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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 366409783
Report Date: 10/10/2024
Date Signed: 10/10/2024 02:05:20 PM

Document Has Been Signed on 10/10/2024 02:05 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:OPARC ADULT DEVELOPMENT CENTER ONTARIOFACILITY NUMBER:
366409783
ADMINISTRATOR/
DIRECTOR:		FLORENCE ARNECILLOFACILITY TYPE:
775
ADDRESS:1235 E FRANCIS ST. SUITE A-CTELEPHONE:
(909) 923-5355
CITY:ONTARIOSTATE: CAZIP CODE:
91761
CAPACITY: 75CENSUS: 64DATE:
10/10/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:35 PM
MET WITH:Florence ArnecilloTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analysts (LPAs) Paola Guerrero and Beena Singh made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPAs met with Facility Administrator Florence Arnecillo and was granted entry to the facility. The facility is an Adult Day Program (ADF) Licensed capacity is (75) current census (64). LPAs were accompanied by Facility Adminstrator, 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. LPAs inspected facility activity rooms; they are equipped with required furniture. LPAs observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, and other dangerous items were kept inaccessible to clients in care. There was a designated storage space for client/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for clients in care. PRN Medication is kept inside a locked cabinet inaccessible to clients in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care.

Food Service: Clients bring their own lunch, and snacks are available up on request based on on dietary/allergy needs.

Care & Supervision: Facility has sufficient care staff for coverage 5 days a week (Mon-Fri), 9:00am- 2:30pm. 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: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2024
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: OPARC ADULT DEVELOPMENT CENTER ONTARIO
FACILITY NUMBER: 366409783
VISIT DATE: 10/10/2024
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Record Review: LPAs reviewed four (4) client files for admission agreements, updated physician reports, and needs and services plans. LPAs also reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings. PRN medication for one resident was audited at random and appeared to be dispensed appropriately by staff.

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 Administrator Florence Arnecillo.

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

DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024
LIC809 (FAS) - (06/04)
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