565801544-2-15-2024-29-AS-TCAA-D2GTEN-20240215134013

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 565801544
Report Date: 02/15/2024
Date Signed: 02/15/2024 01:41:14 PM

Document Has Been Signed on 02/15/2024 01:41 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:	ARC OF VENTURA COUNTY - OXNARD, THE		FACILITY NUMBER:	565801544
ADMINISTRATOR:	JUAN GARCIA		FACILITY TYPE:	775
ADDRESS:	416 NORTH "A" ST		TELEPHONE:	(805) 240-1620
CITY:	OXNARD	STATE: CA	ZIP CODE:	93030
CAPACITY: 90		CENSUS: 65	DATE:	02/15/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:18 AM
MET WITH:	Juan Garcia		TIME COMPLETED:	01:50 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) Teresa Camara arrived at the facility unannounced to conduct a required annual visit at 9:18 a.m. LPA met with administrator Juan Garcia and explained the reason for the visit.

Water Temperature was measured in each wing of the facility as they are each on separate water heaters. Regulatory requirements for hot water is 105*F - 120*F. Water temperatures ranged from 101-114*F. One of the water heaters was turned up a bit to meet requirements during LPA's visit. The kitchen has a dishwasher which exceeds 120*F; there is a warning posted and this is not accessible to clients.

Fire extinguishers were last serviced on 6/22/2023 and appeared full. The carbon monoxide and smoke detectors were tested and functioned properly during the visit. The facility has a fire suppression system which was last inspected on 1/3/2023 and the fire system was inspected 8/28/2023.

Common Activity Space: There are several activity rooms all throughout the facility. There is an administration building, laundry room, kitchen, dining room, building B and building D. There is an isolation room in building D for any sick clients to stay in until they can be taken home. The center outdoor patio has a covered area equipped with furniture for client use. There were no bodies of water noted. LPA did not observe any obstructions or hazards.

Activities: Activities are both designed for individuals and groups. The LPA observed staff working with clients at the facility and other staff taking clients out into the community.

(continued on 809-C)

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

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 3

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: ARC OF VENTURA COUNTY - OXNARD, THE	FACILITY NUMBER: 565801544
	VISIT DATE: 02/15/2024

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
26
27
28
29
30
31
32

(continued from 809)

Food Service: Snacks are served to clients in the morning and afternoon. Clients bring their own lunches. The kitchen is used for teaching purposes and only used under supervision with staff and participants. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. All knives and cleaning supplies were observed to be locked and properly stored at the time of the visit.

Restrooms: There are restrooms with stalls in building B and a single restroom in the administration building. The restrooms were clean and sanitary.

Files: LPA reviewed five files for randomly chosen staff and five files for randomly chosen clients. All files were complete with required documentation. All staff on the schedule were fingerprint cleared and associated to the facility.

Infection Control: There are hand sanitizers throughout the facility. The facility has a sufficient amount of PPE. The facility's procedures as it pertains to infection control are adequate.

Disaster Plan: The facility has a disaster plan and conducts monthly evacuation drills.

No deficiencies were observed. Exit interview conducted. A copy of the report was issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3