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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603679
Report Date: 08/04/2023
Date Signed: 08/04/2023 10:55:08 AM

Document Has Been Signed on 08/04/2023 10:55 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:MAINSTREAM CENTERS, INCFACILITY NUMBER:
198603679
ADMINISTRATOR:SOMMERS, TIAFACILITY TYPE:
775
ADDRESS:345 E ROWLAND STREETTELEPHONE:
(626) 335-8110
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY: 120CENSUS: 0DATE:
08/04/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:12 AM
MET WITH:Tia Sommers - AdministratorTIME COMPLETED:
11:05 AM
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Licensing Program Analyst (LPA) Tena Herrera conducted an announced pre-licensing visit and met with Administrator Tia Sommers. This Pre-Licensing Inspection is due to change of location.

The physical plant was toured alongside Administrator Tia Sommers. The Pre-Licensing Inspection Tool was used for this visit.



The facility has an approved fire clearance to be licensed to serve one hundred and twenty (120) where twenty four (24) can be non-ambulatory. This is a single story facility with a Front Office Area, 5 Activity Rooms, Coed Restroom with 1 sink and 3 stalls, Women's Restroom with 1 sink and 3 stalls, Men's Restroom with 1 sink, 1 urinal and 2 stalls, Multi-Station Hand Sink Station, and Break Room.


The following was observed/inspected:
  • Carbon monoxide detectors observed throughout the facility and are operable
  • Program site appears to clean, safe, sanitary and in good repair
  • Disinfectants and cleaning solutions are centrally stored in a locked container
  • Plenty storage space for clients personal belongings
  • Water Temperature throughout the restrooms and sinks measured within required range of 105 - 120 degrees F.
  • Solid waste containers have tight fitting covers on them
  • All client records and staff files have a centrally stored location that is locked within the front office

(Continued on 809-C)

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2023
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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: MAINSTREAM CENTERS, INC
FACILITY NUMBER: 198603679
VISIT DATE: 08/04/2023
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  • Food Preparation area is equipped with working and clean equipment storage space for utensils
  • First Aid Supplies were observed and is centrally stored
  • Emergency Contact information with all local agencies is readily available
  • Locked Medication Box is centrally stored
  • The facility has an Emergency, Disaster and Mass Casualty Plan maintained in the facility with all required information and procedures
  • Fire Extinguishers were observed and charged

Component III was waived due to applicant currently operating licensed Adult Day Program

An exit interview was conducted, and a copy of this report has been furnished to Administrator Tia Sommers. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Tena Herrera
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
LIC809 (FAS) - (06/04)
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