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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610304
Report Date: 08/23/2024
Date Signed: 08/23/2024 12:15:30 PM

Document Has Been Signed on 08/23/2024 12:15 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:WATKINS VITAL CARE PROGRAMFACILITY NUMBER:
197610304
ADMINISTRATOR/
DIRECTOR:		GIACOPUZZI, MALLORYFACILITY TYPE:
775
ADDRESS:3819 OCEAN VIEW BLVDTELEPHONE:
(818) 334-5592
CITY:MONTROSESTATE: CAZIP CODE:
91020
CAPACITY: 15CENSUS: 7DATE:
08/23/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:19 AM
MET WITH:Mallory Giacopuzzi, Administrator TIME VISIT/
INSPECTION COMPLETED:
12:25 PM
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Licensing Program Analyst (LPA) Abeye Duguma met with administrator, Mallory Giacopuzzi, for a One (1) Year Required visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at 09:00am and the following was noted:

There is only one main entrance being utilized at the facility. The facility has enough PPE supplies. Furniture are neat and clean. The facility is fire cleared for fifteen (15) ambulatory. Cleaning agents and other toxins are locked away.

Kitchen is sufficiently stocked to support lunch and snack time for the seven (07) currently active day program participants. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents.

The facility maintains a comfortable temperature at 76°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located near the kitchen, observed to be full and last inspected on 05/15/2024. LPA observed medication and first aid kit to be locked and inaccessible to clients. Residents have enough hygiene products provided by the licensee. The bathrooms were checked for cleanliness and proper operations. The hot water temperature was measured at 112.8°F.

No health and safety hazards noted during the visit.

Exit interview conducted.

A copy of this report was issued.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2024
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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