565801134-12-4-2025-29-AS-ECOZ-DP2TEY-20251204134044

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 565801134
Report Date: 12/04/2025
Date Signed: 12/04/2025 01:41:55 PM

Document Has Been Signed on 12/04/2025 01:41 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 CENTER		FACILITY NUMBER:	565801134
ADMINISTRATOR/ DIRECTOR:	SARAH ARMSTRONG		FACILITY TYPE:	775
ADDRESS:	575 EAST SURFSIDE DRIVE		TELEPHONE:	(805) 986-4818
CITY:	PORT HUENEME	STATE: CA	ZIP CODE:	93041
CAPACITY: 150		CENSUS: 71	DATE:	12/04/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:			TIME VISIT/ INSPECTION COMPLETED:	01:45 PM

NARRATIVE

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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 10:00 a.m. The LPA met with Administrator Sarah Armstrong and explained the reason for the visit. Upon arrival, there were seventy-one (71) consumers. 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 10:30 a.m., the LPA, the Administrator and Activity Director Maria Camarena 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/storage 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 11:25 a.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 12/16/2024. The Administrator has a scheduled fire extinguisher service appointment on 12/09/25.

FOOD SERVICE: The kitchen area was in good condition. Knives and cleaning supplies are stored in a locked cabinet under the sink. The facility does not provide lunch however keeps perishable and non-perishable foods for clients' snacks or if a client forgets their lunch.

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 .Report will continue on LIC809-C, 2nd page.

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Esther Cortez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/04/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: 12/04/2025

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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 113.1 degrees Fahrenheit.

OUTDOORS: The LPA observed appropriate outdoor furniture with a shaded area for consumers in the patio. There are no additional bodies of water on the premises.

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 attempted to interview four (4) consumers. No immediate concerns voiced at this time.

Record Review: At 11:15 a.m. a review of facility files was initiated. The LPA observed documentation of Infection Control, Insurance liability, Disaster prevention, and last fire drill conducted on 12/04/25. The LPA obtained Client Roster, and Staff Roster. The LPA reviewed five (5) consumer and five (5) staff Files. The following was observed: One consumer did not have an updated appraisal/needs and service plan (LIC625) or Individualized Program Plan (IPP) since 2023, otherwise all documents reviewed appeared complete and current.

At 12:21 p.m., the LPA observed Staff 1 (S1) assisting Client 1 (C1) in the restroom with the stall door open, not ensuring privacy for the client and exposing C1 to other clients, staff and visitors in the restroom.

Medication Audit: A medication audit for three (3) consumers was initiated at 12:45 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

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Esther Cortez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/04/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/04/2025 01:41 PM - It Cannot Be Edited

Created By: Esther Cortez On 12/04/2025 at 01:24 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: 12/04/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

82077.4(b)(7)

Care for Clients With Incontinence

(b) If a licensee accepts or retains a client who has bowel and/or bladder incontinence, the licensee is responsible for all of the following: (7) Ensuring privacy when care is provided. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above as the LPA observed S1 assist C1 with incontinece care without closing the bathroom stall door which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 12/08/2025
	Plan of Correction
1 2 3 4	Administrator agrees to hold an in service for all staff regarding personal rights and ensuring clients are given privacy during assistance with incontinence care. 12/08/2025.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 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.

	Kasandra Lopez
NAME OF LICENSING PROGRAM MANAGER:

	Esther Cortez
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/04/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/04/2025 01:41 PM - It Cannot Be Edited

Created By: Esther Cortez On 12/04/2025 at 01:24 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: 12/04/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

82068.3(a)

Modifications to Needs and Services Plan

(a) The licensee shall ensure that each client's written Needs and Services Plan is updated as often as necessary, but at least annually, to ensure its accuracy, and to document significant occurrences that result in changes in the client's physical, mental, psychological, and/or social functioning. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 of 5 client files that did not have an updated needs and service plan since 2023 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/08/2025
	Plan of Correction
1 2 3 4	Administrator will ensure to have the clients needs and service plan updated and submit proof to the LPA by the POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 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.

	Kasandra Lopez
NAME OF LICENSING PROGRAM MANAGER:

	Esther Cortez
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/04/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

LIC809 (FAS) - (06/04)

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