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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609983
Report Date: 06/04/2025
Date Signed: 06/04/2025 01:24:39 PM

Document Has Been Signed on 06/04/2025 01:24 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:PATHPOINTFACILITY NUMBER:
197609983
ADMINISTRATOR/
DIRECTOR:		VANDENBERG, KARENFACILITY TYPE:
775
ADDRESS:8510 BALBOA BLVD. STE. 100TELEPHONE:
(805) 868-9908
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY: 45CENSUS: 18DATE:
06/04/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Maria Ortiz,Vice President.TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 06/04/25, at 9:25AM, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, annual visit. LPA was met by Office Manager/HR Specialist-Debra Ingram and Maria Ortiz-Vice President.

LPA asked for the census, participant, and staff files. The staff and participant files are digital.

The physical tour started at 11:45am and LPA observed the following:

Common Areas: At approximately 11:45am, LPA and Vice President toured the facility. There is one (1) large activity room that can be divided by a divider to become two (2) activity rooms. LPA observed proper tables and chairs for the participants. All trash cans were observed to have lids. The facility maintains a temperature at 72F. There is a large conference room for meetings. There is another room for storage.



The bathrooms: LPA observed three (3) bathrooms to be clean and have the wash your hands signs posted. One (1) of the bathrooms has a shower that can be used for the participants. Another bathroom has a changing table for incontinence participants. And one (1) bathroom does not have a shower or incontinence change table. The bathrooms have grab bars. The hot water temperature tested in the bathroom is with in required range between 110-115F. Trash cans in all bathrooms have lids. The First Aid kits were observed to be complete. There are two (2) first aid kits.

809C-continued
NAME OF LICENSING PROGRAM MANAGER: Troy Agard
NAME OF LICENSING PROGRAM ANALYST: Gina Saucedo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: PATHPOINT
FACILITY NUMBER: 197609983
VISIT DATE: 06/04/2025
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There are two (2) fire extinguishers observed to be full and last serviced on 05/13/2025. One (1) is located by the conference room and the other one (1) by the activity room.

Kitchen area: LPA observed the kitchen area to be adequately clean. The facility has two (2) refrigerators for participant use. The facility does not keep any food for participants. The participants bring their own breakfast/lunch/dinner. There are two (2) microwaves for participant use. There are no knives or chemicals in this area. The knives are kept in one (1) of the bathrooms locked and inaccessible to the participants.

Medications: There are no medications that are kept at this facility.

There are seven (7) main exit doors. There are four (4) vehicles for transportation into the community/emergency purpose. There are several smoke detectors and fire sprinklers through out the facility. There are no AED's-Automated External Defibrillator in the facility. There is no bodies of water in the facility.

Administration: The Infection control were reviewed and there was Covid 19 signs on the wall, hygiene sanitation signs, Emergency and Disaster Plan, Rights of Individuals with Developmental Disabilities, Facility Sketch, Ombudsman. The Earthquakes, Flood and Fire Drill are up to date. The liability insurance expires 07/01/25.

An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the Vice President.

NAME OF LICENSING PROGRAM MANAGER: Troy Agard
NAME OF LICENSING PROGRAM ANALYST: Gina Saucedo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
LIC809 (FAS) - (06/04)
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