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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565850111
Report Date: 03/08/2022
Date Signed: 03/09/2022 01:43:10 PM


Document Has Been Signed on 03/09/2022 01:43 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364



FACILITY NAME:LEXINGTON ASSISTED LIVINGFACILITY NUMBER:
565850111
ADMINISTRATOR:SANJUANA ENRIQUEZFACILITY TYPE:
740
ADDRESS:5440 RALSTON STTELEPHONE:
(805) 644-6710
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:125CENSUS: 72DATE:
03/08/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:04 PM
MET WITH:SanJuana EnriquezTIME COMPLETED:
02:27 PM
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A virtual Informal Conference was conducted today. The purpose of this Informal Conference is to discuss the failure to report a COVID-19 outbreak at the facility in February 2022.

In attendance included Licensing Program Manager (LPM) Kristin Heffernan, Licensing Program Analyst (LPA) JoAnn Rosales, Administrator SanJuana Enriquez and Operations Manager Matteo DiGrigoli.

LPM Heffernan discussed substantiated complaints and citations issued from the past three years. LPM Heffernan discussed how the Administrator plans to stay in compliance and the best ways to work with the Department for additional support and assistance. The Operations Manager indicated that they are almost fully staffed at this point and that they have delegated the reporting to their new Wellness Director. The Operations Manager stated that they will have staff conduct room sweeps and when doing rounds to keep eyes out for chemicals or any other hazardous items. The Operations Manager stated that they have placed numerical locks on doors to medications or hazardous items that auto lock when closed. The Operations Manager stated that before they hire anyone they will be checking the Guardian portal to make sure that are eligible for association to the facility.

The Administrator was informed that Community Care Licensing (CCL) shall continue to monitor the facility with inspection visits as often as necessary to ensure the Licensee's compliance with Title 22 Regulations. The Administrator was also informed that further citations and/or non-compliance may result in a Non-Compliance Conference with the Regional Manager and review with CCL's legal division for further actions warranted.



Exit interview conducted and copy of today's report was provided to the Administrator.
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Joann RosalesTELEPHONE: (626) 419-4072
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2022
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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