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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005250
Report Date: 06/19/2024
Date Signed: 06/19/2024 01:57:07 PM

Document Has Been Signed on 06/19/2024 01:57 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:VOCATIONAL VISIONSFACILITY NUMBER:
306005250
ADMINISTRATOR/
DIRECTOR:		CHELSAE MANSFIELDFACILITY TYPE:
775
ADDRESS:26041 PALATELEPHONE:
(949) 837-7280
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 120CENSUS: 68DATE:
06/19/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Timothy Chervenak- Executive Director
Bob Henning- Director of Operations
Chelsae Mansfield- Administrator		TIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1 Year Inspection using the Care Inspection Tool. LPA Cho was greeted and granted entry and met with Administrator (Admin) Chelsae Mansfield and Director of Operations (DOO) Bob Henning.

The facility is a two story structure. The client census is sixty-eight (68) and twelve (12) staff are present. The fire clearance is approved to serve twenty-five (25) non-ambulatory clients of which four (4) are non-ambulatory during today's visit.

LPA toured the two floors accompanied by DOO Henning and Admin Mansfield. LPA observed the following areas: client work space, computer room, restrooms, med room/isolation room, break room, cleaning supply room, computer room, and office spaces. LPA observed all areas to be clean, sanitary, and operational. The furniture were in good condition. All restrooms observed to have sufficient supply of soap, toilet paper, and paper towels. Hot water measured within the range of 108.1 and 112.1 degrees Fahrenheit in the three client restrooms. LPA observed fire and sprinkler systems were inspected quarterly and were maintained in conformity with the State Fire Marshal per inspection report dated June 4, 2024. Fire extinguishers were observed to be mounted and serviced on May 3, 2024. Emergency drills which includes: water leak, fire, earthquake, power outage, intruder lock down are conducted six times a year. The water leak drill was conducted on February 12, 2024, fire drill on April 2, 2024, power outage drill on April 30, 2024, intruder lock down drill on June 17, 2024. The earthquake drill is scheduled to be conducted in October 2024 with the medical emergency drill scheduled in November 2024. Disinfectants, cleaning solutions, and sharp times were inaccessible to the clients in care. LPA observed the emergency disaster supplies and food/water in the outdoor shed. Facility does not handle medications, however facility does store a three day supply of emergency medication in the event of an emergency if clients opted in the emergency medication consent program.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2024
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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: VOCATIONAL VISIONS
FACILITY NUMBER: 306005250
VISIT DATE: 06/19/2024
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There are no food preparation areas on site however clients can purchase snacks as needed. There were no health and safety hazards observed during the inspection.

LPA conducted an audit of seven clients' files and two staff files. No discrepancies were noted. Staff and resident interviews were also conducted.

Based on the observations made, there are no deficiencies cited in this review as per Title 22, Division 6, Chapter 3 of the California Code of Regulations. An Advisory Note (LIC9102) was issued during the visit.

An exit interview was conducted with Executive Director Timothy Chervenak, Director of Operations Bob Henning, and Administrator Chelsae Mansfield, and a copy of this report was provided.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
LIC809 (FAS) - (06/04)
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