<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801424
Report Date: 02/22/2023
Date Signed: 02/23/2023 02:38:03 PM

Document Has Been Signed on 02/23/2023 02:38 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:ARC VC-COCHRANFACILITY NUMBER:
565801424
ADMINISTRATOR:KARIE RAGANFACILITY TYPE:
775
ADDRESS:5143 COCHRAN STREETTELEPHONE:
(805) 520-0399
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY: 90CENSUS: 36DATE:
02/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Joe Laporte - Program ManagerTIME COMPLETED:
11:45 AM
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 Analysts (LPA) conducted an unannounced required annual visit. This annual had a specific emphasis on infection control practices and procedures.

INFECTION CONTROL: During today’s visit, the LPA spoke with the Program Manager regarding the facility’s infection control practices. Upon entry, the facility has a point for symptom screening. The LPA observed an adequate supply of Personal Protective Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. 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.

Upon arrival the physical plant areas toured inside and outside with Joe Laporte Program Manager and Assistant Supervisor Brianne Esseff to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and dining room furniture was observed to be in good condition. Chairs were observed to be at least 6 (six) feet apart for social distancing. LPA also observed plastic dividers on each table. The LPA observed the required postings in the common hallway. Fire extinguishers were observed to be serviced within the last year. Carbon dioxide detector was also observed to be working at the time of visit. RESTROOMS: Public restrooms were observed to be clean and sanitary and in operating condition. The showers were in operating condition with grab bars and non-skid surfaces. The LPA observed sufficient amounts of soap and paper products in each restroom, as well as hand washing posters. The outdoor patio has a covered area equipped with furniture for client use. There were no bodies of water noted. LPA observed multiple sheds in the surrounding grounds. LPA observed each shed to be locked and inaccessible to clients. KITCHEN: The facility has a sufficient supply of perishable and non-perishable food properly stored. All knives and cleaning supplies observed to be locked and properly stored at the time of the visit. No citations were issued during today’s visit.


Exit interview conducted. A copy of report provided.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1