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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801271
Report Date: 06/24/2022
Date Signed: 06/24/2022 03:57:52 PM

Document Has Been Signed on 06/24/2022 03:57 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:VOCATIONAL SKILLS SERVICES, INC.-ADP/OXNARDFACILITY NUMBER:
565801271
ADMINISTRATOR:LAILANI G. MACASIASFACILITY TYPE:
775
ADDRESS:549 WEST HUENEME ROADTELEPHONE:
(805) 986-8300
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 36CENSUS: 25DATE:
06/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:43 AM
MET WITH:Lailani MacasiasTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced Required 1 Year inspection at the day program today. The LPA met with Administrator Lailani Macasias and explained the reason for today's visit. This annual had a specific emphasis on infection control practices and procedures.

The LPA and the Administrator toured the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Common Activity Space: The facility is a Day Program which operates from 8am to 3:00pm. To help mitigate the spread of COVID-19, the Day Program is currently operating with one group of participants on Mondays and Wednesdays and another group of participants on Tuesdays and Thursdays. The facility is a single-story structure with one large activity room, one small activity room, one conference room, three offices, two bathrooms, a quiet/sick room, and a food service area. The LPA did not observe any obstructions or hazards during the inspection. The program site appeared to be clean, safe, sanitary, and in good repair at this time.

The two restrooms were observed to be clean and sanitary with a hand soap and paper towels. The hot water temperature in the restroom was tested and it measured at 151.2 degrees F. The smoke alarms and carbon monoxide detectors were tested at 10:59 AM and were operational. The fire extinguishers observed were fully charged and last serviced on 06/22/2022. Activity supplies were observed in the large activity room. Cleaning supplies are stored in a locked area. PPE supplies are stored in a locked office. The program is currently serving snacks only to the participants. The kitchen, food preparation, and storage areas are kept clean, free of litter and rubbish. Medications are stored in a locked cabinet inside a locked office.

Report continued on LIC 809-C.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2022
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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: VOCATIONAL SKILLS SERVICES, INC.-ADP/OXNARD
FACILITY NUMBER: 565801271
VISIT DATE: 06/24/2022
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INFECTION CONTROL: During today’s visit, the LPA spoke with the Administrator regarding the facility’s infection control practices. Upon entry, the facility has a central entry point for symptom screening. LPA observed all staff to be wearing masks. The LPA observed an adequate supply of Personal Protective Equipment (PPE). The facility’s cleaning protocol is sufficient. Infection control signs were posted at the entry, throughout the facility, and in the restrooms. All staff have been FIT tested for N95 masks. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility’s policies and procedures as it pertains to infection control are adequate.

The following deficiency (See LIC 809-D) was cited from the CA Code of Regulations. Failure to correct the citation may result in civil penalty. Exit interview and report was reviewed with the Administrator. A copy of the report and appeal rights will be emailed.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/24/2022 03:57 PM - It Cannot Be Edited


Created By: Kasandra Lopez On 06/24/2022 at 12:08 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: VOCATIONAL SKILLS SERVICES, INC.-ADP/OXNARD
FACILITY NUMBER: 565801271

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82088(e)(1)
(e) Faucets used by clients for personal care shall deliver hot water.

(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 observation the licensee did not comply with the section cited above as the hot water temperature in the restroom measured at 151.2 degrees F. which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/07/2022
Plan of Correction
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The water heater was turned down during the inspection. The administrator will test the water temperature and submit proof of a five day water temperature log indicating the water is within the required range. Proof shall be submitted by 7/7/2022.
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:Desaree Perera
LICENSING EVALUATOR NAME:Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 06/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2022


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