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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425850288
Report Date: 08/11/2023
Date Signed: 08/14/2023 09:12:30 AM

Document Has Been Signed on 08/14/2023 09:12 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:ALPHA RESOURCE CENTER OF SANTA BARBARA(SLINGSHOTFACILITY NUMBER:
425850288
ADMINISTRATOR:WEITZMAN, JOSHUAFACILITY TYPE:
775
ADDRESS:1911 DE LA VINA ST.TELEPHONE:
(805) 770-3878
CITY:SANTA BARBARASTATE: CAZIP CODE:
93101
CAPACITY: 35CENSUS: 37DATE:
08/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Kelly Cottrell, AdministratorTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Annual Inspection to the facility. LPA met with Kelly Cottrell, Co-Administrator.
The program is a non-profit Adult Day Program. The program is part of Alpha Resource Center of Santa Barbara, a non-profit corporation 501(c)(3). The facility operation is a leased building located in the downtown area of Santa Barbara with access to local eateries and retail businesses. The facility hours are Monday through Friday, 8:30 am to 4:30 pm. There is a Saturday program from 9:00 am to 1:00 pm.
The program is an art studio featuring artwork from artists with developmental and/or intellectual disabilities (DD/ID). The program is structured towards each artist’s Individualized Support Plan (ISP). Clients have options to actively create various art works such as ceramic and wood sculptures, paintings, drawings, fiber arts, scratch boarding, and woodburning. Clients are self-directed with direction and oversight from the teaching artists. The teaching artists generally have backgrounds in art related fields as well as experience working with clients with DD/ID.
Entrance interview conducted:
At the time of arrival, there were 12 participants participating in art projects with 2 staff, and the administrator on duty.
LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and to ensure facility is in compliance with Title 22 Regulations. The facility has one fire extinguisher last serviced on February 1, 2022. At approximately 12:30 pm, Co-Administrator Cottrell contacted Francisco Gomez, Maintenance Director who brought a replacement fire extinguisher to the facility. The replacement extinguisher was last serviced on 11/11/2022.
LPA and Administrator were unable to locate a carbon monoxide detector in the facility. At approximately 12:30 pm, Maintenance Director installed a carbon monoxide detector in the kitchen area of the facility. Co-Administrator Cottrell was unable to locate smoke alarms within the facility. At approximately 1:55 pm,
Please continue to 809-C, Pg 2.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2023
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: ALPHA RESOURCE CENTER OF SANTA BARBARA(SLINGSHOT
FACILITY NUMBER: 425850288
VISIT DATE: 08/11/2023
NARRATIVE
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Administrator Cottrell contacted the maintenance director who stated there are no smoke alarms in the facility and will bring some today.
The facility consists of an art studio, an art gallery, a ceramics studio, a kitchen, three bathrooms, an office, and a storage area equipped with lockers for the artists’ belongings. Indoor and outdoor activity space is safe and free of hazards. The bathrooms are safe and sanitary and in operating condition with toilet paper, soap, and paper towels.
Personnel records are maintained at the main building (Alpha Resource Center) for each licensee/administrator and employee per organization-wide standards. Employees personnel records were unavailable to Co-Administrator Cottrell. At approximately 12:55 pm, LPA spoke with Cory Sherman, Chief Financial Officer who stated that documents are accessed only electronically; the Human Resources Director and Co-Administrator Joshua Weitzman are currently on vacation; and Co-Administrator Kelly Cottrell does not have access to the facility’s personnel records.
At approximately 12:35 pm, LPA reviewed State of California, Department of Social Services, Community Care Licensing Division Licensing Information System (LIS), Facility Personnel Report Summary and facility staff roster and determined there is one staff member currently working in the facility and has not been associated to the facility prior to their employment. Co-Administrator Kelly Cottrell stated Staff 1 (S1) has been working in the facility since June 6, 2023 and last worked on August 4, 2023.
Due to time restraints, LPA will return at a later date to complete the inspection.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D):

Exit interview conducted. Copy of report and Appeal Rights issued at the time of the visit.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
LIC809 (FAS) - (06/04)
Page: 2 of 7
Document Has Been Signed on 08/14/2023 09:12 AM - It Cannot Be Edited


Created By: Kristin Kontilis On 08/11/2023 at 02:08 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ALPHA RESOURCE CENTER OF SANTA BARBARA(SLINGSHOT
FACILITY NUMBER: 425850288

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82066(c)
Personnel Records
(c) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interviews, the licensee did not comply with the section cited above when personnel records, including but not limited to health screening, First Aid/CPR trainings, miscellaneous training and other required personnel documents were unavailable to Facility Co-Administrator and CCLD LPA during a required annual inspection which poses a potential health and safety risk to residents in care.
POC Due Date: 08/14/2023
Plan of Correction
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Administrator agrees to request access to Personnel records from Human Resources Director on 8/14/2023. Administrator agrees to confirm access to LPA via email no later than 8/14/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Kelly Burley
LICENSING EVALUATOR NAME:Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:
DATE: 08/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/14/2023 09:12 AM - It Cannot Be Edited


Created By: Kristin Kontilis On 08/11/2023 at 02:11 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ALPHA RESOURCE CENTER OF SANTA BARBARA(SLINGSHOT
FACILITY NUMBER: 425850288

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82019(e)(2)
82019(e)(2) Criminal Record Clearance: Prior to working, residing or volunteering in a licensed day program, all individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall do the following: (e) Prior to working, residing or volunteering in a licensed day program, all individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall do the following: (2) Request the licensee or applicant for a license to request a transfer of a criminal record clearance as specified in Section 82019(f); or

This requirement is not met as evidenced by:
Deficient Practice Statement
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This requirement is not met as evidenced by:
Based on interviews and record review, the licensee did not comply with the section cited above and allowed 1 out of 1 individual to work at the facility prior to being associated to the facility from 6/26/2023 and last worked on 8/4/2023 which poses an immediate health and safety risk to residents in care.
POC Due Date: 08/14/2023
Plan of Correction
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Administrator agrees to work with HR Director to ensure S1 is properly associated to the facility. Administrator agrees to ensure all new staff are properly associated to the facility prior to working or volunteering in the facility.
Type A
Section Cited
HSC
1503.2
1503.2 General Provisions: Every facility licensed or certified pursuant to this chapter shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interviews conducted, the licensee did not comply with the section cited above when at approximately 12:35 pm, when LPA observed, that there is no carbon monoxide detector in the facility which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/11/2023
Plan of Correction
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Administrator agreed to contact Maintenance Director to request a carbon monoxide detector be installed as soon as possible.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Kelly Burley
LICENSING EVALUATOR NAME:Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:
DATE: 08/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2023


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Document Has Been Signed on 08/14/2023 09:12 AM - It Cannot Be Edited


Created By: Kristin Kontilis On 08/11/2023 at 03:05 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ALPHA RESOURCE CENTER OF SANTA BARBARA(SLINGSHOT
FACILITY NUMBER: 425850288

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82066(c)
82066(c) Personnel Records: All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours…

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
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Based on observation and interviews conducted, the licensee did not comply with the section cited above when personnel records, including but not limited to health screenings, First Aid/CPR trainings, miscellaneous trainings and other required personnel documents were unavailable to Facility Co-Administrator and CCLD (LPA) during a required annual inspection which poses a potential health and safety risk to residents in care.
POC Due Date: 08/14/2023
Plan of Correction
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Co-Administrator agrees to request access to HR documents for facility staff no later than 8/14/2023. Co-Administrator agrees to send LPA an email confirming access has been granted.
Section Cited
Deficient Practice Statement
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4
POC Due Date:
Plan of Correction
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4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Kelly Burley
LICENSING EVALUATOR NAME:Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:
DATE: 08/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2023


LIC809 (FAS) - (06/04)
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