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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608493
Report Date: 12/20/2022
Date Signed: 12/20/2022 01:27:58 PM

Document Has Been Signed on 12/20/2022 01:27 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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:UNIVERSAL DAY PROGRAM 2FACILITY NUMBER:
197608493
ADMINISTRATOR:AREVIK MATEVOSIANFACILITY TYPE:
775
ADDRESS:8847 LANKERSHIM BL.TELEPHONE:
(747) 223-2350
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY: 128CENSUS: 53DATE:
12/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Suzie HastingsTIME COMPLETED:
01:45 PM
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Licensing Program Analyst Tuesday Cabiness met Program Director Suzie Hastings, for the facility's annual inspection. Upon entry, LPA was requested to sign in and a computerized thermometer was used to measure LPA's temperature.

During today's inspection, LPA designated rooms for clients to participate in activities, such as vocational and daily living skills, volunteering in the community, Community Access Transition, ASL (American Sign Language), and Zumba classes. The facility has a computer room, exercise room, resting room, kitchen, indoor and outdoor common areas, and several staff offices. The upstairs is used for storage and staff office space only.

All rooms, offices, and common areas appeared to be clean, appropriately furnished, and free of accessible hazards. Bathrooms were clean and contained working fixtures.

Clients bring their lunch to the facility 4 days per week and alternate cooking meals at the facility once per week. The facility does not handle and client medications or personal and incidental funds.

Currently, due to the pandemic, the facility conducts weekly COVID testing for clients and staff. A nurse conducts the testing and sends off to the lab, and results are within (24) hours. There is only one entry door used for staff and clients. Administration continue to receive departmental emails and conducts in-service training on the following subjects: CPR/First Aid, OSHA, Mandated Reporting, Special Incident Reports (SIRs), cleaning the facility, and various topics from the inspection control plan. Program Director reported to LPA, that she sent the plan to Licensing. Facility has a COVID agreement, that must be signed by all staff and clients, which entails mandated requirements to minimize the spread of COVID.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2022
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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: UNIVERSAL DAY PROGRAM 2
FACILITY NUMBER: 197608493
VISIT DATE: 12/20/2022
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There is currently no sick leave policy, but staff are allowed to use there sick leave provided by the facility.

Program Director reported that 95% of clients are vaccinated; not sure of booster information. All staff, except for (1) is not vaccinated, but must participate in weekly COVID testing. New hires are mandated to be vaccinated prior to employment. Facility recommends new client admits to be vaccinated. If not, client will have to participate in weekly testing. Alternative program services are currently provided for only (2) clients; who have opted not to be vaccinated. The facility provides virtual program services; which will expire on December 31, 2022.

Program Director was informed to continue implementing the best practices for the facility and to report any changes to Licensing.

Exit interview conducted..
SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022
LIC809 (FAS) - (06/04)
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