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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336409382
Report Date: 05/10/2024
Date Signed: 05/10/2024 10:52:02 AM

Document Has Been Signed on 05/10/2024 10:52 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:BASIC OCCUPATIONAL TRAINING CENTER, INC.FACILITY NUMBER:
336409382
ADMINISTRATOR/
DIRECTOR:		MITZIE YODITESFACILITY TYPE:
775
ADDRESS:1323 JET WAYTELEPHONE:
(951) 657-8028
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY: 105CENSUS: 65DATE:
05/10/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:37 AM
MET WITH:Case Manager, Cheree VogelTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced required annual visit. LPA met with Case Manager, Cheree Vogel who was informed of the purpose of the visit.

The facility is an adult day program comprised of a two story building comprised with activity rooms, staff offices, outdoor space, restrooms, and 2 kitchenettes. There are no pools or fire arms on the premises. LPA observed the following:

Infection Control: LPA observed hand hygiene supplies and cleaning supplies to do regular cleaning of the facility and training on infection control procedures.

Physical Plant: Physical plant, floors, windows, and doors were observed to be clean and fixtures and furniture were present and in good repair. LPA observed the incontinent supplies used for clients and activity materials. The facility's outdoor area was observed to be free of hazards. The carbon monoxide detector was tested and operational during the visit. Hot water temperature was read at 105.6F in a client restroom. Hazardous items such as cleaners were observed to be locked.

Food Service: LPA observed facility kitchenette to store meals. The facility does not provide meal service to clients. LPA observed area were client snacks are stored.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: BASIC OCCUPATIONAL TRAINING CENTER, INC.
FACILITY NUMBER: 336409382
VISIT DATE: 05/10/2024
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Record Review and Resident/Staff Files: LPA reviewed staff records and training along with CPR/First Aid. LPA reviewed the administrators certificates for staff. LPA found all staff files possessed required paperwork. Client files were reviewed and possessed all required paperwork.

Health Related Services/ Incidental Medical Services: Client medications are not administered or stored at the facility. None were observed during the time of the visit.

Disaster preparedness: LPA reviewed documentation showing last fire drill. All emergency exits were observed to be free of obstructions. LPA observed the facility's emergency disaster supplies.

No deficiencies were cited at the time of the visit. An exit interview was conducted where a copy of this report was reviewed and provided to Case Manager, Cheree Vogel.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024
LIC809 (FAS) - (06/04)
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