405801767-8-18-2023-29-AS-RDLN-CUTMC8-20230818092908

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 405801767
Report Date: 08/17/2023
Date Signed: 08/18/2023 09:31:40 AM

Document Has Been Signed on 08/18/2023 09:31 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
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, Administrator		TIME COMPLETED:	03:55 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	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: 08/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2023

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 8

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: 08/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2023

LIC809 (FAS) - (06/04)

Page: 2 of 8

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: 08/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2023

LIC809 (FAS) - (06/04)

Page: 3 of 8

Document Has Been Signed on 01/27/2025 09:58 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 01/27/2025 09:57 AM

Created By: Kelly Burley On 08/18/2023 at 08:38 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
CCLD Regional Office, 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)

Section Cited


	Deficient Practice Statement
1 2 3 4	This page intentionally left blank.
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Jill Nakata

LICENSING EVALUATOR NAME:

Kelly Burley

LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2024

LIC809 (FAS) - (06/04)

Page: 4 of 8

Document Has Been Signed on 01/27/2025 09:55 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 01/27/2025 09:54 AM

Created By: Kelly Burley On 08/18/2023 at 08:38 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
CCLD Regional Office, 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)

Section Cited


	Deficient Practice Statement
1 2 3 4	This page intentionally left blank.
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Jill Nakata

LICENSING EVALUATOR NAME:

Kelly Burley

LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2023

LIC809 (FAS) - (06/04)

Page: 5 of 8

Document Has Been Signed on 01/27/2025 09:57 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 01/27/2025 09:56 AM

Created By: Kelly Burley On 08/18/2023 at 08:39 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
CCLD Regional Office, 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)

Section Cited


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

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:

Jill Nakata

LICENSING EVALUATOR NAME:

Kelly Burley

LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2023

LIC809 (FAS) - (06/04)

Page: 6 of 8