<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608650
Report Date: 04/05/2022
Date Signed: 04/05/2022 01:47:55 PM

Document Has Been Signed on 04/05/2022 01:47 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:VISTAS - NORTH HOLLYWOODFACILITY NUMBER:
197608650
ADMINISTRATOR:MICHAEL LEESFACILITY TYPE:
775
ADDRESS:10940 VICTORY BLVD., SUITE 103TELEPHONE:
(818) 509-0150
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY: 45CENSUS: 0DATE:
04/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Yaniv Geller, Senior Program DirectorTIME COMPLETED:
01:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Salia Walker conducted an unannounced required annual inspection. This annual had a specific emphasis on infection control practices and procedures. The LPA met with Senior Program Director (SPD) Yaniv Geller at 12:47 p.m., and explained the reason for the visit. There are currently 0 clients attending the program at the facility. The SPD advised the LPA that the facility has not been open to the public since 3/17/2020, and have been providing hybrid learning to 24 clients. The facility plans on reopening to the public on 04/11/2022 for in person learning.

The LPA conducted a physical plant tour with Yaniv Geller at 12:46 p.m., to ensure there are no health and safety hazards. The facility consists of multiple rooms with activities for the clients to participate in. These rooms include a computer lab, kitchen/breakroom area, arts and craft area, volunteer/ community area, and a rest area. The rest area/ resting room will also be used as an isolation room in the event of COVID-19 exposure in the facility.

Disinfectants and cleaning supplies are stored in the facility’s storage rooms. First aid supplies had required items. The facility has two (2) client restrooms. Between 1:50 p.m. and 1:53 p.m., hot water temperatures measured between 114.8 and 119.8 degrees Fahrenheit in the facility bathroom(s), and kitchen. The restrooms were observed to be clean, sanitary and in operating condition with hand soap, and toilet paper. The food service area was observed. The clients be bringing their own lunch, and snacks to the program. If needed, Medications will be stored in a lock box in the SPD's office. The fire alarm system and pull stations are tested annually by Absolute Fire Inc., and was last serviced on 06/10/2021. The LPA observed two (2) fire extinguishers last serviced on 08/10/21.

Continue on LIC 809C..
SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Salia Walker
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2022
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. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: VISTAS - NORTH HOLLYWOOD
FACILITY NUMBER: 197608650
VISIT DATE: 04/05/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
INFECTION CONTROL: During today’s visit, the LPA spoke with the Senior Program Director regarding the facility’s infection control practices. Upon entry, the facility had a central entry point for symptom screening, temperature checks, and sanitation station. The LPA observed an adequate supply of Personal Protection 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 a single isolation room if the facility has a confirmed case of COVID-19. The facility does not have a confirmed case of COVID-19 at this tim,e and the LPA reviewed facility’s policies and procedures as it pertains to infection control.

No deficiencies cited at this time. Exit interview conducted, and a copy of the report was provided.
SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Salia Walker
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2