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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608406
Report Date: 06/02/2022
Date Signed: 06/02/2022 03:54:44 PM

Document Has Been Signed on 06/02/2022 03:54 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:E-SOLFACILITY NUMBER:
197608406
ADMINISTRATOR:MICHAEL STEPHENSFACILITY TYPE:
775
ADDRESS:7144 BALBOA AVENUETELEPHONE:
(818) 881-4427
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY: 49CENSUS: 17DATE:
06/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Haley RhyneTIME COMPLETED:
04:00 PM
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Licensing Program Analysts (LPA) Brian Balisi conducted an unannounced required annual visit. This annual had a specific emphasis on infection control practices and procedures. Upon arrival LPA met Program Director Haley Rhyne  and Michael Stephens Director and explained the reason for the visit.

The LPA, along with Hailey Rhyne toured the physical plant areas inside and outside at approximately 2pm to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations.

There were (17) clients in the facility participating for services at the time of visit.   Director stated client participation varies daily.

Kitchen appliances appeared to be clean and operable condition at this time.  The facility has a sufficient supply of perishable and non-perishable snacks properly stored.  All knives and sharp objects were observed to be inaccessible at time of visit stored in a locked cabinet. Kitchen appliances are disinfected throughout the day and are also wiped down after every use. There were several fire extinguishers located in the hallways which were observed to be fully charged and last serviced in March of 2022. First Aid kit was observed to be complete during the time of the visit.

LPA observed a utility room, which stored PPE, cleaning supplies, emergency supplies, and other facility supplies at this time. Public restrooms were observed to be clean and sanitary and in operating condition.  The LPA observed sufficient amounts of soap and paper products in each restroom, as well as hand washing posters. Hot water measured between 108 - 113 degrees Fahrenheit. There were (2) vending machines located near the entrance way of the facility. Hand sanitizer was readily available upon use of vending machine. Extra PPE supplies were also observed on a metal shelf across from the vending machines as well as stored in a drawer in the administrative area.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE: DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2022
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: E-SOL
FACILITY NUMBER: 197608406
VISIT DATE: 06/02/2022
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Continued from 809
In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and office furniture were observed to be in good condition. Chairs were observed to be at least 6 (six) feet apart for social distancing. There are two (2) multipurpose rooms that include an activity room and a computer/gym room. The common areas appeared clean and were properly furnished. Equipment was observed to be functioning and in good condition during the time of the visit. All high traffic surfaces and equipment are disinfected throughout the day and after every use. The facility maintains a comfortable temperature for consumers.

The LPA observed the required postings throughout the facility.LPA observed a large open outdoor area in which program activities are provided. At 2:15pm, LPA observed majority of participants playing outside. Furniture's were observed in good repair. Other equipment used for activities appears to be in adequate condition at this time.  LPA did not observe any obstructions or hazards to emergency exits at the time of visit.
There is a shaded seating area in the rear of the facility next to the parking lot. LPA observed outdoor furniture appropriate for outdoor use.  LPA observed a storage shed, which stored gardening supplies. There is a gate that surrounds the exterior of the building and parking lot. LPA observed gate to be open at this time. LPA did not observe any obstructions to exits at this time.

INFECTION CONTROL: During today’s visit, the LPA spoke with the staff regarding  the facility’s infection control practices. Upon entry, the facility has a single entry point for symptom screening. The LPA observed an adequate supply of Personal Protective Equipment (PPE) and the facility is able to obtain additional supplies as needed.  The facility’s cleaning protocol is sufficient.  If needed, the facility has the capacity to designate  the staff lounge as the single isolation room if the facility has a confirmed case of COVID-19. The facility’s policies and procedures as it pertains to infection control are adequate at this time.

Exit interview conducted. Report issued and sent via email.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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