198603420-7-23-2026-28-AS-JBAE-DW9Q3N-20260723114901

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198603420
Report Date: 07/23/2026
Date Signed: 07/23/2026 11:49:14 AM

Document Has Been Signed on 07/23/2026 11:49 AM - 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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME:	EASTERSEALS PARAMOUNT ADULT DAY PROGRAM		FACILITY NUMBER:	198603420
ADMINISTRATOR/ DIRECTOR:	REAL, ANGELICA		FACILITY TYPE:	775
ADDRESS:	16420 & 16424 ORANGE AVE		TELEPHONE:	(562) 486-3600
CITY:	PARAMOUNT	STATE: CA	ZIP CODE:	90723
CAPACITY: 45		CENSUS: 18	DATE:	07/23/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:20 AM
MET WITH:	Administrator Arely Rodriguez		TIME VISIT/ INSPECTION COMPLETED:	12:03 PM

NARRATIVE

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On 7/23/2026, Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced annual visit at Easterseals Southern California Paramount Day Program. Upon arrival LPA was greeted by Arely Rodriguez and LPA explained the reason for the visit. LPA inspected the facility using the following domains: Infection Control, Physical Plant and Environmental Safety, Operational Requirements, Staffing, Personnel Records- Training, Client records- Incident Reports, Client rights- Information, Food Service, Health Related Services, Incidental Medical Services, Disaster Preparedness, and Emergency Intervention.

The facility is an Adult Day Program (ADP) licensed to serve 45 ambulatory clients, of which 5 may be non-ambulatory, ages 18 and over. The program consists of 1 large single-story building. A tour of the single-story building included: reception area, 3 offices, 3 restrooms, isolation area, kitchen, dining area, 2 activity rooms, computer lab, conference room, and storage room. LPA reviewed eight (8) client files and three (3) Staff files. The last fire/emergency disaster drill was conducted on 06/30/2026.

Report continued on 809C

Lisa Hicks
Jewel Baptiste
	DATE: 07/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: EASTERSEALS PARAMOUNT ADULT DAY PROGRAM	FACILITY NUMBER: 198603420
	VISIT DATE: 07/23/2026

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LPA toured the facility with Administrator Arely Rodriguez and the following was observed: There were 14 clients at the facility during the visit. The staff to client ratio is 3:1. The program site is clean, safe, sanitary and in good repair. All passageways are free from obstruction. Disinfectants, cleaning solutions and poisons are inaccessible to clients and are locked inside the storage room. There are four fire extinguishers and are fully charged. There was multiple smoke alarms coupled with carbon monoxide located throughout the facility. The restrooms were observed to be clean and have the required grab bars for non-ambulatory clients. The water temperature was tested in all 3 restrooms, and it measured at 78.6 F., 97.2 F. and 116.2 F. The administrator provided an email request for maintenance dated 7/15/2026 indicating the need for repair. The program maintains a comfortable temperature in each room/office. The First Aid kit is kept in the kitchen, and it is fully stocked with all required items including the current manual. Facility does not keep or administer medications. Food is not prepared at this program, and clients are able to bring their own food. The kitchen area has a refrigerator where the clients can store their food. Sharps are kept locked in a office. There are storage bins in the reception area for clients. Facility has 30 days supplies of Personal Protective Equipment in the storage room.

Pursuant to Title 22 code of regulations, the following deficiencies were cited (refer to LIC 809-D): Exit Interview Conducted with the Administrator / Appeal Rights Provided / A Copy of the Report Issued.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Jewel Baptiste
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/23/2026 11:49 AM - It Cannot Be Edited

Created By: Jewel Baptiste On 07/23/2026 at 11:10 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
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: EASTERSEALS PARAMOUNT ADULT DAY PROGRAM	FACILITY NUMBER: 198603420
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/23/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

82088(e)(1)

Fixtures, Furniture, Equipment, and Supplies

(1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in 2 out of 3 bathrooms water temperature were measured under 105 degrees, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/04/2026
	Plan of Correction
1 2 3 4	The facility will ensure the water measured within title 22 guidelines. The Administrator will keep a weeks log and send photo proof and logs to LPA by POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Lisa Hicks
NAME OF LICENSING PROGRAM MANAGER:

	Jewel Baptiste
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026

LIC809 (FAS) - (06/04)

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