374603103-3-27-2023-08-AS-ARAZ-CQBVDF-20230327162040

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374603103
Report Date: 03/27/2023
Date Signed: 03/27/2023 04:21:23 PM

Document Has Been Signed on 03/27/2023 04:21 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
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME:	ADVANTAGE CENTER, THE		FACILITY NUMBER:	374603103
ADMINISTRATOR:	DARIUSH RAZAVI		FACILITY TYPE:	775
ADDRESS:	8363 CENTER DR UNIT 4		TELEPHONE:	(619) 697-6311
CITY:	LA MESA	STATE: CA	ZIP CODE:	91942
CAPACITY: 75		CENSUS: 37	DATE:	03/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:17 PM
MET WITH:	Director Ray Pallasigue		TIME COMPLETED:	04:30 PM

NARRATIVE

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Licensing Program Analysts (LPAs) Dang Nguyen and Alyssa Ramirez conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs were welcomed by, identified themselves to, and discussed the purpose of the visit director Ray Pallasigue.

According to the facility’s license, the facility has a maximum capacity of seventy-five (75) clients, of which all seventy-five (75) may be non-ambulatory During today’s inspection, there were a total of thirty-seven (37) clients in care. This facility does not feature a secured perimeter or delayed egress doors. Required licensing postings were observed in visible areas of the facility.

LPAs, accompanied by licensee’s staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Doors, windows and screens, sinks and toilets were in working order. Personal Protective Equipment (PPE) was present. The facility had sufficient space and equipment to facilitate activities. The facility’s ambient internal temperature was comfortable and complaint, at 69 F.

LPAs observed via measurement with a thermometer device that hot water temperature at taps accessible to clients were compliant: Kitchen was 111 F, Bathroom #1 was 110 and 111 F, and Bathroom #2 was 111 F and 110 F. Bathroom #3 was 110 F, classroom #1 sinks were 111F, 111 F and 111 F.

Medications were labeled, as required, and stored in locked areas. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. No pools or bodies of water were observed on the premises. Per the licensee, no firearms or ammunition are kept at the facility.

[CONTINUED FROM LIC 809]

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Alyssa Ramirez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

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
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ADVANTAGE CENTER, THE	FACILITY NUMBER: 374603103
	VISIT DATE: 03/27/2023

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[CONTINUED FROM LIC 809]

LPAs interviewed multiple staff. LPAs did not interview clients due to arriving at the end of the day while clients were transitioning out of program. LPAs reviewed multiple staff and client records/files. The interviews did not raise any licensing concerns. LPAs observed that that direct care Staff #1 (S1), Staff #2 (S2) and Staff #3 (S3) did not have evidence of current First Aid training in their employee files. [See LIC811 Confidential Names List for a description of person identifiers used in this report.] Otherwise, the client and staff files contained the required documents. Confidential records were stored in locked areas. Licensee also presented proof of current/active business liability insurance.

A deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D). A plan of Correction was jointly developed with the licensee. An exit interview was conducted with Pallasigue, to whom a copy of this report, the LIC 809-D, the LIC811

Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Alyssa Ramirez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/27/2023 04:21 PM - It Cannot Be Edited

Created By: Alyssa Ramirez On 03/27/2023 at 03:55 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
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ADVANTAGE CENTER, THE	FACILITY NUMBER: 374603103
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/27/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

82075(f)

Health-Related Services

(f) Staff responsible for providing direct care and supervision shall receive and maintain current training in first aid and cardiopulmonary resuscitation from persons qualified by agencies including, but not limited to, the American Red Cross. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review and interview, the licensee did not comply with the section cited above for 3 of 5 staff files reviewed [S1, S2 and S3], which posed a potential health risk to persons in care.
	POC Due Date: 04/26/2023
	Plan of Correction
1 2 3 4	Licensee agreed to arrange for S1, S2 and S3 to receive First Aid training through a qualified outside training source, and to place evidence of training completion in their employee files. Licensee agreed to E-mail LPA copies of S1 and S2's first aid training certificates/cards by the POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 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:

Simon Jacob

LICENSING EVALUATOR NAME:

Alyssa Ramirez

LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

LIC809 (FAS) - (06/04)

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