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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306001666
Report Date: 10/08/2021
Date Signed: 12/29/2021 06:29:19 PM

Document Has Been Signed on 12/29/2021 06:29 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:EMPOWER COMMUNITY DAY PROGRAMFACILITY NUMBER:
306001666
ADMINISTRATOR:MICHAEL J. MURPHYFACILITY TYPE:
775
ADDRESS:8381 KATELLA AVE. STE C,D, & ETELEPHONE:
(310) 902-2562
CITY:STANTONSTATE: CAZIP CODE:
90680
CAPACITY: 72CENSUS: 20DATE:
10/08/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:27 AM
MET WITH:Administrator Michael MurphyTIME COMPLETED:
12:05 PM
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Licensing Program Analyst, (LPA) Shobhana Frank conducted the Annual Required inspection for the above Day Program. LPA was greeted and granted entry into the facility by Supervisor Wendy Rives and LPA explained the nature of the visit. Facility is licensed for 72 ambulatory clients and offers a partial site day program with a vocational training component as well as adult living skills, academic programs and community integration activities.
LPA tour the facility with the Administrator Michael Murphy During today's visit, all areas of the facility related to client care were toured including activity areas. Facility fire clearance is maintained in conformity with State Fire Marshall regulations; Fire extinguishers were mounted and charged, Smoke detectors and Carbon monoxide detectors meet the regulatory requirements. All disinfectants, cleaning solutions, and poisons were inaccessible to clients. All toilets, hand washing facilities and areas are maintained in a safe, sanitary, operating condition. The program site was noted to be clean, safe, and sanitary.
LPA observed the screening/sanitizing station in the entrance of the facility. Visitors sign in and are screened for temperature. Facility takes clients temperatures daily and documents. Facility has COVID precaution postings as well as all required department postings. Facility has completed the Mitigation Plan and is approved.
Facility has a plan for COVID testing residents and staff as needed as well as a plan for isolation. Staff and
most residents are vaccinated for COVID-19. Resident files contained updated emergency information as
well as required department forms.

Based on the observations made during today’s visit, no deficiencies are being cited in area inspected.
This report was discussed with the facility representative and a copy was provided.
SUPERVISORS NAME: Marina Stanic
LICENSING EVALUATOR NAME: Shobhana Frank
LICENSING EVALUATOR SIGNATURE: DATE: 10/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2021
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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