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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801810
Report Date: 11/16/2020
Date Signed: 02/17/2021 11:02:14 AM

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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:VENTURA TOWNEHOUSEFACILITY NUMBER:
565801810
ADMINISTRATOR:EVAN GRANUCCIFACILITY TYPE:
740
ADDRESS:4900 TELEGRAPH ROADTELEPHONE:
(805) 642-3263
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:566CENSUS: 220DATE:
11/16/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:44 PM
MET WITH:Evan GranucciTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) JoAnn Rosales conducted a Case Management visit virtually with Administrator Evan Granucci due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures. A Decision and Order regarding Staff #1 (S1)'s exclusion from the facility was effective 11/20/2020.

During today’s visit LPA read and reviewed the Decision and Order with the Administrator and verified that S1 resigned on 8/12/2017. Administrator provided documentation of S1's resignation letter. Administrator stated that S1's last day of work was 8/10/17. Administrator verified that they received the Decision and Order today.

No citations issued during today's visit.



A telephonic exit interview was conducted with the Administrator, and a hard copy was provided via email for signature.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Joann RosalesTELEPHONE: (626) 419-4072
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2020
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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