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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336409381
Report Date: 05/31/2022
Date Signed: 05/31/2022 01:25:14 PM

Document Has Been Signed on 05/31/2022 01:25 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:BASIC OCCUPATIONAL TRAINING CENTER SAN JACINTOFACILITY NUMBER:
336409381
ADMINISTRATOR:MITZIE YODITESFACILITY TYPE:
775
ADDRESS:1215 BUENA VISTA, STE F,G & HTELEPHONE:
(951) 487-2725
CITY:SAN JACINTOSTATE: CAZIP CODE:
92583
CAPACITY: 75CENSUS: 35DATE:
05/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:34 PM
MET WITH:Case Manager- Dana GarciaTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA), Janira Arreola made an unannounced visit to the facility to conduct an annual inspection focused on infection control. LPA met with Case Manager, Dana Garcia, who was informed of the purpose of the visit. At the time of visit there was 12 staff and 35 clients present. The facility currently has zero positive or suspected Covid-19 cases.

During today's visit, LPA toured the facility and made observations regarding the infection control measures that the facility has implemented. LPA observed Covid-19 postings at the facility and a single entry point was designated where symptoms screenings and temperature checks occur daily for all visitors, clients, and staff. The facility had an adequate amount of hand hygiene supplies (soap, hand sanitizer, paper towels) in all 5 restrooms. Common areas such as dining areas and activity rooms have been modified with social distancing and masking policies. There are designated isolation rooms and a plan in place to monitor those in the isolation rooms. LPA observed a sufficient 30-day supply of PPE equipment. The facility also has a designated infection control lead and a plan in place to clean and disinfect the highly touched surfaces. Case Manager was able to provide LPA with Mitigation plan LIC808 that the facility is currently following.

There were no deficiencies noted at the time of the visit. An exit interview was conducted, and a copy of this report was reviewed and provided to facility Case Manager, Dana Garcia.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2022
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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