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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603804
Report Date: 12/27/2024
Date Signed: 12/27/2024 11:25:28 AM

Document Has Been Signed on 12/27/2024 11:25 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:ROLAND CENTER, THEFACILITY NUMBER:
198603804
ADMINISTRATOR/
DIRECTOR:
DIAZ, RAULFACILITY TYPE:
775
ADDRESS:400 S COVINA BLVDTELEPHONE:
(909) 233-2484
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: 150CENSUS: 93DATE:
12/27/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:09 AM
MET WITH:Raul Diaz - AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:47 AM
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Licensing Program Analyst (LPA) Erik Zaragoza conducted an announced pre-licensing visit and with Raul Diaz, administrator for the facility. This Pre-Licensing inspection is being conducted as an initial application to be licensed.

The facility is currently working on obtaining an approved fire clearance, and the Centralized Application Bureau (CAB) explained this will be completed following the Pre-Licensing visit. The facility is a large campus located in a residential neighborhood in the city of La Puente. The facility consists of a main activity building that hosts a myriad of activities, a dining room, a kitchen, five (5) client restrooms which all measured between 105 - 120 Degrees Fahrenheit. There are multiple outdoor shaded areas as well along with multiple staff offices throughout the facility.

The following was inspected during the evaluation with the Administrator and determined to be compliant with Title 22 Regulations. A locked storage area for central storage of medications was observed in the main closet of the facility. Cleaning supplies are kept separate from food supplies and are kept locked in the janitorial room of the facility. The walls, ceilings, floors, window screens and areas around the facility were clean and in good repair. There are multiple fully charged fire extinguishers were located throughout the facility. The carbon monoxide and smoke detector was observed to be operational. Doors, exits, hallways, and passageways were clear and free of obstruction. The front and back areas of the facility were observed to be clean and free of debris.

A fountain was observed to be enclosed with required fencing. An operating telephone was observed on the premises, which is easily accessible and available for resident use. The refrigerator was observed to be operable at 41 degrees and freezer below 0 degrees. The first-aid kit was reviewed as well. Activities were observed to be available for the clients as well.

The COMP III was held following the visit, the Pre-Licensing is complete and this facility has no deficiencies. Exit interview held and a copy of the report was provided.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/27/2024
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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