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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801913
Report Date: 02/06/2025
Date Signed: 02/06/2025 03:16:08 PM

Document Has Been Signed on 02/06/2025 03:16 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:BALLARD VOCATIONAL SERVICE CENTERFACILITY NUMBER:
565801913
ADMINISTRATOR/
DIRECTOR:		LYDIA SATTIEWHITEFACILITY TYPE:
775
ADDRESS:3151 WEST 5TH STREET, #102TELEPHONE:
(805) 815-3233
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY: 60CENSUS: DATE:
02/06/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:LaToya TateTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Esther Cortez arrived at the facility unannounced to conduct a required
annual visit at 1:40 p.m. The administrator was not in, LPA was informed clients were going to be leaving for home soon and staff were getting ready to leave as well. LPA met with the Day Program Supervisor LaToya Tate, and discussed the reason for the visit. LPA toured the physical plant with the supervisor to ensure there are no health and safety hazards. LPA observed fire extinguishers throughout the Day Program which were last serviced 12/19/2024 and appeared fully charged. The carbon monoxide and smoke detectors were tested and functioned properly during the visit.
RESTROOMS: The restrooms were observed to be clean, sanitary, and in operating condition. The LPA
observed sufficient amounts of soap and paper products, as well as hand washing signs. LPA tested the hot water temperature to be at 106.5* in the womens restroom and 102.6.*F in the mens restroom.
COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good
condition. At the time of the visit, furniture and equipment were observed to be in good condition. LPA observed the required postings in the kitchen and common hallway. LPA observed both exit doors locked during the visit, during operating hours.
KITCHEN: Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of
non-perishable food and water. Cleaning supplies were observed to be locked and properly stored at the time of the visit. Medications were observed to be locked in a locker in the supply room.
INFECTION CONTROL: LPA spoke with the Supervisor regarding the facility’s infection control practices. 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 a client is ill. The facility’s policies and procedures as it pertains to infection control is adequate.
LPA will return at a later date to continue this annual inspection. visit. 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 Supervisor.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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 02/06/2025 03:16 PM - It Cannot Be Edited


Created By: Esther Cortez On 02/06/2025 at 03:00 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: BALLARD VOCATIONAL SERVICE CENTER
FACILITY NUMBER: 565801913

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82020
Fire Clearance
All day programs shall secure through the licensing agency and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in two out of two exit doors that were locked during operating houts which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/07/2025
Plan of Correction
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Program Supervisor unlocked exit door that is primarily used during the visit and agreed to not lock doors and submit a plan on how they will ensure the safety of residents and facility compliance with the fire clearance to CCL by 02/06/2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: 02/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2025


LIC809 (FAS) - (06/04)
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