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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197603521
Report Date: 02/17/2022
Date Signed: 02/17/2022 11:21:21 AM

Document Has Been Signed on 02/17/2022 11:21 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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:TLC SUPPORT CENTERFACILITY NUMBER:
197603521
ADMINISTRATOR:SANDOVAL,JUANFACILITY TYPE:
775
ADDRESS:7915 LINDLEY AVENUETELEPHONE:
(818) 708-1740
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY: 30CENSUS: 0DATE:
02/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Juan Sandoval and Mario MurrietaTIME COMPLETED:
11:35 AM
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At approximately 9:50 AM on 02/15/22, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection using the Infection Control Domain of the Compliance and Regulatory Enforcement (CARE) Tools. LPA met with Administrator and Administrative Supervisor and disclosed the reason for the visit.

Census: 0

Due to the COVID-19 Pandemic, the Day Program’s physical site has not accommodated clients in person since March of 2020. Programs have been conducted virtually. The building had two stories. Offices and day program were on the second level, while a Child’s Center and playground was on the first floor. In the Day Program, there were two common areas, a kitchen, 3 bathrooms, and a locked office.

Entry: The front yard was well-maintained and surrounded by an unlocked gate. The facility monitored the premises with surveillance cameras at the front and sides of the building. Signs regarding the facility’s COVID-19 policies, such as masking and social distancing requirements, hung on the front door. The facility had one main entrance designated for screening visitors, staff, and clients. Inside, LPA observed signs for social distancing, hygiene, and masking.

Screening: Upon entry, LPA was screened by staff. LPA recorded temperature and symptom information in a visitor log. LPA observed a screening station which contained a digital thermometer, surgical masks, sanitizer, and gloves.

Bathrooms: The facility had 3 bathrooms. A Men’s Bathroom and a Women’s Bathroom were near the front entrance and had multiple stalls. A private bathroom was in the common area in the south side of the building. All bathrooms contained fully stocked liquid soap, paper towels, and trash cans. LPA suggested a handwashing instruction sign and tight-fitting lids for trash cans in bathrooms.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2022
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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: TLC SUPPORT CENTER
FACILITY NUMBER: 197603521
VISIT DATE: 02/17/2022
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Common Areas: All common areas were clean. All furniture was in good repair. Seating was arranged to accommodate social distancing. All floors and ceilings were clean and free from obstruction.

Kitchen: The kitchen contained a sink, a microwave, and a refrigerator with an emergency food supply. All areas were sanitary.

Office: Near the kitchen, LPA observed a locked office with a medication cart.

Safety: LPA observed an Emergency Evacuation Plan and a Personal Rights positng at the front entrance. Emergency exits paths were clear, unlocked, and had functioning auditory alarms. LPA observed 2 inflatable gurneys, 2 wheelchairs with gait belts, and an emergency evacuation chair at the rear emergency exits. Smoke detectors were hard-wired throughout the building, and fire sprinklers were installed throughout the building. Water temperature tested in the Men’s Bathroom was 118.2 degrees Fahrenheit. LPA observed fully-charged fire extinguishers in both common areas. The facility had first aid kits at the front entrance and in the southern common area.

Mitigation: Staff test for COVID-19 two times per week. Staff clean the facility every two hours and sanitize materials after use.

LPA conducted exit interview and issued report.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
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