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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366401845
Report Date: 08/08/2024
Date Signed: 08/08/2024 12:44:50 PM

Document Has Been Signed on 08/08/2024 12:44 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:B.E.S.T OPPORTUNITIES, INC.FACILITY NUMBER:
366401845
ADMINISTRATOR/
DIRECTOR:		KARIN ETHERIDGEFACILITY TYPE:
775
ADDRESS:120 CAL AVENUETELEPHONE:
(760) 628-0111
CITY:BARSTOWSTATE: CAZIP CODE:
92311
CAPACITY: 48CENSUS: 17DATE:
08/08/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Alexandra GraychikTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Alexandra Graychik, Case Manager, and discussed the purpose of the visit. The facility is an Adult Day Program (ADP) with a license capacity of (48) and a current census (17). LPA conducted an overall inspection, which included, but was not limited to, the following:

Operation/Physical Plant: The facility is operating within the capacity of the Licensed approved by the Department. The facility has an infection control plan and emergency disaster plan for review. The facility was observed to have sufficient care staff to assist clients at program. Indoor passageways were kept free of obstruction. Activity and rest areas were maintained clean and odor free. Client bathrooms were maintained in a safe and sanitary condition. The hot water temperature tested at 113 degrees F. The facility is equipped with operating smoke/carbon monoxide alarms. Cleaning supplies, and other dangerous items were kept locked.

Food Service: Facility kitchen area were maintained clean. Clients bring their own lunch and the program provides snacks to clients. Bottled drinking water is readily available for clients.

Health Related Services: no medications are stored at the facility.

Record Review: Five (5) staff records reviewed had First Aid/CPR certifications, training, criminal record clearances, and health screenings. Five (5) client records reviewed reveal: four (4) clients had outdated individual program plans (IPPs) more than 3 year olds and did not have original admissions agreements on file. One (1) client did not have a IPP on file. Client #1 (C1) IPP was dated 12/10/2019 and had no original admissions agreement on file, Client #2(C2) IPP was dated 11/12/2019 and had no original admissions agreement on file.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2024
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: B.E.S.T OPPORTUNITIES, INC.
FACILITY NUMBER: 366401845
VISIT DATE: 08/08/2024
NARRATIVE
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Client #3(C3) did not have a IPP on file and no original admissions agreement. Client #4(C4) IPP was dated 3/3/2020. Client #5(C5) IPP was dated 1/27/2020 and had no original admissions agreement on file.

Based on LPA observations, deficiencies were cited and technical notes were issued in accordance with Title 22 of the California Code of Regulations. An exit interview was conducted were reports (LIC809/LIC809-D) were discussed and a copy provided with Appeal Rights to the Case Manager at the conclusion of the visit.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 08/08/2024 12:44 PM - It Cannot Be Edited


Created By: Magda Malcore On 08/08/2024 at 11:46 AM
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
, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: B.E.S.T OPPORTUNITIES, INC.
FACILITY NUMBER: 366401845

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Admission Agreements
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Type B
Section Cited
CCR
82068(e)
Admission Agreements
(e) The licensee shall retain in the client's file the original of the initial admission agreement and all subsequent modifications.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA record review, the licensee did not comply with the section cited above by not maintaining record of four client's original admissions agreement on file;which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/22/2024
Plan of Correction
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The Licensee or Director shall submit to the licensing agency a statement of understanding of the regulation cited by POC due date.
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:Karen Clemons
LICENSING EVALUATOR NAME:Magda Malcore
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2024


LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 08/08/2024 12:44 PM - It Cannot Be Edited


Created By: Magda Malcore On 08/08/2024 at 11:46 AM
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
, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: B.E.S.T OPPORTUNITIES, INC.
FACILITY NUMBER: 366401845

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82068.3(a)
Modifications to Needs and Services Plan
(a) The licensee shall ensure that each client's written Needs and Services Plan is updated as often as necessary, but at least annually, to ensure its accuracy, and to document significant occurrences that result in changes in the client's physical, mental, psychological, and/or social functioning.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA record review, the licensee did not comply with the section cited above by having outdated client IPPs more that 3 years old on file. which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/06/2024
Plan of Correction
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The Licensee or Director shall submit to the licensing agency a statement of understanding of the regulation cited by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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4
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:Karen Clemons
LICENSING EVALUATOR NAME:Magda Malcore
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2024


LIC809 (FAS) - (06/04)
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