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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361800141
Report Date: 07/25/2022
Date Signed: 07/25/2022 12:09:41 PM

Document Has Been Signed on 07/25/2022 12:09 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, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME:FIRST STEP INDEPENDENT LIVING INCFACILITY NUMBER:
361800141
ADMINISTRATOR:SLAUGHTER, LANAIRFACILITY TYPE:
775
ADDRESS:3654 HIGHLAND AVE STE 17TELEPHONE:
(909) 483-2505
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY: 75CENSUS: 45DATE:
07/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:49 AM
MET WITH:Stacy Minwalla, AdministratorTIME COMPLETED:
12:10 PM
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Licensing Program Analyst (LPA) Anna Bueno made an unannounced visit to the day program to conduct an annual inspection, with an emphasis on infection control. LPA met with administrator Stacy Minwalla and was explained the reason for today's visit. LPA and Administrator confirmed that there are currently no confirmed and/or suspected Covid-19 cases in the facility. The facility is currently providing in-person and remote services for clients.

During today's visit, LPA Bueno and administrator Minwalla toured the facility and made observations regarding the infection control measures that the day program is implementing. LPA and Administrator observed a single entry point for universal symptom screening and another door exclusively used to exit the building. The day program has an adequate amount of hand hygiene, disinfectants, and personal protective equipment. The day program also has multiple sanitation cabinets throughout the facility. LPA and Administrator observed all staff and most consumers present were fitted with the appropriate face coverings. The day program has a plan in place to monitor participants regularly for any changes in condition. Highly touched surfaces after each change in activity in every designated area as well as sanitizing the restrooms.

LPA observed that the facility appeared to be meeting operational requirements. LPA observed that all utilities actively used and appliances in working order. Staff confirmed that the smoke and carbon monoxide detectors and fire alarms are maintained by local Fire department and sprinklers are maintained and monitored by the property management company.

Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and a copy of this report was provided to Administrator Minwalla.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2022
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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