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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197606385
Report Date: 10/16/2023
Date Signed: 10/16/2023 12:57:45 PM

Document Has Been Signed on 10/16/2023 12:57 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:ARC VENTURA COUNTY(ARCADE)FACILITY NUMBER:
197606385
ADMINISTRATOR:MARY KAY SAWYERFACILITY TYPE:
775
ADDRESS:295 S. ARCADE DRIVETELEPHONE:
(805) 652-0541
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY: 100CENSUS: 60DATE:
10/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:May Kay Sawyer / AdministratorTIME COMPLETED:
02:30 PM
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 At 10:00am on 10/16/2023, Licensing Program Analyst (LPA) Jeffries arrived at the facility to conduct the annual inspection. LPA met with Administrator Mary Kay Sawyer, announced who he was and the reason for the inspection.
At 10:10am Administrator and LPA conducted a tour of the facility. This day program is on a small campus with two main buildings. There are two outside areas within the inter-perimeters of the campus grounds. Both have table and umbrellas for shade for clients there is a small pound that is fenced in the main outside patio for clients enjoyment. The main building had has administrative and operation offices, 7 large rooms for client activities and seven bathrooms for client and staff use. The separate building at the back of the campus has two large rooms for client activities and one bathroom One of the client activity rooms is currently under construction to repair a corner of the room that suffered water damage. That repair is in progress and expected to be finished in a timely manor. LPA observed restrooms to have liquid soap and paper towels and be in functioning condition. LPA noted that the water pressure in the facility was functioning but weak, which created a delay in hot water making to faucet. Water temperature was tested and found to be within regulation parameters of 105-120*(f). LPA noted that the refrigerator in the back building needed to be cleaned and that cleaning was mitigated during the annual inspection visit. LPA observed required postings on different walls in the facilities entrance and administrative office hallway. LPA observed fire extinguishers throughout the facility to all be tagged and in the green status for functioning. LPA observed 5 complete first aide kits throughout the facility. LPA reviewed a sample amount of client Centrally Stored Medication records and found them to be in good order and within regulation requirements. LPA observed that the facility to be in overall clean and in good repair, with all hallways and exits to be free and clear of obstruction.
At 11:30am Administrator and LPA conducted the full review of the annual care tools. LPA did not find any violations, citations or technical during the full review. LPA did not find any citations or violations during this annual inspection

Exit interview, report read and report provided.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Mark Jeffries
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2023
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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