198603806-8-4-2026-28-AS-GCAO-DWMQHA-20260804121050

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198603806
Report Date: 08/04/2026
Date Signed: 08/04/2026 12:11:04 PM

Document Has Been Signed on 08/04/2026 12:11 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
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME:	EASTERSEALS ADULT DAY SERVICES		FACILITY NUMBER:	198603806
ADMINISTRATOR/ DIRECTOR:	VASQUEZ, ERICK		FACILITY TYPE:	775
ADDRESS:	1223 E ROUTE 66		TELEPHONE:	(626) 856-1601
CITY:	GLENDORA	STATE: CA	ZIP CODE:	91740
CAPACITY: 50		CENSUS: 48	DATE:	08/04/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Joshua Corzantes, Program Director		TIME VISIT/ INSPECTION COMPLETED:	12:15 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) Gabriela Castro conducted the required annual inspection. LPA met with Joshua Corzantes, Director discussed the purpose of today’s visit.

The facility is an Adult Day Program (ADP) licensed to serve 50 non-ambulatory individuals. The facility is a single-story building located in a commercial area of Glendora. The building consists of a kitchen, (4) restrooms, a conference room, (2) office areas, a computer lab, a laundry area, (3) large activity spaces, a nurse station with storage closet, (2) assisting rooms, two (2) quiet rooms, a file room, a janitor's closet, locker area, an outdoor area, and several storage spaces.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Physical Plant & Environment Safety:

LPA conducted a tour of the facility with Director Corzantes and observed the following:

The facility was clean, organized, and arranged to accommodate individuals receiving services. Program areas were furnished with appropriate furniture, equipment, and materials to support client participation in daily activities. LPA observed a variety of recreational materials and activities available throughout the facility. Assistive devices, including Hoyer lifts, were available to assist clients with mobility and transfers. The outdoor area consisted of a covered patio furnished with tables and chairs, providing a shaded space large enough for outdoor activities. A raised garden table was also observed, allowing clients the opportunity to participate in gardening activities and learn basic gardening skills. No bodies of water were observed on the premises. Required postings, including the facility license, Client Rights, and other mandated notices, were prominently displayed. A fully stocked first aid kits and first aid manual were available. The building is equipped with an operational fire sprinkler system that is connected to the local fire department. Fire extinguishers were observed throughout the facility and were last serviced on 04/06/2026. Facility records reflected that the most recent fire/emergency disaster drill was conducted on 07/28/2026. (continued on 809C)

David Sicairos
Gabriela Castro
	DATE: 08/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: EASTERSEALS ADULT DAY SERVICES	FACILITY NUMBER: 198603806
	VISIT DATE: 08/04/2026

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
26
27
28
29
30
31
32

Staffing: There is sufficient staffing at the facility. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

Personnel Records-Training: LPA reviewed five (5) staff files. Staff have current First Aid/CPR certification. Staff have their Health Screening and Tuberculosis Screening on file. Staff training records were also reviewed which revealed that staff have adequate hours of training.

Client Rights-Information: Client rights are posted and were also observed in client files.

Client Records-Incident Reports: LPA reviewed five (5) client files . Files are maintained at the facility. Admission Agreement, Physician's Report (including T.B and Ambulatory Status), Consent For Medical Treatment, IPP, Program Rules, and Client Rights were observed.

Food Service: The facility provides snacks and/or lunch to clients, as needed. LPA observed weekly menus posted and available for review. A dietary needs binder was also maintained, containing information regarding each client's dietary requirements, allergies, and food preferences to ensure meals and snacks are provided in accordance with individual needs.

Health-Related Services: LPA reviewed the medications and Medication Administration Records (MARs) for four (4) clients. Medications were observed to be properly labeled and maintained. Physician's orders corresponded with the medications on hand, and the MARs accurately reflected the prescribed medication orders.

Disaster Preparedness: The facility has an Emergency Disaster Plan updated and in place.

The facility was observed to be in compliance with applicable Title 22 regulations at the time of the inspection. No deficiencies were cited. An exit interview was conducted with Joshua Corzantes, Program Director, and a copy of this report was reviewed and provided at the conclusion of the visit.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Gabriela Castro
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026

LIC809 (FAS) - (06/04)

Page: 3 of 3

California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

Page: 2 of 3