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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401703834
Report Date: 11/19/2024
Date Signed: 11/19/2024 11:18:58 AM

Document Has Been Signed on 11/19/2024 11:18 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:ESCUELA DEL RIO-STARTFACILITY NUMBER:
401703834
ADMINISTRATOR/
DIRECTOR:		DEBORAH ARGANOFACILITY TYPE:
775
ADDRESS:5045 EL CAMINO REALTELEPHONE:
(805) 466-4438
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY: 30CENSUS: 11DATE:
11/19/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:ShannonTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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At 9:00 am on 11/19/24, Licensing Program Analyst (LPA) Rankin arrived at the facility to conduct an unannounced annual inspection visit. LPA contact and met with Shannon Jackson, Program Director (PD) and informed her the reason for the visit.

LPA toured facility with PD. All outdoor and indoor passageways are free of obstruction. There are no bodies of water on the premises. The facility is maintained in conformance with state fire marshal regulations. Smoke alarms and carbon monoxide detector are in working order, facility does monthly checks and testing of these alarms. Fire extinguishers have current tags and are all within the green charge indicator limits. Hot water temperature is also tested monthly, a log showing the monthly reading was provided to LPA. Temperature is within required ranges. All toilets and hand washing facilities are maintained in a safe, sanitary, operating condition. The program site is clean, safe, sanitary and in good repair for the safety and well-being of clients, employees, and visitors. PD did pre-view the tour by stating and showing the LPA there is a small, fenced area in need of repair. LPA observed there is a gate to protect clients from having access and PD stated it is schedule to be repaired by the end of the year. Each client is accorded safe, healthful, and comfortable accommodations, furnishings, and equipment to meet his/her needs. Clients bring their own lunches. Facility has adequate emergency supplies and first aid supplies. Disinfectants, cleaning solutions, sharp utensils and poisons are inaccessible to clients and locked in the kitchen. LPA observed staff sufficient for client ratio.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE: DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2024
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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ESCUELA DEL RIO-START
FACILITY NUMBER: 401703834
VISIT DATE: 11/19/2024
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The most recent emergency disaster drill was conducted on 10/17/24 during the Great Shake Out event for California. PD presented a log showing that drills for various types of disasters are conducted with in regulation requirements.

LPA conducted a file review of five (5) clients. Client files reviewed had tuberculosis results, admission agreements and current needs and services plans. All records are in-compliance.

LPA conducted a file review of four (4) staff for criminal record clearances and associations, Health screening with TB results, current First Aid/CPR, and adequate training hours. All records are in-compliance. One staff is scheduled for 1st aid but does not work alone with clients.

During the tour LPA observed clients in the “big room” participating in an activity together. All clients were alert, and appeared clean, healthy, and engaged in the activity provided by the staff.

Exit interview conducted, and the report given.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
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