<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 405800703
Report Date: 11/02/2022
Date Signed: 11/02/2022 02:51:53 PM

Document Has Been Signed on 11/02/2022 02:51 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:OPTIONS - CIS - ATASCADEROFACILITY NUMBER:
405800703
ADMINISTRATOR:CHRISTINA HUTCHISONFACILITY TYPE:
775
ADDRESS:5185 EL CAMINO REALTELEPHONE:
(805) 462-0550
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY: 25CENSUS: 15DATE:
11/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:17 PM
MET WITH:Christina Hutchison, Administrator/Program Director, and Verneda Robinson, Program SupervisorTIME COMPLETED:
02:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 11/02/22 at 1:17 pm, Licensing Program Analyst (LPA) Chavez conducted an unannounced on-site annual infection control visit to the facility above. LPA met with Verneda “Neda” Robinson, Program Supervisor, and explained the purpose of the visit. At 1:45 pm, Christina Hutchison, Program Director/Administrator, arrived at the facility, and LPA informed her of the reason for the visit.

LPA toured the facility with the program supervisor and observed the following: The facility has infection control signage at the front door and signage throughout the facility on handwashing and use of masks. Upon entry to the facility, LPA was screened. Staff and clients are wearing masks. The facility has soap and paper towels in bathrooms (3). Fire extinguishers are located in the entryway and kitchen. The extinguishers are fully charged and were inspected on 6/15/22. The facility has a cement slab in the backyard that is exposed due to corrosion and is a potential safety hazard. Licensee will seal the area, take a photo, and send to CCL by 11/9/22. The facility has broken gutter piping near the back door. Licensee will repair, take a photo, and send to CCL by 11/9/22.

At 1:45 pm, LPA conducted the Infection Control mitigation module with the program director and program manager. No deficiencies cited.

Exit interview conducted and report emailed to the administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Darlene Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1