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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 405802297
Report Date: 06/17/2024
Date Signed: 06/17/2024 04:40:54 PM

Document Has Been Signed on 06/17/2024 04:40 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:OPTIONS - LEGATO HOMEFACILITY NUMBER:
405802297
ADMINISTRATOR/
DIRECTOR:
DEBRA BERTRANDOFACILITY TYPE:
735
ADDRESS:3750 LA LUZ RD.TELEPHONE:
(805) 464-4880
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY: 4CENSUS: 4DATE:
06/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Tamm Peterson House Manager and Debie Bertrando, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Rankin arrived at 9:30 a.m. to conducted an unannounced Annual/Required visit. LPA met with Tammy Peterson, House Manager, and explained the purpose of the visit.

LPA toured the facility with the house manager. Facility is maintained in conformity with state fire marshal regulations. Smoke detectors and carbon monoxide detector was tested and is working at time of visit. Fire extinguishers (3) were located at the inside entranceway, the hall near the garage, and the hall near resident bedrooms. Extinguishers were fully charged and last inspected in 2024. There are no pools or bodies of water at facility. Hot water temperature measured between 112 F and 115 F degrees. All toilets and hand washing facilities are maintained in a safe, sanitary, operating condition. The facility is clean, safe, sanitary and in good repair for the safety and well-being of clients, employees, and visitors. Each client is accorded safe, healthful, and comfortable accommodations, furnishings and equipment to meet their needs. LPA observed clients being treated with dignity and respect. There is a minimum 2-day supply of perishables and 7-day supply of nonperishable foods. Food is stored and prepared in a safe and healthful manner. Disinfectants, cleaning solutions and poisons are inaccessible to residents. Facility has adequate emergency supplies and first aid supplies, additional gloves have been requested by LPA. Facility temperature is 72 degrees Fahrenheit. Outdoor walkways are free from obstruction and the facility has outside areas for individuals to use. Centrally stored medication is kept secure in the locked office and inaccessible to clients. Medications are given as prescribed by doctors’ orders. The last emergency disaster drill was conducted on 6/10/24.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE: DATE: 06/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/17/2024
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: OPTIONS - LEGATO HOME
FACILITY NUMBER: 405802297
VISIT DATE: 06/17/2024
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LPA reviewed (4) client files for current needs and services plans and signed admission agreements and personal rights. All files are in compliance.

Staff files are not kept at the facility, at 2:30 p.m. LPA arrived at the main office in San Luis Obispo to review (4) staff files for criminal record clearances, application records, Health screening with TB results, and current First Aid/CPR. All staff had appropriate paperwork; an unclear TB record is being updated for clarity.


Exit interview conducted, and the report given.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2024
LIC809 (FAS) - (06/04)
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