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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197606385
Report Date: 10/16/2024
Date Signed: 01/15/2025 04:37:33 PM

Document Has Been Signed on 01/15/2025 04:37 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/
DIRECTOR:		MARY KAY SAWYERFACILITY TYPE:
775
ADDRESS:295 S. ARCADE DRIVETELEPHONE:
(805) 652-0541
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY: 100CENSUS: 85DATE:
10/16/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:10 AM
MET WITH:Jennifer Chavez, Program SupervisorTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Annual Inspection to the facility. LPA met with Jennifer Chavez, Program Supervisor.
The program is a non-profit Adult Day Program. The program is part of The Arc of Ventura County, Inc, a non-profit corporation 501(3)(b). The facility operates in a building owned by the non-profit corporation and is located in a mostly residential area of the City of Ventura with access to local eateries and retail businesses. The facility hours of operation are Monday through Friday, 8:00 am to 2:30 pm.
The program is a multi-level program serving participants with developmental and/or intellectual disabilities (DD/ID). The facility has a service contract with Tri-Counties Regional Center. The program is structured towards each participant’s Individualized Support Plan (ISP). Participants have options to actively create various art works such as ceramic and wood sculptures, paintings, drawings, and other various arts and crafts. Participants receive job training assistance and some participants are paid employees who work on the facility site. The program is a community based day program that includes participants volunteering at a privately owned community based gardening/farm program; provide companionship to residents in a senior convalescent center; and provides assistance with maintenance at local parks, the harbor, the recreation center, and the YMCA.

Entrance interview conducted:
At the time of arrival, there were 55 participants participating in various projects with 14 staff and the Program Supervisor in attendance.
LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and to ensure facility is in compliance with Title 22 Regulations. The facility has seven (7) fire extinguishers last serviced on 6/26/2024. LPA observed carbon monoxide detector and smoke alarms are in good working order.

Please continue to 809-C, Pg 2.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2024
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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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. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ARC VENTURA COUNTY(ARCADE)
FACILITY NUMBER: 197606385
VISIT DATE: 10/16/2024
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 The facility consists of a kitchen, four bathrooms, a movie room, a garden area, a turtle pond surrounded by a safety fence, and a multi-purpose room with side work rooms, IT room, and a staff lounge. The kitchen consists of an industrial oven, a sink, convection oven/air fryer, toaster, and blender. Sharps are kept in a locked drawer in the kitchen area.
LPA observed six (6) First Aid cabinets were complete. Thermometers are kept in a separate secure location.
The facility has seven (7) vehicles located on the premises. Six vehicles are for participant and staff transport. Each vehicle is equipped with a First Aid kit and fire extinguisher.
LPA reviewed Personnel records for various trainings including First Aid/CPR training, criminal background clearance, and health screening. All staff records and trainings are up to date.
LPA reviewed Participant’s records for health screenings, admission records, Individual Program Plan (IPP), Needs and Services, Pre-Placement Appraisals and Appraisals. All participant’s records were in good order.

Exit interview conducted. No deficiencies noted. Copy of report issued at the time of the visit.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024
LIC809 (FAS) - (06/04)
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