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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197602666
Report Date: 11/27/2023
Date Signed: 11/27/2023 01:13:49 PM

Document Has Been Signed on 11/27/2023 01:13 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:PATHPOINTFACILITY NUMBER:
197602666
ADMINISTRATOR:JENSEN, JAMESFACILITY TYPE:
775
ADDRESS:348 E AVENUE K 4 STE BTELEPHONE:
(661) 723-7484
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 90CENSUS: 73DATE:
11/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Nicholas WilliamsTIME COMPLETED:
01:30 PM
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At 10:15am, Licensing Program Analyst (LPA) Lorena Casillas arrived at facility and met with Nicholas Williams (Program Coordinator) for an unannounced annual visit. Entrance interview conducted.

Infection control: LPA reviewed facility infection control plan (approved on 10/17/2022) to make sure licensee was following current infection control recommendations.

Administration: LPA received LIC 500 and Client roster.

Physical plant: At 11:06 am, LPA and Program Coordinator toured the facility. LPA observed tables and chairs to be in adequate repair. LPA observed there to be no obstructions of passageways. Walls and floors were clean, and in good repair. Equipment and supplies used for day program appear to be in good repair. All trash cans were observed to have lids. The facility maintains a comfortable temperature at 70 F. The last annual fire alarm test was conducted on 7/07/2023 by the 5 Alarm Fire Corporation. Fire extinguishers last charged on 5/01/2023 and routinely checked by staff monthly with last recording on 11/06/2023. The First Aid kit was observed and had necessary equipment.

Kitchen area: LPA observed the two kitchen areas to be neat and clean. Consumers bring their own snacks.
Bathrooms: LPA observed the bathrooms to be clean and have the wash your hands signs posted. The hot water temperature measured in bathroom at 118.6 F. Trash cans in all bathrooms have lids to protect consumers from cross contamination.

Continued...
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE: DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: PATHPOINT
FACILITY NUMBER: 197602666
VISIT DATE: 11/27/2023
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Staff Files: All files are digital. LPA reviewed staff files with Administrator at 11:42 am.

Client Files: All files are digital. LPA reviewed client files with Administrator at 12:00 pm.

Staff Interviews: LPA conducted staff interviews at 12:30 pm.

Client Interviews: LPA conducted client interviews at 1:00 pm.

The facility does not assist with any consumer medications at this time. LPA observed cleaning supplies and PPE in the locked hallway closet.

There are no citations at this time. Exit Interview Conducted. Copy of report delivered to Program Coordinator.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023
LIC809 (FAS) - (06/04)
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