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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 270702591
Report Date: 04/25/2023
Date Signed: 04/25/2023 05:14:29 PM

Document Has Been Signed on 04/25/2023 05:14 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:GATEWAY CENTER OF MONTEREY COUNTY, INC.FACILITY NUMBER:
270702591
ADMINISTRATOR:CHRISTINA HUNTFACILITY TYPE:
775
ADDRESS:850 CONGRESS AVENUETELEPHONE:
(831) 372-8002
CITY:PACIFIC GROVESTATE: CAZIP CODE:
93950
CAPACITY: 90CENSUS: 0DATE:
04/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Christina Hunt - DirectorTIME COMPLETED:
04:20 PM
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On 4/25/2023, Licensing Program Analyst (LPA) D. Ayers arrived unannounced to conduct a required annual inspection. LPA met with Director Christina Hunt and announced the purpose of the inspection. Director's Administrator Certificate is current with renewal date 5/10/2024.

LPA toured the facility. All passageways and exits were clear and free from obstruction. The facility has a centralized fire alarm system and sprinklers throughout the facility. Fire extinguishers are present and recently serviced. Emergency disaster drills were logged and facility maintains adequate disaster/emergency plan. LPA inspected 3 activity rooms, 2 facility bathrooms, facility kitchen, gymnasium, and client and staff records. LPA observed rooms clean, organized and in good repair. Additionally, LPA observed bathrooms are in safe, sanitary and in good working order. All medications and sharps were observed locked, cleaning toxins in the main activity room are stored locked under the sink cabinet.
This facility administers medications for six clients. The centralized medication logs were reviewed and found accurate. Client's files were found to be complete and current. A review of staff records indicates that all facility staff have received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated staff responsible for the care of clients had current first aid/CPR certificates. LPA reviewed records of vehicle maintenance.

At 3:00 pm LPA observed the facility kitchen to be generally unclean, with carrots and onion peels on the ground. LPA observed many stains on the kitchen floors as well as various cardboard boxes in the kitchen. At 3:45 pm, LPA observed a ladder which was propped against the wall in the facility outdoor open porch area, as well as strings of Christmas lights which were strung along the trees in the area and which presented possible tripping hazards. See 809-D for two Type B deficiencies cited in accordance with Title 22 of the CA Code of Regulations. A copy of this report, appeal rights, 809-D were provided and exit interview conducted with Director Christina Hunt.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: David Ayers
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2023
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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Document Has Been Signed on 04/25/2023 05:14 PM - It Cannot Be Edited


Created By: David Ayers On 04/25/2023 at 03:32 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
,
, CA

FACILITY NAME: GATEWAY CENTER OF MONTEREY COUNTY, INC.
FACILITY NUMBER: 270702591

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82087(a)
Buildings and Grounds
(a) The program site shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above by ensuring cleanliness of the facility kitchen, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/02/2023
Plan of Correction
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Facility staff will provide CCLD proof of a general cleaning of the kitchen bu POC due date.
Type B
Section Cited
CCR
82087(c)
82087 Buildings and Grounds: (c) All outdoor and indoor passageways, stairways, inclines, ramps, open porches, and other areas of potential hazard shall be kept free of obstruction.


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 1 out of 1 outdoor porch areas, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/02/2023
Plan of Correction
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Facility staff will provide CCLD with proof of removal of any tripping hazards on open porch area, to include ladders or strings of lights.
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:Brenda Chan
LICENSING EVALUATOR NAME:David Ayers
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2023


LIC809 (FAS) - (06/04)
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