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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197606270
Report Date: 11/28/2022
Date Signed: 11/28/2022 10:55:44 AM

Document Has Been Signed on 11/28/2022 10:55 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:DENOGEAN ADULT RESIDENTIAL FACILITYFACILITY NUMBER:
197606270
ADMINISTRATOR:RICHARD W. DENOGEANFACILITY TYPE:
735
ADDRESS:10712 ARTRUDE STREETTELEPHONE:
(818) 353-8214
CITY:SHADOW HILLSSTATE: CAZIP CODE:
91040
CAPACITY: 4CENSUS: 0DATE:
11/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Richard DenogeanTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Tuesday Cabiness arrived at the facility to conduct an unannounced infection control visit. Upon entry, LPA was greeted by Administrator Richard Denogean, who allowed LPA to enter. LPA’s temperature was taken upon entry, and a cleaning station, or sign-in/visitor record book was located at the front door. There are currently (5) staff and (4) clients that are vaccinated and recently received the 5th booster and flu shot 11/2022.The current census is (4), and during today's visits, clients were at day program. When clients return from program, they are screened at the facility and screened upon entry at program. Clients do not wear mask, but all staff are required. LPA was made aware, if there is an outbreak at program, the facility will close at least (5) days. Client are tested as well. LPA observed staff to have full mask covering. LPA observed signs at the front door.

LPA reviewed the new infection control plan with the the Administrator. It was detailed with mitigation plans to ensure the facility maintains COVID and public health protocols. The facility is a single story home, that is divided, with an additional separate living quarter used for clients. LPA observed the property, and there are (2) shared rooms, and a private bathroom. The common areas were observed to be clean, including bathrooms, with soap and towels. The facility conducts COVID testing for clients and staff as needed. The facility maintains in-house testing kits. At this time, there is no plan to re-hire new staff, but facility maintains all new employee hires are required to be vaccinated before employment. There is paid sick leave policy in place. Administration continues to conduct training to staff in relation to COVID-19 and other related topics pertaining to regulations. LPA reviewed staff files for current CPR/First Aid certificates and current training records. Administrator reported the facility receives departmental emails. LPA reviewed client files for updated reports, such as IPP (Individual Program Plan) from Regional Center.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2022
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: DENOGEAN ADULT RESIDENTIAL FACILITY
FACILITY NUMBER: 197606270
VISIT DATE: 11/28/2022
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There is (1) single designated room for potential positive COVID clients. Facility has a sufficient supply of PPE. Currently, the facility has sufficient staff, and has a contract with an hiring agency if needed. Visiting is conducted outside on the patio; and visitors must wear a mask. Procedures are in place for clients when leaving and returning to the facility. The Administrator informed LPA that they continue to implement the best practices for their facility, which has kept them COVID-19 free. They continue to clean (3x) a day, and has a checklist to ensure safety procedures. The facility is aware to report any changes with clients and staff to Licensing and there LPA, pertaining to positive COVID-19 cases.

Exit interview was conducted with Administrator.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022
LIC809 (FAS) - (06/04)
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