Facility Evaluation Report

A Non-Compliance Conference (NCC) was held at the Monterey Park Adult and Senior Care Program Regional Office. Participants in this meeting included Tony Vasallo - Regional Manager, Janae Hammond - Licensing Program Manager, Fernando Fierros - Licensing Program Manager, Lizeth Villegas, Elena Mallett, and Cynthia Chan – Licensing Program Analysts, Jesse Hansen – State Director, and Juan Zepeda – Area Director.

The purpose of this conference is to discuss the citation issued for the death of a client at the day program which occurred on 6/18/2019. The department concluded the investigation on 3/20/2023 and deficiencies were issued for responsibility for providing care and supervision and health-related services. At the time, the department issued an immediate $500 civil penalty. The community care licensing department has determined that an additional civil penalty will be assessed due to the death of the client. The additional civil penalty will be delivered at a later date and time.

Licensee and Administrator stated the following plans in order to bring the facility into compliance:

* Facility has updated the Clients' Face Sheet to include critical information. Staff sign off and review the face sheet before going on any community outings.

* Facility has hired local trainers to provide training to staff such as CPR & First Aid training and additional training. Training is scheduled in advance to ensure it does not exceed the expiration date.

* Facility has recently added a Quality Assurance Manager to review day program processes.

* Hired a full-time Behavior Consultant to oversee the 3 southern day programs. Facility has additional 40 consulting hours per month.

* Created PODs (consists of 5 Staff and 10 individuals) - 1 staff works with 2 clients to focus on the clients' needs.

* Changed the Intake process to a team approach consisting of 3 staff to ensure the client's information is accurate.

* Face sheet will be entered on an electronic database and will indicate the client's supervision level needed. Staff will be able to view the face sheet electronically and via printout.

· A second program coordinator is hired to assist the program director with the daily operations.

The licensee representative has been advised the department is seeking an additional civil penalty.

An exit interview and a copy of this report was provided to Jesse Hansen, the State Director.