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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
405801767
Report Date:
08/17/2023
Date Signed:
08/17/2023 03:46:25 PM
Document Has Been Signed on
08/17/2023 03:46 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
,
21731 VENTURA BLVD. #250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
OPTIONS COMMUNITY INTEGRATION SERVICES-MORRO BAY
FACILITY NUMBER:
405801767
ADMINISTRATOR:
CHRISTINA HUTCHISON
FACILITY TYPE:
775
ADDRESS:
840 MORRO AVENUE, SUITE A
TELEPHONE:
(805) 772-1019
CITY:
MORRO BAY
STATE:
CA
ZIP CODE:
93442
CAPACITY:
30
CENSUS:
21
DATE:
08/17/2023
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
10:30 AM
MET WITH:
Christina Hutchison,
TIME COMPLETED:
03:55 PM
NARRATIVE
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Licensing Program Analyst (LPA) De Leon arrived at 10:30 am to conducted a 1 year annual visit to the facility above. LPA met Administrator Christina Hutchison and explained the purpose of the visit.
A tour of the inside and outside of the facility was conducted with Administrator. The following was inspected and noted during the annual visit:
Infection Control:
The facility has submitted a current Mitigation Plan, Infection Control Plan, and Emergency Disaster Plan to the department. The facility has a sign in and out binder for visitors at entry with hand sanitizer. The bathrooms have toilet paper, paper towels, hand soap, and hand washing signs. The facility has EPA approved disinfectants spray and cleaners. The facility has a 30 day supply of PPE. Staff are trained on infection control and the use of Personal Protective Equipment (PPE). 1 out of 5 trash cans and waste baskets have tight fitting covers. Facility needs to be cleaned and disinfected. Restrooms need to be cleaned and disinfected.
Physical Plant & Environmental Safety:
The facility is a day program with 2 restrooms currently serving 21 clients and employs 13 staff. The facility needs to be cleaned and sanitized. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors both tested and working. The lighting and lamps are not sufficient due to many of the bulbs are no longer working. The facility does not have a kitchen. The facility refrigerator is clean and operating at required temperature. Toilet and hand washing facilities are operational and secured grab bars are present. The pathways are clear of any obstructions. Disinfectant, cleaning solutions and poisons are inaccessible to clients in care locked in cabinet in the activity area. The facility has sufficient space inside and outside for activities and visiting. The facility has telephone and internet service. Water temperature was checked in restroom #1 at 99.3 and restroom number 2 at 102.9 which is below the required regulation. Staff Manager adjusted the water heater and will monitor with a 7 day log for required temperature.
Continued 809-C
SUPERVISORS NAME
:
Kelly Burley
LICENSING EVALUATOR NAME
:
Rachael De Leon
LICENSING EVALUATOR SIGNATURE
:
DATE:
08/17/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
21731 VENTURA BLVD. #250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
OPTIONS COMMUNITY INTEGRATION SERVICES-MORRO BAY
FACILITY NUMBER:
405801767
VISIT DATE:
08/17/2023
NARRATIVE
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Operational Requirements:
The facility has a current plan of operation and infection control plan on file with the department. The Facility is operating in compliance with the granted fire clearance. The facility is approved for 30 Ambulatory clients of which may be developmentally disabled. Hours of operation are Monday-Friday 8AM-4PM.
Staffing:
The facility employes 8 staff and 1 Administrator. Staff records are kept confidential in the HR office located within 3 minutes of the facility. Staff Administrator brought records to facility for LPA to review.
LPA reviewed 5 random staff files and 1 Administrator file. Files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, Criminal Record statements, and Finger print clearance/Associations/exemptions. Administrator file was reviewed for Continuing Education requirements.
Personnel Records & Training:
The facility keeps confidential files on staff training. LPA reviewed staff training records of 8 hours of annual training. The facility conducts quarterly Disaster Drills records were reviewed and meet requirements. Trainers met the requirements to train staff with required information present on training documents.
Clients Rights-information:
All require postings were posted in the common area of the facility. Personal rights, CCL Complaint poster is posted at entry. The current license along with CCL reports and PIN's were posted in the staff office. Visitation policy is posted at entry. Clients had a consent forms signed and in files.
Clients Records & Incident Reports:
The facility keeps separate files on each client confidentially. Five files were reviewed for signed Admission Agreements, Medical Assessments, LIC. 602A Physicians Report, ID and Emergency contact forms, Appraisal Needs and Services plans (ANS) which facility utilizes the Individual Services Plan (ISP) and contains the same information and is completed annually, TB results, Personal Rights. The Facility does not handle cash resources for any clients in care. Facility does submit incident reports to the department when
required.
Food Service:
The facility does not have a kitchen. The clients bring a packed lunch and snacks from home. If a clients forgets to bring the facility staff will provide something from a local store to provide to the clients while at day program. Continued 809-C
SUPERVISORS NAME
:
Kelly Burley
LICENSING EVALUATOR NAME
:
Rachael De Leon
LICENSING EVALUATOR SIGNATURE
:
DATE:
08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/17/2023
LIC809
(FAS) - (06/04)
Page:
2
of
9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
21731 VENTURA BLVD. #250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
OPTIONS COMMUNITY INTEGRATION SERVICES-MORRO BAY
FACILITY NUMBER:
405801767
VISIT DATE:
08/17/2023
NARRATIVE
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Health Related Services:
First Aid is provided to clients in care with privacy.
Incidental Medical Services:
Facility provides transportation or arranges transportation to medical and dental appointments if needed coordinates with clients homes for pick up or transport. The day program does not do medications for clients in care, medications are given at home prior to coming to program or after attending day program.
Disaster Preparedness:
The current emergency disaster forms were posted. The facility conducts quarterly disaster drills. The fire extinguishers were charged and last inspected 06/08/2023. Emergency exits and telephone numbers were posted. A set of keys is available for staff on all shifts to access full facility in an emergency.
Emergency Intervention:
The facility is a hands off facility and does not use manual restraint or seclusion with any clients in care.
LPA will conduct interviews with 3 staff and 3 clients.
Exit interview conducted, deficiencies cited, copy of report and appeal rights printed for Administrator.
SUPERVISORS NAME
:
Kelly Burley
LICENSING EVALUATOR NAME
:
Rachael De Leon
LICENSING EVALUATOR SIGNATURE
:
DATE:
08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/17/2023
LIC809
(FAS) - (06/04)
Page:
3
of
9
Document Has Been Signed on
08/17/2023 03:46 PM
- It Cannot Be Edited
Created By:
Rachael De Leon
On
08/17/2023
at
03:24 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
,
21731 VENTURA BLVD. #250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
OPTIONS COMMUNITY INTEGRATION SERVICES-MORRO BAY
FACILITY NUMBER:
405801767
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
08/17/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82095.5(a)(2)(A)
Infection Control Requirements
(a) A licensee shall ensure that infection control practices are maintained as follows: (2) Environmental cleaning and disinfection activities shall be performed following the manufacturers’ instructions for proper use of the cleaning and disinfecting products. These activities shall be completed, at a minimum, as follows: (A) Surfaces such as floors, chairs, toilets, sinks, counters and tabletops shall be cleaned and disinfected on a regular basis to ensure they are safe and sanitary. These surfaces shall also be disinfected when these surfaces are contaminated and visibly soiled with blood or body fluids or other potentially infectious material.
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above in the facility was not clean and sanitary which poses potential health, safety or personal rights risk to persons in care.
POC Due Date:
08/24/2023
Plan of Correction
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2
3
4
Administrator agreed to clean and sanitze the facility and provide photographs of the walls, windows, blinds, and restrooms.
Type B
Section Cited
CCR
82095.5(a)(2)(B)
Infection Control Requirements
(a) A licensee shall ensure that infection control practices are maintained as follows: (2) Environmental cleaning and disinfection activities shall be performed following the manufacturers’ instructions for proper use of the cleaning and disinfecting products. These activities shall be completed, at a minimum, as follows: (B) Walls and window coverings in client care areas shall be dusted or cleaned on a regular schedule to ensure they are safe and sanitary and when they are visibly contaminated or soiled.
This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on observation the licensee did not comply with the regulation above the facility walls and windrows were dirty and not sanitary which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
08/24/2023
Plan of Correction
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2
3
4
Administrator agreed to clean and sanitze the facility and provide photographs of the walls, windows, blinds, and restrooms.
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:
Kelly Burley
LICENSING EVALUATOR NAME:
Rachael De Leon
LICENSING EVALUATOR SIGNATURE:
DATE:
08/17/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/17/2023
LIC809
(FAS) - (06/04)
Page:
4
of
9
Document Has Been Signed on
08/17/2023 03:46 PM
- It Cannot Be Edited
Created By:
Rachael De Leon
On
08/17/2023
at
03:24 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
,
21731 VENTURA BLVD. #250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
OPTIONS COMMUNITY INTEGRATION SERVICES-MORRO BAY
FACILITY NUMBER:
405801767
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
08/17/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82095.5(a)(4)(C)
Infection Control Requirements
(a) A licensee shall ensure that infection control practices are maintained as follows: (4) All facility staff and volunteers shall use gloves as a protective barrier to prevent the spread of potential infection as specified below. (C) Gloves shall be removed and discarded in the nearest appropriate waste receptacle with a tight-fitting cover immediately following the glove use as required by subsection (a)(4)(A) with one client and prior to an interaction with another client.
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation the licensee did not comply with the section cited above the trash bins did not have tight fitting covers which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
08/24/2023
Plan of Correction
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2
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Administrator agreed to get waste bakets/trash bins with tight fitting covers, take pictures and send photos to LPA.
Type B
Section Cited
CCR
82087(a)
Buildings and Grounds
(a) The program site shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
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4
Based on observation the licensee did not comply with the section cited above the facility is in need of repair walls and flooring are beyond normal wear and tear which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
08/24/2023
Plan of Correction
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2
3
4
Administrator agreed to clean walls and floors of the facility and if not able to clean will repair those areas needed, take pictures of areas and send to LPA.
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:
Kelly Burley
LICENSING EVALUATOR NAME:
Rachael De Leon
LICENSING EVALUATOR SIGNATURE:
DATE:
08/17/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/17/2023
LIC809
(FAS) - (06/04)
Page:
5
of
9
Document Has Been Signed on
08/17/2023 03:46 PM
- It Cannot Be Edited
Created By:
Rachael De Leon
On
08/17/2023
at
03:24 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
,
21731 VENTURA BLVD. #250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
OPTIONS COMMUNITY INTEGRATION SERVICES-MORRO BAY
FACILITY NUMBER:
405801767
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
08/17/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82088(e)(1)
Fixtures, Furniture, Equipment, and Supplies
(1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above the water tempature was below regualtion requirements and tested at 99.3 and 102.9 in the restrooms which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
08/24/2023
Plan of Correction
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2
3
4
Administrator adjusted water heater and brought water temp into complinace 109 degrees, Administrator will montior water for 7 days and provide log to LPA.
Type B
Section Cited
CCR
82088(e)(3)
Fixtures, Furniture, Equipment, and Supplies
(3) All toilets, hand washing and bathing facilities shall be maintained in safe and sanitary operating condition. Additional equipment, aids, and/or conveniences shall be provided in day programs accommodating physically handicapped clients who need such items.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above two restrooms were not clean and sanitary which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
08/24/2023
Plan of Correction
1
2
3
4
Administrator agreed to clean and sanitze both restrooms and provide pictures to LPA.
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:
Kelly Burley
LICENSING EVALUATOR NAME:
Rachael De Leon
LICENSING EVALUATOR SIGNATURE:
DATE:
08/17/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/17/2023
LIC809
(FAS) - (06/04)
Page:
6
of
9