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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700394
Report Date: 05/15/2024
Date Signed: 05/15/2024 01:39:20 PM

Document Has Been Signed on 05/15/2024 01:39 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:PATHWAY TO CHOICES SAC BMPFACILITY NUMBER:
342700394
ADMINISTRATOR/
DIRECTOR:		MOORMAN, DIANAFACILITY TYPE:
775
ADDRESS:7723 OLD AUBURN RDTELEPHONE:
(916) 735-5968
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 60CENSUS: 16DATE:
05/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:25 AM
MET WITH:Diana Moorman, Administrator TIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct an annual inspection. LPA met with Diana Moorman, Administrator and Claudia Romero, Associate Director, and explained the purpose of the inspection. The location is a licensed Adult Day Program (ADP), is vendorized through the regional center, and operates on a 1:3 staff ratio. Today, there are sixteen (16) clients and (5) staff present along with (2) Associate Directors and the Administrator.

LPA and one Associate Director toured the interior and exterior of the facility including, but not limited to, the office, kitchen, six (6) client classrooms, (3) client bathrooms, isolation room, gardens and patio. LPA observed the facility to be clean, safe and in good repair. There is sufficient indoor and outdoor space for clients to participate in a variety of activities. LPA observed staff present with clients in each classroom. Clients will rotate to (5) different classrooms daily.

LPA observed locked toxins and sharps in the kitchen. Clients bring their own lunches, and the day program provides snacks and beverages. Fire extinguishers were last serviced 12/28/23 and there are First aid kits in each classroom. Fire drills are conducted monthly. Hot water temperature measured 60*F in the kitchen and 65*F in a client bathroom. (See deficiency cited). There are (20) second hand-washing posters at some sinks- Administrator to ensure they are posted at each sink.

LPA reviewed (3) client files and (5) staff files and found them to be organized and contain required documentation. Administrator and staff training documentation is current. Discussed SOC341- facility to conduct a refresher training and post a blank copy. The Emergency Disaster Plan and Infection Control Plan were reviewed.

Per California Code of Regulations Title 22, Division 6, Chapter 8, the following (1) deficiency is cited on the 809D page.
Exit interview with Associate Director. Copy of report and appeal rights provided.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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 05/15/2024 01:39 PM - It Cannot Be Edited


Created By: Sabrina Calzada On 05/15/2024 at 01:20 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: PATHWAY TO CHOICES SAC BMP
FACILITY NUMBER: 342700394

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82088(e)(1)
82088 Fixtures, Furniture, Equipment, and Supplies

(e) Faucets used by clients for personal care shall deliver hot water. (1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and hot water temprature check, the licensee did not comply with the section cited above in (2) out of (5) faucets delivering hot water, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/29/2024
Plan of Correction
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Licensee/Administrator agree to adjust the hot water heater so all sinks will deliver hot water between 105*F- 120*F. Documentation/Photo of hot water temperature for kitchen and client bathrooms to be provided to the Department by 5/29/24.
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:Maribeth Senty
LICENSING EVALUATOR NAME:Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2024


LIC809 (FAS) - (06/04)
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