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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565800394
Report Date: 02/13/2025
Date Signed: 02/13/2025 11:15:34 AM

Document Has Been Signed on 02/13/2025 11:15 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:BROWN BOARD & CAREFACILITY NUMBER:
565800394
ADMINISTRATOR/
DIRECTOR:
BETTINA BROWNFACILITY TYPE:
735
ADDRESS:1337 W. HILL STREETTELEPHONE:
(805) 483-9618
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 10CENSUS: 9DATE:
02/13/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Bettina BrownTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced Required 1 Year inspection at the facility today. The LPA met with staff and explained the reason for the visit. At 10:15 a.m., the Administrator Bettina Brown arrived at the facility.

At 9:50 a.m., the LPA, along with staff, toured the physical plant areas inside and outside to ensure there are no health and safety hazards. During the time of the visit, the LPA observed renovations being done in the kitchen. The Administrator will update the LPA as other renovations continue. The facility is a double-story residence that consists of five (5) client bedrooms, one (1) office, two (2) staff rooms, three (3) client bathrooms and one (1) staff bathroom.

Common Areas: The living room area and dining room area has sufficient seating for clients. The carbon monoxide detector and smoke alarms in the common areas and bedrooms were tested and operational. The fire extinguishers were observed to be charged and last serviced on 01/20/2025. Washer and dryer were observed in the laundry area. Cleaning supplies are locked in a closet. Medications are stored in a locked closet in the office. Kitchen: The facility has a sufficient supply of perishable and non-perishable food. There are two refrigerators and an extra freezer that store food for client use. Staff stated that they are currently using disposable plates and utensils as the kitchen is being renovated. Kitchen knives are locked and inaccessible in the office. Restrooms: At 10:03 a.m. the hot water temperature throughout the restrooms measured within required rage. The restrooms were observed to have soap and paper towels. Bedrooms: The five client bedrooms were observed which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting.

Due to time constraints the LPA will return to complete the annual at a later date. No deficiencies were cited during today's inspection. Exit interview conducted. A copy of the report was provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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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