197609662-1-31-2022-31-AS-NRED-CB7UFW-20220131143326

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197609662
Report Date: 01/31/2022
Date Signed: 01/31/2022 02:35:11 PM

Document Has Been Signed on 01/31/2022 02:35 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:	TEEN PROJECT INC, THE		FACILITY NUMBER:	197609662
ADMINISTRATOR:	BURNS, LAURI LYNNE		FACILITY TYPE:	772
ADDRESS:	8142 SUNLAND BLVD		TELEPHONE:	(818) 582-8832
CITY:	SUN VALLEY	STATE: CA	ZIP CODE:	91352
CAPACITY: 16		CENSUS: 7	DATE:	01/31/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:53 AM
MET WITH:	Nicole Negrete		TIME COMPLETED:	02:33 PM

NARRATIVE

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At approximately 11:53 AM on 01/31/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with Program Director and disclosed the reason for the visit. The visit was conducted using the Infection Control Domain of the Compliance and Regulatory Enforcement (CARE) Tools.

The facility has a Mitigation Plan which is approved by the Department.

Census: 7

The facility contains 8 shared bedrooms with a maximum capacity of 16.

At approximately 12:20 PM, LPA conducted the physical plant tour.

Outside Areas: LPA observed fresh painted walls outside with artistic designs. There was a basketball hoop and two recreation areas shaded by tents. The tents were secured by screws in the asphalt. Recreation areas contained chairs and benches for seating. A ramp with secure handrails on the north side of the facility led to a well-maintained courtyard with seven planter boxes. The courtyard served as the facility’s designated visitation area.

Entrance: LPA observed one main entrance with 3 signs on the front door related to COVID-19. One sign pertained to a masking requirement. Another sign from the LA County Department of Public Health indicated a limited visitation policy. The main entrance was locked from the outside but unlocked from the inside. Upon entry, LPA observed signs related to COVID-19 policies such as handwashing practices, cough etiquette, signs and symptoms, PPE donning and doffing, and testing requirements.

Screening: LPA was screened upon entry. LPA recorded temperature and symptom check in the visitor log. LPA also observed a screening log for employees. On the screening station, LPA observed 3 bottles of hand sanitizer, surgical masks, 2 digital thermometers, gowns, face shields, and cleaning wipes.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

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: TEEN PROJECT INC, THE	FACILITY NUMBER: 197609662
	VISIT DATE: 01/31/2022

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LPA observed two offices prior to the main facility recreation area. Past the two offices, LPA observed a locked Medication Room, a Therapist Room, Case Manager Room, a locked Laundry Room, 2 bathrooms, a Dining Area, a Television Area, and 8 bedrooms.

Bedrooms: The facility contained 8 shared bedrooms. Bedrooms #1, #2, #3, and #4 were separated from Bedrooms #5, #6, #7, and #8 on opposite sides of the facility. The facility can designate vacant bedrooms for isolation purposes.

Bathrooms: The facility had 4 bathrooms. Bathrooms #1 and #2 were located at the front for staff and visitors. Bathrooms #3 and #4 were located by the laundry room. Bathroom #3 is a private bathroom which could be designated for isolation purposes. Bathroom #4 contained showers, multiple stalls, and sinks. All bathrooms contained fully stocked soap, paper towels, signs for handwashing instructions, and trash cans with tight-fitting lids.

Common Areas: LPA observed clients at Recreation Area and a Television Area. Couches in the Television Area were arranged at least 6 feet apart, and LPA observed signs throughout the facility promoting social distancing, masking, and other COVID-19 related precautions. All common spaces were clean, odorless, and tidy. Laundry: The facility has a locked laundry room with a washer, a dryer, and cleaning supplies inside. The facility is able to sanitize the machines between loads.

Fire Safety: LPA observed a fully charged fire extinguisher with monthly documented inspections The most recent inspection occurred on 01/21/22.

Emergency Exits: LPA observed two emergency exit doors which were unlocked and free from obstruction.

At approximately 1:11 PM, LPA reviewed the facility’s Mitigation Plan and Infection Control Practices with Program Director and Head Nurse.

Mitigation: The facility provides access to a free telephone as well as video communication in offices. Staff conduct 30 minute rounds to monitor all clients. Staff provide 24 hour supervision to clients. The Head Nurse monitors clients on a daily basis for vital signs, blood pressure, temperature, and symptoms of COVID-19. All staff are fully vaccinated or have a religious exemption on file. The facility provides rapid tests for any symptomatic clients or staff. All staff were wearing face masks.

LPA conducted exit interview and issued a copy of report.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

LIC809 (FAS) - (06/04)

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