<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565802554
Report Date: 06/19/2024
Date Signed: 06/19/2024 03:53:08 PM

Document Has Been Signed on 06/19/2024 03:53 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:E3 WELLNESS CENTERFACILITY NUMBER:
565802554
ADMINISTRATOR/
DIRECTOR:		MARIA MCMANUSFACILITY TYPE:
775
ADDRESS:2585-2587 TELLER ROADTELEPHONE:
(805) 375-9222
CITY:NEWBURY PARKSTATE: CAZIP CODE:
91320
CAPACITY: 45CENSUS: 35DATE:
06/19/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:47 PM
MET WITH:Marie McManusTIME 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) Teresa Camara arrived at the facility unannounced for a required one-year annual inspection. LPA met with the Administrator Marie McManus and Program Manager Sierra Liufau and explained the reason for the visit.

At 2:00 p.m. LPA toured the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

The day program operates from 8:30 a.m. to 2:30 p.m. The day program is currently staffed appropriately with the necessary 1:1 and 1:3 staff to consumer ratios. The facility has five classrooms used as activity rooms, two conference rooms, five client bathrooms, a staff room, and a kitchen area.

Common Areas: LPA observed the kitchen area to be clean with working appliances and in good condition. Clients use the refrigerator to store their lunches. The fire extinguishers appeared fully charged and were last serviced on 5/7/2024. Smoke and carbon monoxide detectors are hardwired and tested by a service. The last fire inspection was completed in May 2024 and the facility was found to be in compliance with Fire Code Regulations at the time of inspection. Fire and earthquake drills are conducted every six months as per regulations. Facility temperature is kept at 67 degrees Fahrenheit. There were no bodies of water observed. Activities are designed for individuals and as a group. LPA observed staff interacting with clients during time of visit. No obstructions or hazards were observed inside or out. Equipment used for activities was in good condition.

(continued on LIC809-C)

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: E3 WELLNESS CENTER
FACILITY NUMBER: 565802554
VISIT DATE: 06/19/2024
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
26
27
28
29
30
31
32
(continued from LIC809)

Restrooms: LPA inspected five client restrooms. Restrooms were clean and trash cans have lids to protect clients from cross contamination. The hot water temperature was tested and measured at 103 degrees Fahrenheit. The administrator will ensure the hot water heater is adjusted to increase the temperature to between 105 - 120 degrees Fahrenheit.

File Review: LPA reviewed three staff files and three client files. Files were complete.

Medications: Facility staff handle medications for three clients. LPA reviewed all medications which appeared to be given as prescribed.

Interviews: Starting at 1:20 pm, LPA interviewed three staff members and three clients. There were no concerns noted. Clients are happy with the services provided at this day program.

Exit interview conducted. No citations issued. A copy of the report was provided.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3