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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197600690
Report Date: 05/23/2022
Date Signed: 05/23/2022 12:59:39 PM

Document Has Been Signed on 05/23/2022 12:59 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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:THERAPEUTIC LIVING CENTERS FOR THE BLINDFACILITY NUMBER:
197600690
ADMINISTRATOR:HITZ, JADEFACILITY TYPE:
735
ADDRESS:17712 PARTHENIATELEPHONE:
(818) 349-3440
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY: 6CENSUS: 2DATE:
05/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Joshua Cration - AdministratorTIME COMPLETED:
01:10 PM
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At 12:00 p.m. Licensing Program Analyst (LPA) Melissa Ruiz arrived at the facility to conduct an annual infection control inspection. Upon entry, LPA observed covid infection control signs posted outside and throughout the facility. LPA was greeted by a staff member and the later met with the facility administrator, Joshua Ceation. All staff were observed to be wearing masks. LPA’s temperature was taken, infection control questions were asked and LPA was signed in the visitors log.

This is a five (5) bedroom, four (4) bathroom single story home. LPA was able to tour the home and did not observe any immediate health and safety concerns. Sufficient PPE supplies were observed. The fire extinguisher was observed in the kitchen area and fire alarms were last tested on 02/28/2022. LPA observed there to be sufficient stock of one-week non-perishable foods and two-day perishable foods. Sharps, cleaning supplies and medications are centrally stored and are kept locked. Extra towels and linens were readily available. The backyard is clean, has a covered shaded area and there are no bodies of water.

The facility is currently following their mitigation plan and no deficiencies were observed during today’s visit. Report was signed and delivered. An exit interview was conducted with the Administrator.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Melissa Ruiz
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2022
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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