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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191220171
Report Date: 01/11/2024
Date Signed: 01/11/2024 02:08:08 PM

Document Has Been Signed on 01/11/2024 02:08 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:THERAPEUTIC LIVING CENTERS FOR THE BLINDFACILITY NUMBER:
191220171
ADMINISTRATOR:SANDOVAL,JUANFACILITY TYPE:
775
ADDRESS:7955 LINDLEY AVENUETELEPHONE:
(818) 708-4940
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY: 90CENSUS: 90DATE:
01/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Juan Sandoval, AdministratorTIME COMPLETED:
02:30 PM
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At 10:25 a.m., Licensing Program Analysts (LPAs) Huma Rahimi, and Perchui Milena Khurshudyan conducted an unannounced annual inspection. LPAs met with Administrator, Juan Sandoval and disclosed the reason for the visit. LPAs and Administrator toured the facility inside and out.

It is a single story building with activity rooms, music room, theater room, sensory room, arts and crafts room, occupational therapy room, exercise room, business offices, common areas, and outdoor areas. It has an approved fire clearance for 60 ambulatory consumers and 30 nonambulatory consumers aged 18 – 81.

Physical plant At 10:30 a.m., LPAs observed total of nine (9) activity classrooms for clients in care. LPAs observed the walls, windows, ceilings, floors and floors to be in good repair. LPAs did not observed any hazards or obstructions during the walk through of the facility. Activity rooms and furniture were checked. The facility maintains a comfortable temperature at 71°F.



Outside activity space- LPAs observed appropriate chair and table furnishings along with a covered shaded area for consumers.

Indoor activity rooms: LPAs observed the furniture to be in good repair. Staff were actively participating in activities which appear to be appropriate for the clients.

The kitchen area: LPAs observed that the facility uses the kitchen as a cooking classroom for clients. LPAs observed the kitchen area to be clean and free from pests. The garbage cans have fitted lids. The kitchen equipment were observed to be clean. At 10:45 a.m., LPAs observed cleaning supplies and sharps to be locked and not accessible to consumers. The carbon monoxide detector in the dining area was operational. At 10:50 a.m., LPAs observed that the fire drill last conducted on 05/04/2023.

Continue on LIC 809C
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: THERAPEUTIC LIVING CENTERS FOR THE BLIND
FACILITY NUMBER: 191220171
VISIT DATE: 01/11/2024
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Document Link IconThe facility did not offer food or medication service. LPAs observed that clients bring their own food and eat in the dining area of the facility. The facility keeps only PRN medication for few of the clients. LPAs observed the PRN medication inside the office in the locked drawer.

LPAs toured the laundry area. The washing machine and dryer are in good repair. The dining area was observed to be clean. Table and chairs in good repair.

LPAs toured the male and female bathrooms. Hot water measured 106 degrees F. LPAs observed sufficient supply of toilet paper, soap and paper products. Trash cans have lids to protect from cross contamination.

Between 11:40 AM to 2:00 PM, LPA reviewed records of five (5) clients and five (5) staff. Client and staff records appeared to be complete and updated.



Administrative: LPA collected Certificate of Liability Insurance, and LIC500.

During today's inspection, the facility is in compliance with Title 22 regulations. No citations issued.

Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
LIC809 (FAS) - (06/04)
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