DOWNEY — During this time of societal turmoil and economic uncertainties, we must highlight those things we are thankful for; those that provide us hope, resilience and connection. 

Following a devastating life change, adjustment to a disability and community reintegration are serious challenges that our patients face. Returning to work is a goal for many people with a disability. In some cases, being gainfully employed is the last horizon of community living and participation. It provides a means for financial independence and engagement in meaningful, productive activity. 

Unfortunately, going back to work for people with a disability is very hard.

The Rancho Works Café & Gift Shop is a program at Rancho Los Amigos National Rehabilitation Center (Rancho) that supports patients recovering from disabling conditions to gain and practice job skills in a real work environment. The café and gift shop sells a menu of affordably priced, healthy food choices and handcrafted novelty items to serve the needs of patients, staff, visitors and the community. 

Participants learn fundamental job skills and can practice work habits in a supportive work environment. The goal for participants is to sharpen their work skills and increase their confidence before transitioning to competitive employment in the community. 

The Rancho Works Café & Gift Shop is located at the main lobby of the new Outpatient Building at Rancho. Rancho began in 1888 as a Los Angeles County Poor Farm, where people of different abilities were given a chance to live and work as contributing members of their community.

The story continues through the Rancho Works Café & Gift Shop. The program, under the Occupational Therapy Vocational Services Department and operated by Rancho Research Institute, builds on that legacy of inclusivity and productivity.  It enables participants (patients) of all diagnoses, abilities and backgrounds to regain a sense of self-esteem and well-being through work-related activities.  

Michelle Diaz sustained a traumatic brain injury and other bodily injury from a car accident in 2014, three days before her birthday. She was rehabbed at Rancho then volunteered before being interviewed and accepted as a paid trainee into the Rancho Works Café and Gift Shop. 

Michelle said that when she started at Rancho, “I wasn’t all there, but here I am now.” Because Rancho is such a good hospital, she wanted to come back and help other people.

“Making patients happy -- because that was my number one thing that I wanted to feel when I was in the hospital,” Michelle said. “Not for people to do things for me, but to just help me out. Now that I work here, I feel that it’s a blessing. I like helping out other people.”

The Rancho Works Café & Gift Shop is designed to enable participants of all diagnoses, abilities, and backgrounds to regain a sense of self-worth, well-being, and healthy routines through engagement in physical and cognitive activities in an actual work setting.

As part of this paid training program, participants work 3-6 hours a day, running the day to day operation of the cafe. Participants learn how to stock shelves, monitor inventory, complete sales transactions, and manage bookkeeping. 

They learn sanitary procedures for safe food handling under a limited food preparation license, as well as essential work behaviors, ethics, and customer service. They also learn how to write a resume, fill out an application, and practice how to interview so that they are prepared for gainful employment. Participants are able to use their work experience in the Rancho Works Café & Gift Shop as a reference on their resume.

Participants’ recovery is promoted by engaging both the mind and body while practicing learned skills in a supportive work environment. In this real work setting, participants develop core self-management and work skills such as taking responsibility, following a schedule, time management, organization, appropriate work behaviors, and teamwork.

“At first it was very difficult because I did not get along with the other workers, so that was very, very hard,” Michelle said. “Knowing not to flip out or not to just explode and knowing how to be calm and polite was a challenge. I knew I just had to control myself. Learn how to control my temper. I had a really hard time at first. But little by little, I really learned to get along with others.”

The program also fosters a sense of belonging and feelings of purpose while working alongside others toward the common goal of returning to work. It empowers individuals through personalized goal setting and individualized work plans to gain the knowledge, skills, and confidence needed to maximize their work performance and improve their quality of life. 

When asked what the difference is from when she started to now, Michelle says, “Before the car accident, I was not the person I am now. I was not as nice, as friendly, and as polite that I am now. I would always be using foul language. Being here made me change my whole lifestyle. It made me change the way I dress, the way I talk, the way I greet people. I talk to people now; before I would not talk to anybody. I was very antisocial, like don’t talk to me.” 

She credited her change in attitude to being exposed to Rancho. 

When asked what Michelle is thankful for during this Thanksgiving holiday, she happily said “Life! I am truly grateful for my life. It marks six years this year of my car accident, so it is a blessing in disguise, and I love it. I feel like every year, I am becoming a better person, more and more. I really appreciate all the therapists who helped me even though I wasn’t’ very nice to them at the beginning. I needed to apologize to them later. I‘m just very grateful for life and the ability to touch, feel, smell.”

“I must admit that my huge encouragement was Jorge Orozco and Carlos Benavidez,” Michelle continued. “Carlos was my peer mentor and Jorge motivated me to go to school. Jorge used to ask me where I saw myself, even when I was still in a wheelchair. He helped me see what I wanted to do and where I want to work. They helped me think about all the possibilities before I knew there were possibilities. I have my house, but Rancho is my home.”

When asked what she sees as most challenging during this time of the pandemic, she said, “Wearing a mask. Because I spent a lot of money for my teeth, and you can’t see my smile. My smile is a beautiful smile.”

One objective of this employment training program is to actively partner with other local community programs who share similar objectives, visions and missions as a way to assist program graduates with a structured means to become gainfully employed and be productive members of their communities. 

By partnering with employers in the community, we can ensure that participants are truly ready for work. The program serves as a bridge for participants to transition back into the community with valuable skills that can be utilized by local businesses such as restaurants, retail stores, farmer’s markets and community service programs.   

A recent graduate of the program is Lorena Rodas. Lorena was referred to the program to explore her readiness to return to work.  

Before her stroke, she worked as a forklift driver for a cosmetics company where she also set up for trade shows. While participating in Rancho Works Café & Gift Shop program, she increased her standing tolerance, improved her ability to use her weak arm, and learned new strategies to effectively participate in work-related activities. 

During this time and despite the ongoing pandemic, she became a valued member and team leader. Her positive attitude and self-confidence, she became an example for her co-workers and a mentor for newly hired trainees. She was recently hired as an employee of Sodexo.

“The program not just provided me with the work skills but gave me the opportunity to build my self-confidence to do what I thought was not possible. For that I am always grateful,” said Lorena.

The Rancho Works Cafe & Gift Shop is open Monday through Friday from 7:30 am to 3:30 pm.  All proceeds go to the Rancho Works Café & Gift Shop program, with the goal of providing patients opportunities to go back to work or engage in productive, meaningful activity. 

For more information, call the program at (562) 385-8205.  The administrative office can be reached at asandoval@dhs.lacounty.gov 

Philip S. Requejo, PhD, is chief executive officer of the Rancho Research Institute.