421701729-3-27-2023-29-AS-RDLN-CPXTAS-20230315143400

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 421701729
Report Date: 03/15/2023
Date Signed: 03/27/2023 02:35:50 PM

Document Has Been Signed on 03/27/2023 02:35 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:	VTC ENTERPRISES		FACILITY NUMBER:	421701729
ADMINISTRATOR:	JASON TELANDER		FACILITY TYPE:	775
ADDRESS:	2445 A STREET		TELEPHONE:	(805) 928-5000
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY: 150		CENSUS: 71	DATE:	03/15/2023
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Crystal Smith, LLL Manager		TIME COMPLETED:	02:40 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	Licensing Program Analyst's (LPA's) De Leon, Phillips and Olson conducted an annual continuation visit to the facility above. LPA's met with Crystal Smith, LLL Manager and explained the purpose of the visit. LPA's met Jason Telander Administrator on the visit. LPA's conducted a medication review on 6 clients receiving central stored medications at the day program. The facility uses SETWORKS for medication management which utilizes the same information as Community Care Licensing (CCL) Central Stored Medication and Destruct Record (CSMDR) and the Medication Administration Records (MAR) forms. Prescriptions medications were locked in a medication cart in the medication room. Staff provide medications to the clients and if unable to take by self the staff with Assist in self administration of the medications with the hand over hand technique. All medications are labeled and maintained in compliance. Prescriptions are stored in original containers and no medication labels are altered. The facility has a refrigerator to preserve required mediations if needed with lock. Once ordered by the physician the medications are given according to the physicians directions. The facility does not currently have any clients in care with oxygen or restricted health conditions. Medications not taken by the client on discharge from the program are destroyed by the Administrator and another adult staff or they are taken to the pharmacy to be destroyed. The facility does not currently have an AED on the premises. Staff are trained in AED and training has remained current. Staff ensures all clients with incontinence are kept clean and dry. Staff do evaluate clients to make sure skin breakdown is not occurring. Continued 809-C

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VTC ENTERPRISES	FACILITY NUMBER: 421701729
	VISIT DATE: 03/15/2023

NARRATIVE

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LPA's reviewed 7 staff files for current 1st Aid/CPR/AED, Background Fingerprints and associated to work at the facility, Job Applications, Health Screening, Criminal Record Statement, Employee Rights, and TB results.
LPA Phillips reviewed the same 7 staff for 8 hours of training completed annually.

LPA's reviewed 7 residents files for Admission Agreements, Medical Assessments, Consent forms, Emergency ID and information, Person Centered Plan completed annually which meets the Appraisal Needs and Services Plan, Immunization records, TB test with results, CSMDR with MAR, and Personal Rights. The facility does not keep cash resources on clients in care.

LPA Olson interviewed 3 clients and 4 staff from records reviews. LPA Phillips interviewed 4 clients and 3 staff from the records reviews.

LPA Phillips received Control of Property, Transportation Procedures and an up to date Emergency disaster Plan for facility file.

Exit interview conducted, no deficiencies cited and copy of report printed for Administrator.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023

LIC809 (FAS) - (06/04)

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