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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602405
Report Date: 03/09/2023
Date Signed: 03/13/2023 03:18:13 PM

Document Has Been Signed on 03/13/2023 03:18 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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:ANEW DIRECTION ADULT LIVINGFACILITY NUMBER:
198602405
ADMINISTRATOR:PATRICIA DUFRENNEFACILITY TYPE:
735
ADDRESS:2300 S PACIFIC AVETELEPHONE:
(909) 210-0365
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY: 72CENSUS: 67DATE:
03/09/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Joyce Garcia, Assistant AdministratorTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Ana Soto conducted an initial unannounced case management - incident/death investigation to the above facility. Today’s case management investigation was conducted with Joyce Garcia, Assistant Administrator.


On 03/09/2023, LPA Soto conducted a case management visit to gain additional information pertaining to the death of a client who shall be referred to as: C#1 who expired on:02/26/2023. A copy of the decedent's Certificate of Death is not yet available. The primary cause of death is unknown at this time. LPA Soto reviewed C#1 file, interviewed S#1 Assistant administrator, S#2, S#3, C#2, C#3, C#4, & W#1. Family did not request autopsy to be performed, they are going ahead with funeral services. Based on: interviews of clients, staff, and witness, there are no deficiencies observed. The facility is in compliance with applicable Title 22 Regulations. The death was reported as specified in regulations. The facility administrator contacted the appropriate agencies and family member as required. Police Department was called and arrived at the facility they conducted their own investigation of C#1 death. No action was taken by Police department. Report #2023-0222.

No Deficiencies Cited at this time, additional information is required. LPA will return to complete the investigation at a later date.

An exit interview was conducted with Joyce Garcia, Assistant Administrator, and a hard copy of report was provided
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ana Soto
LICENSING EVALUATOR SIGNATURE: DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/09/2023
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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