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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801817
Report Date: 09/15/2023
Date Signed: 09/15/2023 12:47:16 PM

Document Has Been Signed on 09/15/2023 12:47 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:CREATING OPPORTUNITIES & VOCATIONAL ENTERPRISESFACILITY NUMBER:
565801817
ADMINISTRATOR:JUDITH FLICKNERFACILITY TYPE:
775
ADDRESS:2041 CABOT PLACETELEPHONE:
(805) 988-6508
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY: 60CENSUS: 24DATE:
09/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:36 AM
MET WITH:Judith FlicknerTIME COMPLETED:
12:51 PM
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Licensing Program Analyst (LPA) Teresa Camara conducted an unannounced required annual visit. LPA met with the Administrator Judith Flickner and explained the reason for the visit. At 9:40 a.m. the LPA toured the physical plant inside and out with the administrator to ensure there are no health and safety hazards.

RESTROOMS: There are four (4) total bathrooms at the facility. One (1) is designated as a shower bathroom. The bathrooms have grab bars and were clean and sanitary.

COMMON SPACES/ACTIVITY SPACE: 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. LPA observed the required postings in the common hallway. The fire extinguishers were last serviced on 2/14/2023 and there is an upcoming fire panel inspection by Boyd & Associates scheduled for 9/20/2023.

NURSE/MEDICATION ROOM: All medications were locked in a medication cart. LPA reviewed randomly chosen medication logs and medications which appear to be given as prescribed. There was a first aid kit in the medication room.

KITCHEN: Kitchen knives are stored in the locked cabinet in the administrator's office. The supply of dishes, utensils, pots, pans and drink ware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The hot water temperature was measured at 116.9*F. The supply of nonperishable food is adequate. Clients bring their own lunches. Snacks are offered to clients in the morning. There are no pesticides or toxins stored in any food storage or preparation area with utensils.

Continued on LIC 809-C
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2023
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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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: CREATING OPPORTUNITIES & VOCATIONAL ENTERPRISES
FACILITY NUMBER: 565801817
VISIT DATE: 09/15/2023
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(continued from 809)

Appliances in the kitchen were clean and all appeared functional. Trash cans had tight fitting lids. Kitchen, laundry and house cleaning supplies are stored in a locked cabinet located in a locked closet in the hallway. No flies or other vermin were observed.

INFECTION CONTROL: LPA reviewed infection control practices with the administrator. 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 does not have a confirmed case of COVID-19 at this time. The facility’s policies and procedures as it pertains to infection control are adequate.

No deficiencies were observed during today's visit. Exit interview conducted and report issued to administrator.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023
LIC809 (FAS) - (06/04)
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