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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565850260
Report Date: 09/21/2022
Date Signed: 09/21/2022 11:36:22 AM

Document Has Been Signed on 09/21/2022 11:36 AM - 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:BEST OF CARE HOMES, INC.FACILITY NUMBER:
565850260
ADMINISTRATOR:ARCENAS, OSKAR KYLEFACILITY TYPE:
735
ADDRESS:1742 EUCLID AVENUETELEPHONE:
(805) 758-3474
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY: 4CENSUS: 0DATE:
09/21/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Oskar Kyle ArcenasTIME COMPLETED:
11:40 AM
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Licensing Program Analyst (LPA) Kelly Dulek conducted a pre-licensing inspection for this proposed facility on 09/21/2022 at 09:15AM. LPA met with Licensee Representative/Administrator Oskar Kyle Arcenas. Entrance interview conducted.

A tour of the facility was initiated at 09:20AM with the licensee representative. LPA inspected facility for Fire Safety, Personal Accommodations and Services, Medication Procedures, and Food Service. The following was noted:

The facility consists of four (4) total bedrooms – all 4 are designated private rooms for client use as well as one private bathroom and one and a half shared bathrooms. Shared facility space includes a common living room, and dining area. Fire clearance was approved on 04/07/2022 for 4 total clients, two of which may be non-ambulatory in bedrooms #1 and #2.

Fire extinguishers were purchased on 03/26/2022. Fire alarms/carbon monoxide detectors were tested during today’s visit at 09:45AM and were functional. LPA observed all required postings on the wall in the main hallway/entryway.

Kitchen: The kitchen appeared clean and the appliances and fixtures functional during the time of visit. LPA observed a sufficient amount of non-perishable food at the facility; properly stored. Cleaning supplies are stored under the sink in a locked cabinet. Knives and sharp objects are stored locked. Medication: Medications and client files will be stored in a locked kitchen cabinet. First aid supplies are available. Bedrooms: There are 4 total bedrooms in the facility. All 4 are private client bedrooms. All 4 client bedrooms were checked and only one of the bedrooms contained the required dresser drawer space for client use. All

Report Continued on LIC 809-C

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2022
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: BEST OF CARE HOMES, INC.
FACILITY NUMBER: 565850260
VISIT DATE: 09/21/2022
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4 client bedrooms contained beds, chair, night stand and sufficient lighting for each client. The bedrooms had appropriate and adequate bedding and linens. Bathrooms: LPA observed all 2 and 1/2 bathrooms were clean, properly supplied and had functional fixtures. LPA observed all bathrooms to have non-skid mats. Clients have sufficient amounts of supplies for personal hygiene, which will be stored locked, if deemed appropriate for the level of care the clients require. Hot water was measured in all 3 sinks and measured at 149.1, 150.4, and 150.4 degrees Fahrenheit. Common Areas: These included the dining area and living room. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. There is a designated telephone available for client use. There are nightlights in all common hallways/rooms providing ample lighting to common bathrooms. A fireplace, which was properly screened, was observed in the living room. There is a laundry room available for client use; all chemicals were observed in a locked cabinet. Surrounding Grounds (Outdoors): There was a shaded area with proper furniture for outdoor use. There are no bodies of water on the premises.

In addition, during today’s visit, LPA conducted the Component III Orientation with the licensee representative.



The following items need to be in compliance prior to licensure:
  • Hot water temperature needs to be within the 105 to 120 degrees Fahrenheit range
  • Drawer space needs to be available for each client, minimum of 2 drawers or 8 cubic foot space

This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating under the new license until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license.

Exit interview conducted. A copy of report was provided via email.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022
LIC809 (FAS) - (06/04)
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