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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565850175
Report Date: 07/01/2022
Date Signed: 07/01/2022 01:25:00 PM

Document Has Been Signed on 07/01/2022 01:25 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:LA VENTANA TREATMENT PROGRAMSFACILITY NUMBER:
565850175
ADMINISTRATOR:VOLNER, SHARONFACILITY TYPE:
772
ADDRESS:965 RANCHO ROADTELEPHONE:
(818) 584-5615
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91362
CAPACITY: 6CENSUS: 2DATE:
07/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Rebekah Sanchez NortonTIME COMPLETED:
01:10 PM
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Licensing Program Analyst (LPA) Ashley Smith arrived at the facility unannounced at 11:50 a.m. to conduct a post-licensing/required one year annual. The LPA met with Program Director Rebekah Sanchez Norton and Sharon Volner and explained the reason for the visit.

The LPA toured the physical plant areas inside and outside with applicants to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

BEDROOMS: Whereas the facility has six (6) rooms, the facility has designated three (3) shared bedrooms for clients. All rooms are set up with beds, night stands, lamps, chests of drawers and closet space. Client Room #2 has a direct exit to the outside. Lighting in the rooms appeared adequate. Client Room #1 has a fireplace, which is covered.

BATHROOMS: There are three (3) bathrooms for client use; the half bathroom in the hallway is a designated for staff. Two out of the three client rooms has an attached bathroom, and the other client full bathroom is in the hallway. The client tubs are equipped with nonskid surfaces. Grab bars were observed in the bathrooms. The LPA observed appropriate hand washing signs in the bathrooms. Temperature in the bathroom measured at 111.2 degrees Fahrenheit.

COMMON AREA: The common areas were appropriately furnished, and the lighting was adequate. The facility smoke alarm system is hard wired; the smoke detectors were tested and were operable at the time of the visit. Emergency exiting plans/sketch are posted throughout the facility. Emergency telephone numbers are posted in the kitchen. Other required postings are posted in the hallway upon entry into the facility.
SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Ashley Smith
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2022
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: LA VENTANA TREATMENT PROGRAMS
FACILITY NUMBER: 565850175
VISIT DATE: 07/01/2022
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KITCHEN: Kitchen knives are stored locked and inaccessible in the medication closet in the hallway. The facility has a sufficient supply of perishable and nonperishable food. Appliances in the kitchen were clean and all appeared functional.

MEDICATIONS: Medications were kept locked inaccessible in the medication cabinet in the hallway.

THERAPY AND STAFF: There is an Isolation Room, a Group/Zen Room, and a Staff Room. Group and individual therapy takes place in the Recreational Room, Group Room, Living Room, and the outdoor space. Staff files will be kept in the main office. Client files will be stored electronically and physically.

LAUNDRY: The laundry area is in the hallway. Laundry detergent will be stored inaccessible in the garage.

GARAGE AND GROUNDS: The garage is accessible from the house but is designated as the Recreational Room. Personal hygiene items (shampoos, soaps) and toxic items stored in inaccessible the garage. There are additional linens and towels in the garage cabinets. The exterior passageways were clean and clear of any obstructions. There is a covered patio area in the backyard with tables and chairs where clients can sit. There is a storage shed in the backyard. There is a cascading water feature in the backyard; however the water level does not pose a safety hazard to clients in care.

INFECTION CONTROL: There is a central entry point for symptom screening and temperature checks for staff, clients and visitors. The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The staff are up to date on vaccine and visitation requirements. The facility's policies and procedures as it relates to infection control are adequate.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.

SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Ashley Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2022
LIC809 (FAS) - (06/04)
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