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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602949
Report Date: 07/11/2024
Date Signed: 07/11/2024 06:32:03 PM

Document Has Been Signed on 07/11/2024 06:32 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.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:VALLEY CARE LLCFACILITY NUMBER:
198602949
ADMINISTRATOR/
DIRECTOR:		RECTO CECILEFACILITY TYPE:
735
ADDRESS:2220 N LAMER STREETTELEPHONE:
(818) 263-4222
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY: 4CENSUS: 2DATE:
07/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:19 PM
MET WITH:Cecile Recto - AdministratorTIME VISIT/
INSPECTION COMPLETED:
06:35 PM
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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced Required One (1) year visit to this facility. LPA met with Administrator Cecile Recto and explained the purpose of the visit. This is a Frank D. Lanterman Regional center vendored facility Level II.

At 3:35 PM, LPA conducted a physical plant tour assessment with the Administrator and the following was noted:

The main door is the only entrance being utilized for entry. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Mitigation and Infection plan.

Hand washing, coughing etiquette, physical distancing and other signs were posted in the bathroom and all over the facility. All trash cans were observed to be with cover. The facility has a designated visitors' area at the backyard. The facility has sufficient stock of PPE in the storage room.

Facility has four (4) private client bedrooms. There are three (3) additional bedroom designated for staff use. The facility has three (3) bathrooms, two (2) is designated for staff use. There is no body of water in the facility.

Bedrooms were toured and observed to be clean and have appropriate lighting and furniture.
Bathrooms were observed to be clean and have necessary supplies. Hot water temperature measured at
117.2°F Linen closet was also inspected and observed to have sufficient stock of clean linen and towels.

(continued on LIC 809-C)
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE: DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/11/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: VALLEY CARE LLC
FACILITY NUMBER: 198602949
VISIT DATE: 07/11/2024
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(continued from LIC 809)

Physical plant was checked for cleanliness and condition. Facility was observed to be in good repair and clean during today's visit.
Living and dining room furniture were also checked for functionality (wear and tear). Furniture was observed to be in clean and in good repair.
Kitchen area was observed to be clean and sanitary. All disinfectants, cleaning solutions and poisons are locked in the cabinet inside the garage.
Food. The facility was observed to have sufficient food supply for clients. Temperature of facility wall thermostat was set at 74.0°F to and observed to be within the required range.
Fire extinguisher was observed in the living room wall. Extinguisher was observed to be operable and current, last bought on 12/06/23.
Garage is attached from the home and being used as a frozen and emergency food storage, PPE, tools and toxins storage and observed to be locked and inaccessible to residents. Laundry area is located in the backyard immediately after garage exit. Laundry soap and other toxins are kept in the locked garage.
Medication were observed to be locked, inaccessible and stored in a kitchen cabinet. First aid kit was located in the medication cabinet was observed to be complete.
Client records were reviewed for current IPPs or Needs and Service plans. physician report, admission agreements and P&I funds. Client records appeared to be complete and updated.
Staff records were also reviewed. Staff present has criminal record clearances and associated to this facility. Current training and first aid/CPR observed for staff on duty. Administrator's certificate observed to be current.

Disaster drill was last conducted on 05/16/24. Required posting observed in facility (including complaint hot line poster).

There is no health and safety hazard observed during today's inspection.

Exit interview conducted. Copy of this report provided.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024
LIC809 (FAS) - (06/04)
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