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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191222639
Report Date: 08/19/2022
Date Signed: 11/09/2022 08:44:18 AM

Document Has Been Signed on 11/09/2022 08:44 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:ONEGENERATION - MARK TAPER J.O.Y. PROGRAMFACILITY NUMBER:
191222639
ADMINISTRATOR:ANNA SWIFTFACILITY TYPE:
775
ADDRESS:17400 VICTORY BLVD.TELEPHONE:
(818) 708-6625
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY: 90CENSUS: 18DATE:
08/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Michelle Quiroga-Diaz - DirectorTIME COMPLETED:
12:00 PM
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Licensing Program Analysts (LPA) Brian Balisi conducted an unannounced required annual visit. This annual had a specific emphasis on infection control practices and procedures. Upon arrival LPA met with Michelle Quiroga-Diaz - Program Director and explained the reason for the visit. The Adult day program is a part of the inter-generational program. The program includes an adult day program, health care and child care participants.

The LPA, along with Quiroga-Diaz toured the physical plant areas inside and outside at approximately 09:50am  to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations.  Quiroga-Diaz stated participants average to approximately (18) clients daily. There are no clients participating via zoom at this time.
 
The rooms toured  in the facility consisted of  the waiting area,  (2) Activity  Rooms, Rehab area, Patio, program offices, Nurses station, Charting / records room, (2) bathrooms for clients use, parking lot and community food pantry. At approx. 10:15am, LPA observed clients participating in a sit down exercises in one of the activity rooms.

The LPA observed the required postings throughout the facility. Fire extinguishers were observed to be fully charged and last serviced on June 2022.  Carbon / Fire  detectors were also observed to be working at the time of visit. Emergency drills are conducted monthly, the last emergency drill was conducted on July 2022. Furniture in each activity  room  were observed to be  in good repair. Other equipment used for activities appears to be in adequate condition at this time.

Continued on 809-C
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2022
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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ONEGENERATION - MARK TAPER J.O.Y. PROGRAM
FACILITY NUMBER: 191222639
VISIT DATE: 08/19/2022
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Continued from 809

Nurses station stored medication for (1) participant, first aid, PPE and  all were observed to be inaccessible to clients at this time. Public restrooms were observed to be clean and sanitary and in operating condition.  The LPA observed sufficient amounts of soap and paper products in each restroom, as well as hand washing posters. Hot water measured between 110 - 115 degrees Fahrenheit.  Storage area located in the rear of the men's restroom was observed to store cleaning supplies. This room was observed to be locked during the visit. Laundry room was located across the hall from women's restroom. Cleaning supplies and detergent were observed to be stored in this area and was inaccessible to clients during the visit.

Dining area/Kitchen: The dining/kitchen area appeared clean and sanitary; appliances and fixtures were observed to be functioning during the time of the visit. Perishable and non-perishable foods were observed to be properly stored. LPA observed sufficient room in the fridge for clients to store snacks and beverages.  All knives and cleaning supplies were observed to be inaccessible at time of visit.

Outside area was observed free of clutter and obstruction. There was a shaded seating area with furniture appropriate for outdoor use. Parking is located in the front  of the building . The vehicles used for client transportation are properly registered and current at this time. At approx. 11:20am, LPA observed clients singing in 2nd activity room.

INFECTION CONTROL: During today’s visit, the LPA spoke with  Quiroga-Diaz regarding  the facility’s infection control practices. Upon entry, the facility has a single entry point for symptom screening. The LPA observed an adequate supply of Personal Protective Equipment (PPE) and the facility is able to obtain additional supplies as needed.  The facility’s cleaning protocol is sufficient.  If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility’s policies and procedures as it pertains to infection control are adequate at this time.

Exit interview conducted. Report issued and sent via email.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022
LIC809 (FAS) - (06/04)
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