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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202555
Report Date: 10/24/2023
Date Signed: 10/24/2023 12:58:27 PM

Document Has Been Signed on 10/24/2023 12:58 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:NEW PERSPECTIVES INC 2 GILROYFACILITY NUMBER:
435202555
ADMINISTRATOR:SUH, SEANFACILITY TYPE:
775
ADDRESS:6400 MONTEREY RDTELEPHONE:
(916) 203-6246
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY: 90CENSUS: 25DATE:
10/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Tiffany CeballosTIME COMPLETED:
01:05 PM
NARRATIVE
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Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct the day program's Required - 1 Year inspection. LPA met with Case Manager (CM), Dulce Alba and Regional Director (RD1) in Training, Tiffany Ceballos.

Based on interview with CM and RD1, Administrator, Sean Suh is rarely on site at the day program. RD1 states Sean Suh works in the back end of the operations. Regional Director (RD2), Jessica Greco is on site at the day program frequently and oversees the in-person operations of the program. RD2 and Designated Administrator/Program Director, Judy Gomez was unable to meet LPA during visit.

LPA toured the day program with CM to include the common area, kitchen, bathroom, storage, classrooms, office, and exterior. The side exterior fire exit route observed with tall prickly weeds about 4-5 feet tall, in the middle of the pathway. During visit, staff cleaned the weeds. Temperature maintained between 71 - 72 degrees Fahrenheit. Fire extinguishers last serviced on 09/06/2023. Carbon monoxide and sprinkler system observed present. LPA observed all the classrooms. Chemicals and disinfectants observed locked.

Upon entrance, LPA observed COVID-19 related posters at the entrance. Facility has hand washing signs and hand sanitizer located throughout the day program. Kitchen contained a refrigerator / freezer to store the client's home-brought meals. Filtered water pitcher observed inside the refrigerator for clients. Kitchen area has a cabinet above the sink that contains sharp objects to include knives and blades that was not observed locked. The kitchen is open and accessible to the clients. Staff took about 10 minutes to attempt to lock the cabinet. Staff ended up moving all the sharp objects to another secured area. RD1 immediately purchased a new lock for the cabinet. Quarantine room observed and equipped with PPE supplies. Quiet room observed with chairs, tables, computers, and adequate lighting. Day program does not store medications. SEE LIC809-C.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: Christine Dolores
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2023
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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Document Has Been Signed on 10/24/2023 12:58 PM - It Cannot Be Edited


Created By: Christine Dolores On 10/24/2023 at 12:09 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
, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: NEW PERSPECTIVES INC 2 GILROY
FACILITY NUMBER: 435202555

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82087(a)(3)
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. (3) Disinfectants, cleaning solutions, poisons, and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review the licensee did not comply with the section cited above by the observation of an unlocked cabinet in the kitchen containing knives and sharp objects which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/25/2023
Plan of Correction
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Licensee immediately purchased a lock for the cabinet. Licensee will submit the receipt of the new lock that was purchased and training documents pertaining to the section cited above to LPA Dolores by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Sarah Yip
LICENSING EVALUATOR NAME:Christine Dolores
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2023


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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: NEW PERSPECTIVES INC 2 GILROY
FACILITY NUMBER: 435202555
VISIT DATE: 10/24/2023
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5 client files observed. Client files contained an identification and emergency form, admission agreement, consent form, personal rights, physician's report, TB result, and updated IPP and/or appraisal/needs and services plan.

5 staff files observed. Staff files observed complete with 1st Aid certification, fingerprint clearance, job application, employee rights, health screening, and TB result. Administrator was not observed associated to the day program. Administrator obtains an active ARF Administrator Certificate. Staff are provided at least 8 hours of training yearly. LPA advised to input the hours of training on training documentation.

Emergency disaster plan and infection control plan reviewed during visit. LPA observed the infection preventionist listed on the infection control plan was not associated to the facility. RD1 states the staff is only in charge of the program's paperwork and does not work on-site. LPA advised that the infection preventionist should be a staff on-site to perform duties for the program. First Aid kit observed complete with a manual, tweezers, scissors, gauze, and bandages. Facility staff conducts and documents fire drills monthly. Staff are provided training on infection control during initial hire.

Deficiencies are being cited per California Code of Regulations, Title 22. See LIC809-D. This report was reviewed with Regional Director (RD1) in Training, Tiffany Ceballos and a copy of the report and appeal rights were provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: Christine Dolores
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4
Document Has Been Signed on 10/24/2023 12:58 PM - It Cannot Be Edited


Created By: Christine Dolores On 10/24/2023 at 12:21 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
, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: NEW PERSPECTIVES INC 2 GILROY
FACILITY NUMBER: 435202555

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82064(g)
(g) The administrator shall be at the program site the number of hours necessary to manage and administer the program in compliance with applicable laws and regulations.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review the licensee did not comply with the section cited above by not having the Administrator at the program site for the number of hours necessary to manage and administer the program which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/31/2023
Plan of Correction
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Licensee will provide the change of Administrator documents to LPA Dolores by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Sarah Yip
LICENSING EVALUATOR NAME:Christine Dolores
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2023


LIC809 (FAS) - (06/04)
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