565801817-10-22-2025-29-AS-ECOZ-DMPUYK-20251022160003

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 565801817
Report Date: 10/22/2025
Date Signed: 10/22/2025 04:00:49 PM

Document Has Been Signed on 10/22/2025 04:00 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 ENTERPRISES		FACILITY NUMBER:	565801817
ADMINISTRATOR/ DIRECTOR:	JUDITH FLICKNER		FACILITY TYPE:	775
ADDRESS:	2041 CABOT PLACE		TELEPHONE:	(805) 988-6508
CITY:	OXNARD	STATE: CA	ZIP CODE:	93030
CAPACITY: 60		CENSUS: 28	DATE:	10/22/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:15 PM
MET WITH:	Judith Flickner		TIME VISIT/ INSPECTION COMPLETED:	04:00 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) Esther Cortez an arrived at the Adult Day Program (ADP) unannounced to conduct a required annual visit at 12:15 p.m. The LPA met with Director Judith Flickner and explained the reason for the visit. Upon arrival, there were one (1) consumers and five (5) staff in the building. The program currently operates from 8:00 a.m. to 2:00 p.m. Record Review: A review of facility files was conducted at 12:30 p.m. The LPA observed documentation of Infection Control, Disaster prevention, and last disaster drill conducted on 10/16/25. The LPA obtained Client Roster, Staff Roster, and Insurance Liability. The LPA reviewed five (5) of twenty-eight (28) Client Files, and five (5) of seventeen (17) staff files. The LPA observed Client 1 (C1) did not have a Physician's Report on file, and staff 1 (S1) did not have a CPR/1st aid on file. Upon observation, Director Judith stated S1 does have their certificate and will submit to LPA, otherwise all resident and staff documents reviewed appeared complete and current. At 3:15 p.m., the LPA and Administrator toured the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. Cleaning supplies are stored in a locked supply closet. The fire extinguishers were fully charged and last serviced on 12/19/2024. 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. The hot water temperature in one of the restrooms measured at 110.0 degrees Fahrenheit. Report will continue on LIC 809-C 2nd page.

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Esther Cortez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: 10/22/2025

NARRATIVE

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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.

Activities: Activities are both designed for individual and as a group. Activity supplies were observed in the large activity 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. 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. Carbon monoxide in the kitchen area was tested and operable.

Due to time constraints the LPA will return at a later date to complete the annual.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted and copy of the report and appeal rights provided to the Director.

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Esther Cortez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/22/2025 04:00 PM - It Cannot Be Edited

Created By: Esther Cortez On 10/22/2025 at 03:49 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: CREATING OPPORTUNITIES & VOCATIONAL ENTERPRISES	FACILITY NUMBER: 565801817
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/22/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

82069(a)

Client Medical Assessments

(a) Prior to or within 30 calendar days following the acceptance of a client, the licensee shall obtain a written medical assessment of the client that determines the licensee's ability to provide necessary health-related services to the client. The assessment shall be used in developing the Needs and Services Plan. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in one out of five clients which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/05/2025
	Plan of Correction
1 2 3 4	Director Judith agrees to obtain clients medical assessment and submit to LPA by 11/05/2025.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Kasandra Lopez
NAME OF LICENSING PROGRAM MANAGER:

	Esther Cortez
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025

LIC809 (FAS) - (06/04)

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