565850215-2-24-2023-29-AS-MARO-CPCVU9-20230224154422

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 565850215
Report Date: 02/24/2023
Date Signed: 02/24/2023 03:56:30 PM

Document Has Been Signed on 02/24/2023 03:56 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:	NEWPORT INSTITUTE -READ		FACILITY NUMBER:	565850215
ADMINISTRATOR:	STOKES, JEP		FACILITY TYPE:	772
ADDRESS:	4914 READ ROAD		TELEPHONE:	(805) 222-5110
CITY:	MOORPARK	STATE: CA	ZIP CODE:	93021
CAPACITY: 6		CENSUS: 5	DATE:	02/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Charles Jimenez		TIME COMPLETED:	04:00 PM

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Licensing Program Analyst (LPA), Martha Arroyo arrived unannounced to conduct a Required 1-Year Annual with focus on Infection Control. This will be the first Annual conducted at this facility following the pre-licensing visit on 12/22/2021. Upon arrival, LPA was scanned and greeted at the door by staff. LPA me with Residential Supervisor Charles Jimemez and the reason for the visit was explained. Entrance Interview.

At 1:57 pm, the LPA along with the Residential Supervisor began the physical plant tour of the common areas, kitchen area, client bedrooms, bathrooms, staff rooms, and outdoor area to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

The LPA observed client bathrooms for hot water temperature; the first bathroom measured 113.4 degrees Fahrenheit at 2:00 pm; the second bathroom measured 109.4 degrees Fahrenheit at 2:03 pm; the third bathroom measured 113.9 degrees Fahrenheit at 2:06 pm; and the fourth bathroom measured at 111.4 degrees Fahrenheit at 2:10 pm. LPA toured the kitchen area and observed an adequate amount of perishable and non-perishable food. LPA observed medications and first aid kit in a locked closet located near the kitchen. Sharps and knives were observed in a locked cabinet. The laundry room is locked at all times. LPA observed detergents, cleaning supplies, and toxins in locked cabinets inside the laundry room. The living areas, activity room, and dining areas are clean and properly furnished. At 2:16 p.m., the fire alarms and carbon monoxide detectors were tested and were functioning properly. LPA observed the fire extinguishers to be fully charged and last serviced on 07/20/2022. The facility was maintained at 66 degrees Fahrenheit at the time of the visit. LPA observed outdoor grounds with clear passageways with no obstructions for emergency use. No bodies of water observed at the time of visit.

Report Continued on LIC 809C ...

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

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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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: NEWPORT INSTITUTE -READ	FACILITY NUMBER: 565850215
	VISIT DATE: 02/24/2023

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Report Continued from LIC 809 ...

During today's visit, the LPA spoke with the Residential Supervisor regarding the facility's infection control practices. The LPA observed appropriate signage which promoted good hand hygiene, physical distancing, symptoms of COVID-19, and CDSS Pins. The facility has a central entry point for symptom screening, temperature checks, and sanitation station. The LPA observed 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 COVlD-19. All staff are fully vaccinated and boosted. The LPA observed staff wearing face coverings at the time of visit. No identified staffing concerns.

Exit interview conducted. No citations issued. Report was reviewed and a copy was issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

LIC809 (FAS) - (06/04)

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