heater on north wing and adjust water on south wing. Director Turner will share LPA with a plan on when the water heater work will be completed.
Type A
Section Cited
CCR
80019(e)(2)


Section 80019 (e)(2) Criminal Record Clearance. (e) All individuals subject to a criminal record review shall, prior to working, residing, or volunteering in a licensed facility, (2) request a transfer of a criminal record clearance.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation, review of staff roster sheet and file reviews, it was observed that there are five (5) staff that were not associated to the facility. LPAs checked Guardian and found no association of these staff.
POC Due Date: 12/23/2024
Plan of Correction
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Director Turner will create a Guardian account and will provide via email a proof of Guarding association print out of staff to this facility.
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:Fernando Fierros
LICENSING EVALUATOR NAME:Luis DeLeon
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2024


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 12/20/2024 04:09 PM - It Cannot Be Edited


Created By: Luis DeLeon On 12/20/2024 at 02:49 PM
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: 12/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82095.5(b)(1)(c)

Section 82095.5 (b)(1)(c)(1) (b) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 82022. (1) The Infection Control Plan shall include all of the following: (C) An Infection Control Training Plan.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation, review of facility records found that an infection control plan was incomplete. There were many elements from this section missing on the plan produced by facility.
POC Due Date: 01/03/2025
Plan of Correction
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Director Turner will email the infection control plan by the plan of correction date above.
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:Fernando Fierros
LICENSING EVALUATOR NAME:Luis DeLeon
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2024


LIC809 (FAS) - (06/04)
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