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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603525
Report Date: 01/14/2025
Date Signed: 01/14/2025 04:22:12 PM

Document Has Been Signed on 01/14/2025 04:22 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:
01/14/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:29 AM
MET WITH:Eduardo Alvarez, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to RBT Lead Christopher Madrigal. Administrator Eduardo Alvarez arrived later. The facility is as an Enhanced Behavioral Support Home (EBSH) for developmentally disabled adults ages 18-59 years old vendored by Eastern Los Angeles Regional Center. The following 12 Care Compliance and Regulatory Enforcement (CARE) tool domains were utilized during the inspection.

The following were observed/inspected:



Infection Control: The Infection Control Plan was reviewed. The facility has sufficient supply of Personal Protective Equipment (PPEs).

Physical Plant/Environment Safety: The EBSH home is a single-story home consisting of three (3) bedrooms, two (2) full bathrooms, one (1) 1/2 bathroom, kitchen, dining room, living room, laundry area, office, and a 2-car detached garage with an activity room. There is an assembly/recreation area with a basketball court located in the rear of the property. The backyard has a covered patio area with patio furniture. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances were locked and inaccessible to residents.

The facility has an approved fire clearance for secured perimeter with delayed egress. The home is equipped with automatic sprinkler system and fire door. Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors were tested and are operational. There are three (3) fire extinguishers in the facility.

Operational Requirements: Fire clearance is approved for three (3) non-ambulatory residents. Special equipment and supplies are not used by residents. The Surety Bond is current. Care and supervision to meet the clients needs was observed. Two residents require 2 to 1 staff ratio and one resident requires 3 to 1 staff while they are in the home. While out in the community two of the residents require 3 to 1 staff ratio and the other resident requires 2 to 1 staff ratios.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: LAMBERT PLACE, THE
FACILITY NUMBER: 198603525
VISIT DATE: 01/14/2025
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Operational Requirements (continuation):Currently the facility is out of compliance by not having a delayed egress system as indicated in their program design. The delayed egress system is operational. However, the front metal gate door needs a delayed egress mechanism. Licensee is awaiting Brilliant Corners (landlord) to contract and approve the metal door egress mechanism. Additionally, licensee has not obtained proof of adequate automobile liability insurance. Complaint control # 28-AS-20241204170716 addresses the aforementioned issues.

Staffing: A total of 39 staff members provide care and supervision to the clients. 30 out of 39 staff are Registered Behavior Technicians.

Personnel Records/Staff Training: Administrator certificate expires 1/15/2025. Staff have criminal background clearance and training. Eleven (11) staff files were reviewed. Proof of staff training, health and TB clearance, RBT and/or DSP, 1st Aid/CPR training are on file. Consultant logs, RBT Log, and CEUs & Certifications were reviewed. Staff (S10's) file is incomplete. Citation was issued.

Client Rights/Information: Physician orders, and personal rights were reviewed in client files.

Client Records/Incident Reports: Three (3) resident files were reviewed. Admission agreements, Physician's Report, medical/functional assessments, Needs and Services Plans, TB clearance, IPP reports, personal rights, medical consent, dietician report, consultant logs, Personal & Incidental (P & I) monies/records, and Medication Administration Records were reviewed. HCBS Tenant/Landlord Agreements are in files.

P & I money records were inaccurate for residents (R1 & R2). Citation was issued.

Food Service: The kitchen was inspected and has sufficient supply of 2 day perishable & 7 day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. One (1) resident has a modified diet.

Health Related Services: Residents are assisted with self administration of prescription and non-prescription medications. Centrally stored resident medication records were reviewed and are given according to Physician directions. 30-Day supply of medications were observed.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
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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: LAMBERT PLACE, THE
FACILITY NUMBER: 198603525
VISIT DATE: 01/14/2025
NARRATIVE
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Incident Medical and Dental: All residents have updated consultant assessments, Physician Reports, and COVID-19 vaccination cards on file.

Disaster Preparedness, and Emergency Intervention: Emergency Disaster Plan was reviewed. The plan shall be reviewed annually, updated as necessary, and maintained on file at the facility. First Aid Kit and Manual were observed. The last emergency drill was conducted on 1/1/2025.

Emergency Intervention: Manual restraints or seclusion is implemented by staff if needed via CPI techniques.

Per Title 22, California Code of Regulations, deficiencies were cited.



Exit interview conducted with Administrator Eduardo Alvarez. A copy of the report and appeal rights were issued.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/14/2025 04:22 PM - It Cannot Be Edited


Created By: Noemi Galarza On 01/14/2025 at 03:04 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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: LAMBERT PLACE, THE
FACILITY NUMBER: 198603525

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80066(a)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above in that staff (S10's) personnel record is incomplete i.e., is missing required personnel documents, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/24/2025
Plan of Correction
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3
4
Administrator shall provide proof that the staff file is complete.
Section Cited
Deficient Practice Statement
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4
POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME:Lisa Hicks
LICENSING EVALUATOR NAME:Noemi Galarza
LICENSING EVALUATOR SIGNATURE:
DATE: 01/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/14/2025


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 01/14/2025 04:22 PM - It Cannot Be Edited


Created By: Noemi Galarza On 01/14/2025 at 03:05 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: 01/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80026(h)
Safeguards for Cash Resources, Personal Property and Valuables
(h) Each licensee shall maintain accurate records of accounts of cash resources, personal property, and valuables entrusted to his/her care, including, but not limited to the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that all resident cash resource records on site are inaccurate; residents (R1’s) P & I money is over and R2’s P & I monies are under, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/24/2025
Plan of Correction
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Administrator shall ensure that all Personal & Incidental (P&I) funds and logs are updated. Submit a copy of the updated logs and a written statement that state how the deficiency was corrected.
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:Lisa Hicks
LICENSING EVALUATOR NAME:Noemi Galarza
LICENSING EVALUATOR SIGNATURE:
DATE: 01/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/14/2025


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