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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306001156
Report Date: 06/20/2023
Date Signed: 06/20/2023 03:50:42 PM

Document Has Been Signed on 06/20/2023 03:50 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:CONSUMER CHOICE DAY ACTIVITY PROGRAMFACILITY NUMBER:
306001156
ADMINISTRATOR:HEARN, JOYCE A.FACILITY TYPE:
775
ADDRESS:225 CARL KARCHER WAYTELEPHONE:
(714) 744-5301
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY: 100CENSUS: 93DATE:
06/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Michael GallianoTIME COMPLETED:
04:05 PM
NARRATIVE
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This unannounced inspection is being conducted by Licensing Program Analysts (LPAs) Sean Haddad and Dwayne Mason Jr. for the purpose of conducting a Required – 1 Year Inspection. LPAs met with President & CEO (CEO) Michael Galliano and discussed the purpose of the inspection.
LPAs reviewed Infection Control requirements. At about 12:30PM, LPAs and CEO conducted a tour of the inside and outside of the facility, common areas, group rooms, storage areas, and bathrooms and observed the following: Structure: this is a large commercial facility which houses two day programs. Facility has 3 common areas, 8 group rooms, multiple storage areas, and 5 bathrooms. There is a side patio with shaded seating for the clients. LPAs observed 23 staff and 93 clients present for this program. LPAs observed clients and staff engaging in program activities throughout the facility. LPAs inspected all rooms and areas of the facility. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: the water heater was temporarily disabled. LPAs reviewed water temperature logs. LPAs inspected all rooms in the facility. Emergency Phone Numbers and Exit Plan: reviewed. Food Service: this facility does not provide food service. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: inspected. Appliances: microwave, washer, and dryer inspected. Knives: observed locked in the storage closet. Toxins: observed locked in the storage closets. Medication cabinet: facility does not handle medications. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 1:00PM, LPAs reviewed 6 client files and 6 staff files and interviewed 6 clients and 6 staff. Facility does not handle client medications or money.
During the inspection, LPAs and CEO observed the following: 3 knives and multiple toxins were accessible to clients in the non-lockable drawer and cabinet in the staff breakroom and in the cleaning closet. During the inspection, CEO properly secured these items and LPAs confirmed.
Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE: DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2023
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 06/20/2023 03:50 PM - It Cannot Be Edited


Created By: Sean Haddad On 06/20/2023 at 03:33 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
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: CONSUMER CHOICE DAY ACTIVITY PROGRAM
FACILITY NUMBER: 306001156

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82087(a)(3)
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. (3) Disinfectants, cleaning solutions, poisons, and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.

This requirement is not met as evidenced by:
Deficient Practice Statement
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 Based on observation, the licensee did not ensure 3 knives and multiple toxins were inaccessible to clients in the staff breakroom drawers and cabinet and the cleaning closet, which poses an immediate health and safety risk to persons in care.
POC Due Date: 06/21/2023
Plan of Correction
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During the inspection, licensee secured the knives and toxins and LPAs confirmed. POC CLEARED.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Armando J Lucero
LICENSING EVALUATOR NAME:Sean Haddad
LICENSING EVALUATOR SIGNATURE:
DATE: 06/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/20/2023


LIC809 (FAS) - (06/04)
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