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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603679
Report Date: 07/02/2024
Date Signed: 07/02/2024 12:24:41 PM

Document Has Been Signed on 07/02/2024 12:24 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:MAINSTREAM CENTERS, INCFACILITY NUMBER:
198603679
ADMINISTRATOR/
DIRECTOR:		SOMMERS, TIAFACILITY TYPE:
775
ADDRESS:345 E ROWLAND STREETTELEPHONE:
(626) 335-8110
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY: 120CENSUS: 64DATE:
07/02/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:59 AM
MET WITH:Tia Sommers, AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection using the CARE tool. LPA met the Administrator, Tia Sommers, and explained the reason for the visit. The day program is licensed for 120 clients, ages 18 and over, of which 24 may be non-ambulatory.

LPA toured the facility and inspected/observed the following:
The single story facility has 5 activity rooms, 3 bathrooms with multiple stalls, hand washing station, and a kitchen. Staff are cleaning and disinfecting the facility daily and more often for high touched surfaces.The facility is clean, sanitary, and in good repair. Knives, disinfectants and cleaning solutions are properly stored and locked. The facility is operating within the approved fire clearance.
LPA reviewed 5 personnel records. Staff files contained the required documents such as health screening with TB test results, employee rights form, and personnel record. Staff have current CPR & First Aid certificates and receive on-going training. LPA reviewed 6 Client records and the files consist of the admission agreement, medical assessment with TB test result, consent forms, and current IPP. Client using postural supports have a physician's order. Clients bring their own lunches and snacks daily. There are 2 clients currently receiving medications on site and are administered as prescribed. There are no clients in attendance at this time with a restricted health condition. Facility has the updated LIC610D form with emergency contact numbers, shutoff valves, and relocation sites. Staff do not utilize manual restraints at the site. The facility conducts monthly disaster drills.

There are no deficiencies observed today. A copy of this report was given to the Program Director.
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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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