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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565800360
Report Date: 08/02/2022
Date Signed: 08/02/2022 01:00:26 PM

Document Has Been Signed on 08/02/2022 01:00 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:ARC-OJAI ENRICHMENT CENTERFACILITY NUMBER:
565800360
ADMINISTRATOR:AMBER LUNDEENFACILITY TYPE:
775
ADDRESS:210 CANADATELEPHONE:
(805) 646-5186
CITY:OJAISTATE: CAZIP CODE:
93023
CAPACITY: 105CENSUS: 35DATE:
08/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Amber LundeenTIME COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) JoAnn Rosales conducted an unannounced Required -1 Year inspection. LPA met with Administrator Amber Lundeen.

During facility tour to inspect for infection control practices LPA observed one central entry point in the front of the building designated for staff universal entry screening and one central entry point in the back of the building designated for client universal entry screening. Cleaning supplies were observed and infection control practices were discussed. An inspection of the common area, client rooms and restrooms were conducted. Bathrooms were safe and sanitary and in operating condition with toilet paper, soap and paper towels. LPA observed fire extinguishers fully charged. LPA observed smoke alarms and carbon monoxide detectors in working order. Clients provide their own lunch. LPA observed a sufficient supply of snacks. Medications were centrally stored and are kept in a locked filing cabinet in the gallery classroom. LPA observed 1st Aid Kit complete. LPA observed a sufficient supply of PPE. Disinfectants and cleaning solutions are stored in a locked supply room. Outdoor area toured- passageways are free of obstruction.

During facility tour at 12:18 pm with the Administrator LPA observed hot water temperature (read at 74.2 degrees F.) in client bathroom.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiency was cited (refer to LIC 809-D):

Exit interview conducted. Today's reports and appeal rights were reviewed and issued.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Joann Rosales
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2022
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 2
Document Has Been Signed on 08/02/2022 01:00 PM - It Cannot Be Edited


Created By: Joann Rosales On 08/02/2022 at 12:47 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: ARC-OJAI ENRICHMENT CENTER
FACILITY NUMBER: 565800360

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/02/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82088(e)(1)
Fixtures, Furniture, Equipment, and Supplies
(1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observation, the licensee did not comply with the section cited above as hot water temperature in client bathroom read at 74.2 degrees F which poses a potential health and personal rights risk to persons in care.
POC Due Date: 08/05/2022
Plan of Correction
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Administrator stated that they will have the hot water temperature adjusted to read between 105 and 120 degrees F in client bathroom. Administrator will submit documentation indicating that this has been completed to CCL by 8/5/22.
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:Kristin Heffernan
LICENSING EVALUATOR NAME:Joann Rosales
LICENSING EVALUATOR SIGNATURE:
DATE: 08/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/02/2022


LIC809 (FAS) - (06/04)
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