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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801379
Report Date: 08/19/2022
Date Signed: 08/22/2022 04:49:32 PM

Document Has Been Signed on 08/22/2022 04:49 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/SAVIERSFACILITY NUMBER:
565801379
ADMINISTRATOR:SUSANA MIXFACILITY TYPE:
775
ADDRESS:4225 SAVIERS ROAD, SUITE #10TELEPHONE:
(805) 487-5848
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 12CENSUS: 6DATE:
08/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:47 PM
MET WITH:Lailani MacaciasTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced Required 1 Year inspection at the day program today. When the LPA arrived there was no one at the day program site. The LPA contacted the day program's other site at 12:50 PM and spoke with Administrator Lailani Macasias who came to this site at approximately 12:55 PM.

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. This annual had a specific emphasis on infection control practices and procedures.

Common Activity Space: The facility is a Day Program which operates from 8:30 AM to 3:00 PM. To help mitigate the spread of COVID-19, the Day Program is currently operating with one group of four participants on Mondays and Wednesdays and another group of two participants on Tuesdays and Thursdays. The facility is closed on Fridays. The day program is a single-story structure with one large activity room, one small activity room, one quiet/sick room, a dining room, small kitchen area, one office, and one restroom. 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 activity schedule was reviewed. The restroom was 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 108.9 degrees F. The smoke alarms and carbon monoxide detectors were tested and were operational. The fire extinguishers observed were fully charged and last serviced on 06/22/2022. Activity supplies were observed in the activity room. Cleaning supplies are stored in a locked cabinet. PPE supplies are also stored in a locked cabinet. The program is currently serving snacks only to the participants and had a sufficient supply. The dining room had a refrigerator for storing participant lunches. The kitchen, food preparation, and storage areas are kept clean, free of litter and rubbish. Storage for medications are stored in a locked cabinet inside the office. Report continued on LIC 809-C.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2022
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/SAVIERS
FACILITY NUMBER: 565801379
VISIT DATE: 08/19/2022
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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.

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: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022
LIC809 (FAS) - (06/04)
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