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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366400103
Report Date: 07/19/2024
Date Signed: 07/19/2024 10:42:21 AM

Document Has Been Signed on 07/19/2024 10:42 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:ANTHESIS ADULT DEVELOPMENT CENTERFACILITY NUMBER:
366400103
ADMINISTRATOR/
DIRECTOR:		LUCY YAMAS-CORTEZFACILITY TYPE:
775
ADDRESS:10550 RAMONA SUITE A & BTELEPHONE:
(909) 399-0617
CITY:MONTCLAIRSTATE: CAZIP CODE:
91763
CAPACITY: 72CENSUS: 55DATE:
07/19/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Lucy Jimenez- ADC Program ManagerTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Program Manager Lucy Jimenez and was granted entry to the facility. The facility is an Adult Day Program (ADP) vendorized by Inland Regional Center. Licensed capacity is (72) current census (55). LPA was accompanied by Lucy Jimenez, to conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected five (5) client/staff bathrooms and four (4) activity rooms which had sufficient lighting throughout the facility. Activity rooms were equipped with all materials and supplies for clients at Day Program. Facility is equipped with operating smoke detectors and carbon monoxide alarms. Fire systems are inspected by third party vendor. Program conducts fire drills every quarter. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated storage space for client/staff files. Medications are kept inside staff office inaccessible to clients in care. Overall, the facility is clean, in good repair, and operating in safe conditions for clients in care.

Food Service: Clients are responsible to bring lunches. Facility provides snacks to clients based on allergies and special food diets.

Care & Supervision: Day Program has sufficient care staff for coverage 6 1/2 hours, 5 days a week. All staff members working in the facility have criminal record clearance through the department.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ANTHESIS ADULT DEVELOPMENT CENTER
FACILITY NUMBER: 366400103
VISIT DATE: 07/19/2024
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Record Review: LPA reviewed five (5) client files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed five (5) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings.

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 this report (LIC809) was discussed and provided to Facility Program Manager Lucy Jimenez.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2024
LIC809 (FAS) - (06/04)
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