565801404-1-12-2023-29-AS-MARO-CMZTBN-20230112133525

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 565801404
Report Date: 01/12/2023
Date Signed: 01/12/2023 01:36:16 PM

Document Has Been Signed on 01/12/2023 01:36 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:	SAILS EL CERRITO		FACILITY NUMBER:	565801404
ADMINISTRATOR:	CRISTINA MARCIA		FACILITY TYPE:	735
ADDRESS:	187 EL CERRITO CIR		TELEPHONE:	(805) 323-7600
CITY:	VENTURA	STATE: CA	ZIP CODE:	93002
CAPACITY: 3		CENSUS: 3	DATE:	01/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Erma Ledesma		TIME COMPLETED:	01:45 PM

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Licensing Program Analyst (LPA), Martha Arroyo arrived unannounced to conduct a Required 1-Year Annual Inspection with focus on Infection Control. The last Annual visit conducted at this facility was on 02/14/2022. Upon arrival, the LPA was scanned and greeted at the door by House Manager, Erma Ledesma and the reason for the visit was explained. Entrance interview.

At 11:30 a.m., the LPA began the physical plant tour of the common areas, kitchen area, client bedrooms, bathrooms, office, and outdoor area to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN: The kitchen appeared clean and the appliances and fixtures functional. The facility has a sufficient supply of seven (7) days perishable and two (2) days non-perishable food.

BEDROOMS: The LPA observed all three (3) client rooms which were properly furnished, and had appropriate bedding, linens, and sufficient lighting.

RESTROOMS: LPA observed three (3) client restrooms which appeared clean and in operating condition with functional fixtures. Restrooms are sufficiently stocked with hand liquid soap and paper towels. The appropriate hand-washing signs were observed throughout. Bathrooms were measured for hot water and in compliance measuring between 105- and 120-degrees Fahrenheit at the time of visit.

…Report Continued on LIC 809C...

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

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: SAILS EL CERRITO	FACILITY NUMBER: 565801404
	VISIT DATE: 01/12/2023

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…Report Continued from LIC 809...

GARAGE AND GROUNDS: The garage is locked and attached to the house. There is a pantry with a sufficient supply of emergency food and water. LPA observed the laundry room with cleaning supplies and chemicals locked and inaccessible to clients. There is a covered patio area with patio furniture for client use. No bodies of water observed at the time of visit.

COMMON SPACES: The living and dining areas are clean and properly furnished with seating and a table for client use. Medication was observed in a locked closet by the hallway. Knives and sharps were also observed locked in hallway closet. The fire extinguisher was observed and fully charged. LPA observed one (1) client watching television in the living room at the time of visit.

INFECTION CONTROL: During today’s visit, the LPA spoke with the House Manager regarding the facility’s infection control practices. The LPA observed appropriate signage which promoted good hand hygiene, physical distancing, and symptoms of COVID-19. The facility has a central entry point for symptom screening, temperature checks, and sanitation station. The LPA observed an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. All staff and residents are fully vaccinated and boosted. No identified staffing concerns.

Exit interview conducted. No citations issued. A copy of the report was provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

LIC809 (FAS) - (06/04)

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