<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603525
Report Date: 08/22/2024
Date Signed: 08/22/2024 04:37:00 PM

Document Has Been Signed on 08/22/2024 04:37 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 CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:LAMBERT PLACE, THEFACILITY NUMBER:
198603525
ADMINISTRATOR/
DIRECTOR:		ALVAREZ, EDUARDOFACILITY TYPE:
737
ADDRESS:13304 LAMBERT RDTELEPHONE:
(909) 631-8521
CITY:WHITTIERSTATE: CAZIP CODE:
90602
CAPACITY: 3CENSUS: 3DATE:
08/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:22 PM
MET WITH:Eduardo Alvarez, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:30 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
Licensing Program Analyst (LPA) Galarza conducted an unannounced Case Management - Other visit as a result of the Department of Developmental Services (DDS) semiannual report findings that indicated a significant number of staff are out of compliance with initial and annual emergency intervention training requirements. The purpose of the visit was explained to Administrator Eduardo Alvarez and Assistant Administrator Adrianna Harbin.

The facility is an Enhanced Behavioral Support Home (EBSH) with a Certificate of Program Approval from the Department of Developmental Services. In addition to California Code of Regulations, Title 22 requirements the facility program plan shall fulfill the requirements of California Code of Regulations, Title 17.

In addition to any other required training, each direct care staff person shall have a minimum of 16 hours


of emergency intervention training per Section 1567.64 of the Health and Safety Code. The licensee shall ensure that a direct care staff person renews the emergency intervention training annually.

The visit consisted of the following:

1. LPA conducted a physical plant tour of the facility. No health and safety concerns were addressed.

2. Reviewed and obtained 27 copies of staff emergency intervention CPI training cards.

3. Reviewed Records of Client's/Resident's Safeguarded Cash Resources for residents (R1-R3).

4. Reviewed and obtained a copy of Surety Bond. The Surety Bond is for $1,000.00. The cash on-site exceeded

the limit of the bond. Administrator was advised to refer to Title 22, Division 6, Chapter 1, Article 03 80025

Bonding.

During the visit, 2 shifts were observed; AM shift [6AM- 2PM] and PM shift [2PM - 10 PM]. The AM shift had 9 staff +1 lead staff. The PM shift has 9 staff + 1 lead staff. Total number of staff on site per shift was ten (10). The facility has a total of 44 staff.

Per Title 22 a citation was issued.

Exit interview was held with Administrator Eduardo Alvarez and Assistant Administrator Christopher Madrigal. A copy of the report and appeal rights were provided.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 08/22/2024 04:37 PM - It Cannot Be Edited


Created By: Noemi Galarza On 08/22/2024 at 03:57 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: LAMBERT PLACE, THE
FACILITY NUMBER: 198603525

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/29/2024
Section Cited
CCR
80025(c)

1
2
3
4
5
6
7
Bonding. The amount of the bond shall be according to the following schedule:
AMOUNT SAFEGUARDED PER MONTH BOND REQUIRED
$750 or less $1,000
$751 to $1,500 $2,000
$1,501 to $2,500 $3,000
1
2
3
4
5
6
7
License shall submit a copy of Surety Bond policy that reflects the on-site cash handling money amount.

8
9
10
11
12
13
14
Based on P & I record review, the findings indicate that the facility has a Surety Bond for $1,000.00 however, P & I monies onsite exceeded that amount, which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Lisa Hicks
LICENSING EVALUATOR NAME:Noemi Galarza
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2