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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300605516
Report Date: 06/24/2022
Date Signed: 06/24/2022 11:27:38 AM

Document Has Been Signed on 06/24/2022 11:27 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:BUENA PARK SENIOR DAY CARE CENTERFACILITY NUMBER:
300605516
ADMINISTRATOR:PAT STEWARTFACILITY TYPE:
775
ADDRESS:8150 KNOTT AVENUETELEPHONE:
(714) 826-3163
CITY:BUENA PARKSTATE: CAZIP CODE:
90620
CAPACITY: 20CENSUS: 5DATE:
06/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Pat StewartTIME COMPLETED:
11:46 AM
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Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one year infection control annual visit. LPA Haley entered the Senior Day program and was greeted by Administrator (AD) Pat Stewart and explained the reason for the visit.

This Senior Day Program is for elderly adults ages 60 years old and above. The program operates Monday through Friday, with operating hours of 8:30 AM - 4:00 PM. However, due to cleaning requirements Program participants are served from 9:00 AM - 3:30 PM Monday - Friday. The current capacity is 10 and there's 10 registered participants. There were five participants present during the visit, and all were participating in a variety of activities during the visit.

During the inspection, LPA Haley observed a screening station at the entrance of the facility equipped with a temperature thermometer, hand sanitizer, surgical face mask, and a screening log book. There were cabinets full of supplies for the program, as well as different activities. LPA Haley observed a fully charged fire extinguisher in the cabinet with a first aid kit that has all the required elements. The program has a pantry room where participants "cold packs" are stored. The "cold packs" contain lunch and snack items for the program participants to enjoy and are provided daily.

The program shares restrooms with the senior center. The restroom was clean, organized, and stocked with had soap and paper towels. LPA Haley observed several COVID postings through out the program.

The last fire drill was held May 4, 2022. The program has smoke detectors and a sprinkler system that is inspected by the Fire Department. There were no bodies of water observed.

No deficiencies are being cited during todays visit. An exit interview conducted and a copy of the report was provided to the Administrator Pat Stewart
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2022
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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