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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801810
Report Date: 02/06/2023
Date Signed: 02/06/2023 01:56:36 PM

Document Has Been Signed on 02/06/2023 01:56 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,
, CA
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: DATE:
02/06/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Evan GranucciTIME COMPLETED:
02:10 PM
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Licensing Program Analsyt (LPA) Teresa Camara conducted a Collateral visit to this facility regarding complaint control number 29-AS-20221006144842. This complaint is unrelated to this facility. LPA met with Executive Director (ED) Evan Granucci and explained the reason for the visit.

At 12:50 p.m. the ED escorted LPA to the room of resident #1 (R1). At 12:52 p.m. LPA conducted an interview of R1 and R1's private companion regarding an incident which too place at another facility. R1 moved from the other facility at the end of October 2022 into Ventura Townehouse.

No deficiencies were observed during LPA's visit to Ventura Townehouse. Report emailed to ED.
SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2023
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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