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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801817
Report Date: 01/08/2025
Date Signed: 01/08/2025 04:20:14 PM

Document Has Been Signed on 01/08/2025 04:20 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/
DIRECTOR:		JUDITH FLICKNERFACILITY TYPE:
775
ADDRESS:2041 CABOT PLACETELEPHONE:
(805) 988-6508
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY: 60CENSUS: 32DATE:
01/08/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Judith FlicknerTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced Case Management - Incident inspection at the facility today and met with Administrator Judi Flickner. The purpose of today's inspection is to follow up on a self-reported incident which occurred on 12/04/2024. During today's visit there were no clients present.

On 12/05/2024, the Regional Office received an Incident Report (IR), reporting that on 12/04/2024 at approximately 11:51 a.m., Staff 1 (S1) gave Client 1 (C1) Klonopin 1MG which belonged to another client during an outing. C1 was returned to the day program where vitals were taken and normal. It was further reported that the DP was instructed by C1's care home, who consulted their MD, to monitor C1.

On 12/05/2025, LPA Cortez contacted the programs Administrator to request additional information over the phone. Administrator Judith Flickner advised the LPA that C1 was doing well and that other than being sleepy and groggy the day of the incident there were no other side effects. The DP informed C1's care home of the incident and they consulted with the pharmacist, who let them know there should be no concern and to monitor the client. The Administrator further reported that S1 was disciplined and would receive medication re-training.

During today's visit the LPA interviewed the Administrator and one staff. The Administrator revealed that C1 was back to normal the next morning and is doing fine. S1 received training and proof had been submitted to licensing, however DP did not notify C1's physician of the incident. The Administrator further revealed that they have now implemented that a nurse will be going with the clients during an outing.

The following deficiencies were cited (See LIC 809-D.) from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. Report and appeal rights were provided.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2025
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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Document Has Been Signed on 01/08/2025 04:20 PM - It Cannot Be Edited


Created By: Esther Cortez On 01/08/2025 at 03:51 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: 01/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/09/2025
Section Cited
CCR
80075(b)

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Health Related Services (b) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications.

This requirement is not met as evidenced by:
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S1 was disciplined and retrained on medications, proof was received by LPA Cortez. Administrator agreed to notify C1's physican of the incident and submit proof to LPA by 1/09/2025.
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Based on record review, the licensee did not comply with the section cited above as C1 was given another clients medication, and their physician was not notified which poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Kasandra Lopez
LICENSING EVALUATOR NAME:Esther Cortez
LICENSING EVALUATOR SIGNATURE:
DATE: 01/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2025


LIC809 (FAS) - (06/04)
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