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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801134
Report Date: 12/03/2024
Date Signed: 12/03/2024 04:30:12 PM

Document Has Been Signed on 12/03/2024 04:30 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:OCEANVIEW WORKSHOP & RECREATION CENTERFACILITY NUMBER:
565801134
ADMINISTRATOR/
DIRECTOR:		SARAH ARMSTRONGFACILITY TYPE:
775
ADDRESS:575 EAST SURFSIDE DRIVETELEPHONE:
(805) 986-4818
CITY:PORT HUENEMESTATE: CAZIP CODE:
93041
CAPACITY: 150CENSUS: 71DATE:
12/03/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:25 AM
MET WITH:Sarah ArmstrongTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Esther Cortez arrived at the Adult Day Program (ADP) unannounced to conduct a required annual visit at 11:25 a.m. The LPA met with Administrator Sarah Armstrong and explained the reason for the visit. Upon arrival, there were seventy-one (71) consumers and thirty-six (36) staff in the building. The program currently operates from 7:45 a.m. to 12:45 p.m. The day program is staffed with 1:3, 1:4, and 1:1 staff to consumer ratios.

At 11:40 a.m., the LPA, the Administrator and Activity Director toured the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The facility is a two story structure with one large activity room (day room), one small activity room (day room), one isolation room, two (2) offices, two bathrooms, a changing room, and a food service/kitchen area. Day Program only operates on the first floor of the structure. At 1:31 p.m. the smoke alarms and carbon monoxide detectors were tested and were operational. The LPA observed fire extinguishers throughout the facility, which were fully charged and last serviced 11/30/2023. The Administrator has a scheduled fire extinguisher service appointment on 12/16/24.


ISOLATION ROOM: The tour began in the isolation room which is equipped with a bed and additional linens in the event a client shows signs of illness. This room is also used for storing arts and crafts activities.

COMMON SPACES: This includes the large and small day room. At the time of the visit, furnishings were observed to be in good condition. The LPA did not observe any obstructions or hazards during the inspection. There are areas blocked off from consumers, including the upstairs balcony, the stage, and backstage areas.

FOOD SERVICE: The kitchen area was in good condition. Knives and cleaning supplies are stored in a locked cabinet under the sink. The facility has a sufficient supply of non-perishable emergency food and water. The facility keeps some perishable and non-perishable foods for clients' snacks or if a client forgets their lunch. Report will continue on LIC809-C, 2nd page.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: OCEANVIEW WORKSHOP & RECREATION CENTER
FACILITY NUMBER: 565801134
VISIT DATE: 12/03/2024
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RESTROOMS: The two restrooms were observed to be clean and sanitary with a hand soap and paper towels. The hot water temperature in the women’s restroom was tested and it measured at 117.1 degrees Fahrenheit.

OUTDOORS: The LPA observed appropriate outdoor furniture with a shaded area for consumers in the patio. At 12:13 p.m. the LPA observed a large bucket of water in the patio. Upon observation the water was dumped. There are no additional bodies of water on the premises.

CHANGING ROOM: The changing room had a supply of hygiene products, a bed with protective paper that is changed between clients and a hoyer lift if needed.

INFECTION CONTROL: The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility has appropriate plans in place in the event of clients and/or staff showing symptoms of COVID or testing positive for COVID.

INTERVIEWS: During today's visit, the LPA interviewed six (6) consumers and three (3) staff. No immediate concerns voiced at this time.

Record Review: A review of facility files was initiated. The LPA observed documentation of Infection Control, Insurance liability, Disaster prevention, and last fire drill conducted on 12/02/24. The LPA obtained Client Roster, and Staff Roster. The LPA reviewed five (5) consumer and five (5) staff Files. All documents reviewed appeared complete and current.

Medication Audit: A medication audit for five (5) consumers was initiated at 3:48 p.m. and the


following was observed. The medications were stored in a locked cabinet inside an office and
inaccessible to the consumers; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D). Civil Penalty was issued. Exit interview conducted and copy of the report and appeal rights provided to Administrator.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/03/2024 04:30 PM - It Cannot Be Edited


Created By: Esther Cortez On 12/03/2024 at 04:12 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: OCEANVIEW WORKSHOP & RECREATION CENTER
FACILITY NUMBER: 565801134

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
80087(e)
80087 Buildings and Grounds (e) All licensees serving children or serving clients who have physical handicaps, mental disorders, or developmental disabilities shall ensure the inaccessibility of pools, including swimming pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds or similar bodies of water through a pool cover or by surrounding the pool with a fence. This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in one large bucket filled with water left in the patio accessible to the consumers in care which poses an immediate health and safety risk to persons in care.
POC Due Date: 12/03/2024
Plan of Correction
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Plan of correction has been met, the water was emptied during the visit. This a zero tolerance violation. In pursuant to H&S code §1548, a civil penalty of $500 was issued. See LIC 421C.
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:Kasandra Lopez
LICENSING EVALUATOR NAME:Esther Cortez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/03/2024


LIC809 (FAS) - (06/04)
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