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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197606198
Report Date: 12/16/2024
Date Signed: 12/16/2024 02:04:49 PM

Document Has Been Signed on 12/16/2024 02:04 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. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:PATHPOINTFACILITY NUMBER:
197606198
ADMINISTRATOR/
DIRECTOR:
DESTINY NADEAUFACILITY TYPE:
775
ADDRESS:1463 E LOS ANGELES AVETELEPHONE:
(805) 520-8744
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY: 45CENSUS: 25DATE:
12/16/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:55 AM
MET WITH:Riley Breen, Facility DesigneeTIME VISIT/
INSPECTION COMPLETED:
02:05 PM
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Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit. The LPA met with Facility Designee Riley Breen. Reason for the visit was discussed.

The program currently operates from 09:00AM to 03:00PM.

Beginning at 01:21PM, LPA along with Facility Designee, toured the physical plant area to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. The following was observed:

Common Activity Space: The facility is a two-story structure. Downstairs contains activity rooms, a conference room, two (2) bathrooms, office, and a food service area. The second floor includes administrative offices, activity room, one (1) bathroom, and a conference room. The LPA did not observe any obstructions or hazards. Fire extinguishers were charged and serviced 06/25/2024. Fire safety systems are checked bi-annually.

Food Service: The kitchen area was clean and in good condition. Persons served bring their lunch and snacks or purchase them in the community.

Restrooms: Restrooms observed to be clean and sanitary and stocked with soap, paper towels and toilet paper. Water temperature was measured in bathrooms and was within the required range.

During today's annual, LPA Dulek visited and toured the day program today to determine if it is feasible to convert the day program into an emergency shelter when a natural disaster happens in the area. Further discussion will occur between the Regional Centers and the Department of Developmental Services. Licensee will be notified once a decision is made.

No deficiencies cited. Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
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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