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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565800360
Report Date: 09/08/2023
Date Signed: 09/08/2023 12:10:41 PM

Document Has Been Signed on 09/08/2023 12:10 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: 54DATE:
09/08/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Andrea Tillman, SupervisorTIME COMPLETED:
12:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jenny Olson conducted a Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint Control # 29-AS-20230511155340). The purpose of the visit is to issue citations for deficiencies observed during the complaint investigation.

During the complaint investigation of complaint # 29-AS-20230511155340, the following deficiency was observed:

Facility issued a 24 hour termination due to C1 exhibiting behavior that put staff and clients in immediate danger. LPA reviewed facility Program Plan which states: “a. Arc Ventura County staff determine the program no longer meets the consumer’s needs. (1) Arc Ventura County will provide regional center with written notice 30 days in advance of the proposed termination date; the written notice will include a statement of reasons for termination…b. Ventura County may exclude a consumer from participation in advance of the proposed termination date if it determined that the consumer is a threat to the health and safety of others. (1) A conference will be scheduled within 3 working days of the date of exclusion from program…” The facility did not follow the Program Plan and schedule a conference or notify CCL per regulation 82068.5(b)(1)

Exit interview conducted, copy of report and appeal rights were issued.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Jeannette Olson
LICENSING EVALUATOR SIGNATURE: DATE: 09/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2023
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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Document Has Been Signed on 09/08/2023 12:10 PM - It Cannot Be Edited


Created By: Jeannette Olson On 09/08/2023 at 08:50 AM
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: 09/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/11/2023
Section Cited
CCR
82068.5(a)

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82068.5 Procedures for Discharge
(a) A minimum of two weeks' notice shall be given to a client...if the Adult Day Program determines that the day program can no longer meet the needs of the client, and he/she must be discharged from the day program. This requirement was not met as
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Administrator agreed to issue a statement of understanding of regulation 82068.5 to CCL by 9/11/23.
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evidenced by: Based on interviews and record review, the licensee did not comply in the section cited above when staff did not issue C1 with proper discharge notice, which posed a potential health, safety, or personal rights risk to persons in care.
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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:Jeannette Olson
LICENSING EVALUATOR SIGNATURE:
DATE: 09/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/08/2023


LIC809 (FAS) - (06/04)
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