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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197600225
Report Date: 02/13/2025
Date Signed: 02/13/2025 12:57:25 PM

Document Has Been Signed on 02/13/2025 12:57 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:L.A.R.C. INDUSTRIESFACILITY NUMBER:
197600225
ADMINISTRATOR/
DIRECTOR:		GLORIA ALLISONFACILITY TYPE:
775
ADDRESS:26639 VALLEY CTR. DR., #105TELEPHONE:
(661) 254-1946
CITY:SANTA CLARITASTATE: CAZIP CODE:
91351
CAPACITY: 65CENSUS: 39DATE:
02/13/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 2/13/2025 at approximately 9:40 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by Supervisor Corrine Dombovary. LPA stated the reason for their visit.

LPA asked for Census, Staff and Clients Rosters. LPA conducted a physical plant tour at approximately 11:00 AM and the following was noted:

There is only one entrance being utilized at the facility. The facility is a single unit building with Administrative/staff offices, activity rooms, bathrooms, kitchen, and staff lounge. The facilities capacity is sixty-five (65) clients, and during the inspection, thirty-nine (39) clients were present. The licensed facility has a fire clearance for sixty (60) ambulatory clients and five (5) non-ambulatory clients. This facility is vendor through North Los Angeles Regional Center. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available.

Common areas: include activity area, media area, computer/gaming areas, arts/craft area, Lunchroom, Bathrooms, Kitchen, and Administrative/staff offices. Common areas observed to be neat, clean, and organized. All rooms observed to be properly furnished and in good repair. Client personal lockers are provided if needed. The facility maintains a comfortable temperature at 70°F. Multiple working telephones observed. Clients are provided a daily stipend of $35 to use for their daily activities of choice.

Fire extinguishers located throughout the facility and dated 2/4/2025. The facility is scheduled on 03/01/2025, for maintenance and operational use in testing all fire/carbon monoxide alarms. Interconnected fire sprinklers observed. Last Fire Drill conducted on 1/24/25. Emergency and Disaster Plan observed with all proper information readily available in staff room. Required postings Personal Rights and Rights of Individuals with Developmental Disabilities are located alongside administrative/staff offices. (continued on LIC 809-C)

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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: L.A.R.C. INDUSTRIES
FACILITY NUMBER: 197600225
VISIT DATE: 02/13/2025
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Kitchen: Kitchen observed to be clean and inaccessible to pests. The kitchen is equipped with appropriate fixtures. Lunch is not provided by program; however snacks are provided. Working refrigerators are provided for clients to store their own personal lunches if needed. All labeled and organized. Sufficient supplies of disposal cups/plates observed. Locked Administrative office maintains knives and sharps which were observed to be kept in a separate locked box within locked cabinet along with Medication. Staff files kept in locked filing cabinet within Administrative office. Client files are kept in filing cabinets in locked staff room.

Bathrooms: Bathrooms were checked for cleanliness, proper operation, and handicap accessible. The hot water temperature was measured within regulations at 112.5°F. No bodies of water located at this facility.

Laundry Room: The laundry room is located within the back of the facility for client use if needed. Laundry appliances observed to be working and in proper condition. LPA observed cleaning solutions, toxins, and laundry detergents kept locked in back storage closet.

First-aid kit observed to be equipped with but not limited to bandages, scissors, digital thermometer, tweezer, and manual.

Client/Staff Records: LPA conducted a complete file review of Client records. Client records appeared to be complete and updated. Staff records: LPA conducted a complete file review of staff records. Staff records appeared to be complete and updated.

There was no immediate health and safety hazards observed during the day of inspection. Exit interview conducted and a copy of this report was provided to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
LIC809 (FAS) - (06/04)
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