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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801555
Report Date: 06/24/2022
Date Signed: 06/24/2022 04:03:57 PM

Document Has Been Signed on 06/24/2022 04:03 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:JOYCE NEIL CARE HOMEFACILITY NUMBER:
565801555
ADMINISTRATOR:SAMUEL N. GONZALESFACILITY TYPE:
735
ADDRESS:3851 BOSTON DRIVETELEPHONE:
(805) 488-7146
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 6CENSUS: 6DATE:
06/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:02 PM
MET WITH:Wilfredo EnriquezTIME COMPLETED:
02:10 PM
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Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced Required 1 Year inspection at the facility today. The LPA met with caregiver Wilfredo Enriquez and explained the reason for today's visit. At 1:06 PM, the LPA spoke with Licensee Venie Gonzales on the telephone and informed her of the reason for today's visit. The Licensee gave permission for staff to sign today's report. When the LPA arrived there were two caregivers and four clients present. The facility is vendored by Tri Counties Regional Center as a level IV-G home

This annual had a specific emphasis on infection control practices and procedures. The LPA, along with the caregiver, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed:

KITCHEN: The kitchen and food storage areas were observed. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food stored. Items that could pose a danger were secured in the locked office. Medications are centrally stored in a locked cabinet in the kitchen area.

COMMON SPACES: In the common areas, furniture, walls, and flooring were clean and in good condition at the time of the inspection. All indoor and outdoor passages were free of obstruction. The fire extinguisher was fully charged and last serviced on 07/29/2021. The carbon monoxide detector and smoke detectors in the common areas and bedrooms were tested and were operational. Cleaning supplies were observed to be locked in the garage and inaccessible to clients in care. The backyard has outdoor seating for client use.

BEDROOMS: There are three client bedrooms. The LPA observed the client bedrooms to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting.



Report continued on LIC 809-C.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2022
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: JOYCE NEIL CARE HOME
FACILITY NUMBER: 565801555
VISIT DATE: 06/24/2022
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RESTROOMS: The facility has one common restroom and one shared restroom for client use. Restrooms were observed to be clean and sanitary with hand soap, toilet paper and paper towels. The hot water temperature was measured in the common restroom.

INFECTION CONTROL: During today’s visit, the LPA spoke with the staff 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. 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.

No deficiencies cited. Exit interview and reported reviewed with the caregiver. A copy of the report was emailed.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022
LIC809 (FAS) - (06/04)
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