565801379-9-18-2025-29-AS-EPEI-DLMQFJ-20250918120801

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 565801379
Report Date: 09/18/2025
Date Signed: 09/18/2025 12:09:11 PM

Document Has Been Signed on 09/18/2025 12:09 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:	VOCATIONAL SKILLS SERVICES, INC.-ADP/SAVIERS		FACILITY NUMBER:	565801379
ADMINISTRATOR/ DIRECTOR:	LAILANI MACASIAS		FACILITY TYPE:	775
ADDRESS:	4225 SAVIERS ROAD, SUITE #10		TELEPHONE:	(805) 487-5848
CITY:	OXNARD	STATE: CA	ZIP CODE:	93033
CAPACITY: 12		CENSUS: 3	DATE:	09/18/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:	Lailani Macasias, Administrator		TIME VISIT/ INSPECTION COMPLETED:	12:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced for a required annual inspection today. At 10:00 a.m., the LPA met with staff and explained the reason for the visit. At 10:14 a.m., the Administrator Lailani Macasias arrived at the facility. There are three (3) consumers and two (2) staff in program today. The program currently operates from 8:30 a.m. to 3:00 p.m. Monday through Friday. Record Review: Between 10:15 a.m. and 11:10 a.m., the LPA conducted a file review for four (4) consumers and for two (2) staff and observed the following: Staff have current first aid and training completed. Consumer records were reviewed for but not limited to current Individual Program Plan (IPP), medical assessments, admissions agreement, and consent forms. All records were in order. The last fire drill took place on 08/06/2025. The LPA observed documentation of the Infection Control Plan and Emergency and Disaster Plan. The Administrator certificate is valid until 03/12/2027. Starting at 11:11 a.m., the LPA, along with the Administrator toured the physical plant to ensure there are no health and safety hazards. Common Activity Space: The facility location is located in a business area of the community and consists of one building with multiple entrances and exits. The facility consists of one (1) large activity area, two (2) staff/ office rooms, one (1) dedicated activity room, a quiet room, one (1) bathroom and a food service area. The LPA did not observe any obstructions or hazards. There are several fire extinguishers throughout the facility; they all were fully charged and were last serviced on 06/03/2025. Continued on LIC 809-C.

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Emily Peraldi
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025

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: VOCATIONAL SKILLS SERVICES, INC.-ADP/SAVIERS	FACILITY NUMBER: 565801379
	VISIT DATE: 09/18/2025

NARRATIVE

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Smoke detectors and carbon monoxide detectors were tested at 11:15 a.m. and were operational at the time of the visit. Facility temperature was maintained at a comfortable level. No bodies of water noted. Disinfectants and cleaning supplies are locked inaccessible to consumers. First aid kits are located inside the office.

Activities: Activities are both designed for individuals and as a group. The equipment used for activities was in good condition at the time of the visit.

Food Service: The LPA toured the kitchen preparation area, which was clean and in good condition. There are food supplies and snacks available for consumers.

Restroom: Restroom is relatively clean and sanitary and in operating condition. The sink had sufficient liquid soap, and paper towels. Water temperature was observed to be within required range.

During the time of the visit, the LPA spoke with staff and consumers. No concerns were noted.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Emily Peraldi
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025

LIC809 (FAS) - (06/04)

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