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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602405
Report Date: 11/09/2024
Date Signed: 11/09/2024 05:48:11 PM

Document Has Been Signed on 11/09/2024 05:48 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 ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:ANEW DIRECTION ADULT LIVINGFACILITY NUMBER:
198602405
ADMINISTRATOR/
DIRECTOR:		PATRICIA DUFRENNEFACILITY TYPE:
735
ADDRESS:2300 S PACIFIC AVETELEPHONE:
(909) 210-0365
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY: 72CENSUS: 65DATE:
11/09/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:53 AM
MET WITH:Virgilio Camacho & Diane De Asis TIME VISIT/
INSPECTION COMPLETED:
12:34 PM
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On 11/09/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Administrators Diane De Asis and Virgilio Camacho Jr. 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 Diane De Asis. 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: #3, #4, #14, #24, #26, #36 and #37. All call buttons were in working condition. Bathrooms were operational with water temperature measured at 105.0 – 116.7 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 09/17/24. 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: 11/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2024
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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: ANEW DIRECTION ADULT LIVING
FACILITY NUMBER: 198602405
VISIT DATE: 11/09/2024
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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. The facility is current on (CCL) annual license fees. The facility has a current liability insurance coverage effective 08/15/24 through 08/15/25. The facility has a current Administrator's Certificate for Virgilio Camacho Jr #7032298735 Exp. 07/15/25.

DEFICIENCIES:
  • LPA observed rooms #3 had available a bleach,a Clorox, (2) insect sprays and other cleaning toxic solutions accessible to clients in care. (Corrected during visit on 11/09/24)

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 Diane De Asis, 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: 11/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2024
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Document Has Been Signed on 11/09/2024 05:48 PM - It Cannot Be Edited


Created By: Ernand Dabuet On 11/09/2024 at 11:49 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
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: ANEW DIRECTION ADULT LIVING
FACILITY NUMBER: 198602405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
80087(g)
Building and Grounds
(g) Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. LPA observed at 11:29 am in room #3 toxic cleaning solutions accessible to clients in care. This violation which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/10/2024
Plan of Correction
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The licensee will ensure that all hazardous chemicals or materials are stored in locked storage closets at all times. The licensee will store all toxic and hazardous chemicals in lock storage. Proof of correction must be sent to LPA at ernand.dabuet@dss.ca.gov. By due date 11/10/24. ***CORRECTED ON VISIT 11/09/24***
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:Janae Hammond
LICENSING EVALUATOR NAME:Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2024


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