198602405-11-18-2023-11-AS-EDAT-CXQ2PY-20231118163508

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198602405
Report Date: 11/18/2023
Date Signed: 11/18/2023 04:35:18 PM

Document Has Been Signed on 11/18/2023 04:35 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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME:	ANEW DIRECTION ADULT LIVING		FACILITY NUMBER:	198602405
ADMINISTRATOR:	PATRICIA DUFRENNE		FACILITY TYPE:	735
ADDRESS:	2300 S PACIFIC AVE		TELEPHONE:	(909) 210-0365
CITY:	SAN PEDRO	STATE: CA	ZIP CODE:	90731
CAPACITY: 72		CENSUS: 62	DATE:	11/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:32 AM
MET WITH:	Joyce Garcia & Pat Dufrenne		TIME COMPLETED:	03:59 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	On 11/18/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with administrator Joyce Garcia and licensee Pat Dufrenne. LPA explained the purpose of today’s visit. The facility is licensed to operate for clients ages 18-59 all ambulatory status only. The facility is a two-story structure located in a commercial neighborhood. It consists of the following: (36) client's rooms and (32) bathrooms, an activity room, a dining area, a commercial kitchen, and a courtyard patio area. LPA toured the physical plant with Garcia and Dufrenne. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the client's personal belongings was observed. The client's rooms were inspected: #6, #14, #24, #25, #31, and #37. All call buttons were in working condition. Bathrooms were operational with water temperature measured at 105.0 – 111.9 degrees F. A comfortable temperature was maintained in the facility at 72 - 74 degrees F. LPA observed the facility to be sanitary and furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to clients. The kitchen was inspected and there is sufficient perishable and non-perishable food available and maintained properly. Fire extinguishers were charged, and smoke detectors and carbon monoxide were operable. A review of Fire Drill was completed on 05/08/23. Several working landline phones were available and operable. (Evaluation Report continues on LIC 809-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: ANEW DIRECTION ADULT LIVING	FACILITY NUMBER: 198602405
	VISIT DATE: 11/18/2023

NARRATIVE

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A review of the Medication Records Administration (MAR) was observed to be maintained in order and accurate. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted.

LPA conducted an audit of client #1-#6 (C1-C6) service files, and staff #1-#6 (S1-S6) personnel files were in order. A review of P&I records for clients revealed to be in order and complete. LPA conducted (6) client and (4) staff interviews. The facility is not current on annual license fees. A copy of the invoice was provided to the licensee. The facility has a current liability insurance coverage effective 11/29/22 - 11/29/23.

DEFICIENCIES:

LPA observed rooms #31 is (1) missing a window screen and (1) window screen need to be replace or repaired. Room #2 (1) window screen need to be replaced or repaired. The second floor (1) window screen in the rear hallway need to be replaced or repaired.

Client #3 admitted on 10/02/23 did not have a TB test result.

According to the California Code of Regulations (Title 22, Division 6, Chapter 1), the following deficiencies have been observed and citations issued (ref. LIC 809-D).

An exit interview was conducted with Garcia and Dufrenne, and a copy of the report and appeal rights were provided.

Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. *

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/18/2023 04:35 PM - It Cannot Be Edited

Created By: Ernand Dabuet On 11/18/2023 at 02:04 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 DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: ANEW DIRECTION ADULT LIVING	FACILITY NUMBER: 198602405
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/18/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

80088(b)

Fixtures, Furniture, Equipment, and Supplies

(b) All window screens shall be in good repair and be free of insects, dirt and other debris.
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited. Window screens for room #2 and #31 need to be replaced or repaired. (1) window screen is missing for room #31 and (1) window screen in the rear hallway need to be replaced or repaired. This violation which poses an potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/18/2023
	Plan of Correction
1 2 3 4	Licensee will ensure that all facility window screens shall be in good repair. Proof of correction photos must be sent to LPA with service receipts or purchase sent to ernand.dabuet@dss.ca.gov by due date: 12/18/23.

Type B

Section Cited

CCR

80069(c)(1)

Client Medical Assessments

(c) The medical assessment shall include the following: (1) The results of an examination for communicable tuberculosis and other contagious/infectious diseases.
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited. Client #3 was admitted on 10/02/23 without a TB test result. This violation which poses an potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/02/2023
	Plan of Correction
1 2 3 4	Licensee will ensure that all facility prior to admission, all clients must have the require TB test completed. Proof of correction with at TB test result must be sent to ernand.dabuet@dss.ca.gov by due date: 12/02/23.

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:

Janae Hammond

LICENSING EVALUATOR NAME:

Ernand Dabuet

LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2023

LIC809 (FAS) - (06/04)

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