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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197600416
Report Date: 11/16/2024
Date Signed: 11/16/2024 11:26:16 AM

Document Has Been Signed on 11/16/2024 11:26 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
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:WACHTER RESIDENTIAL CAREFACILITY NUMBER:
197600416
ADMINISTRATOR/
DIRECTOR:
WACHTER, FRANKFACILITY TYPE:
735
ADDRESS:28161 HAXTON DR.TELEPHONE:
(661) 252-5402
CITY:CANYON COUNTRYSTATE: CAZIP CODE:
91351
CAPACITY: 4CENSUS: 4DATE:
11/16/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Chase Kuty & Frank WachterTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Tuesday Cabiness arrived to the facility to conduct an annual inspection. LPA met with direct care staff Chase Kuty, who was informed the reason of the visit. Administrator Frank Wachter was notified who arrived shortly after. The current census is (4) and all clients were present during the visit. All required Licensing postings on the walls; and Administrator certificate current and valid until 01/14/2026.

The physical plant tour consisted of: Smoke and Carbon Monoxide detectors tested and functioning properly. Fire extinguisher observed full charged; first aid kit completed. Kitchen: The kitchen was clean and the appliances had functional fixtures. There was a (2) day supply of perishable and seven (7) day non-perishable. Food was properly stored. There is an extra fridge located upstairs with additional perishable and non-perishable. Knives are stored inaccessible in locked cabinet. Cleaning supplies were locked in a cabinet; with laundry supplies located in the garage area. Bedrooms: There are four (4) bedrooms designated for clients use, located on the first floor. Upstairs has (2) rooms that are used for staff and storage. All bedrooms were clean, properly furnished and have sufficient lighting. Bathrooms: There are (2) bathrooms designated for clients downstairs; and (1) bathroom located upstairs. All bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 109.4 degrees F. Common Areas: The common areas (living/dining/family room) appeared clean and were properly furnished. Surrounding Grounds: Entry/exits were free of obstruction; with covered patio and furniture for client's use. Client and Staff Records: Client files included medical assessments, quarterly appraisals; Individual Program Plan, admission agreements, and all other required forms. Staff - Staff files included current first aid and CPR certifications as well as training. Medications: Physician orders for medications and centrally stored medication logs observed. Medications and logs are consistent and appeared to be given as prescribed. Fire and earthquake drill conducted on 11/14/2024. No citations issued during the visit.

Exit interview and copy of report provided to Administrator Frank Wachter.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2024
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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