567609703-2-13-2023-29-AS-SURA-CNZTAY-20230213133419

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 567609703
Report Date: 02/13/2023
Date Signed: 02/13/2023 01:35:49 PM

Document Has Been Signed on 02/13/2023 01:35 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:	REESEJOY CARE HOME		FACILITY NUMBER:	567609703
ADMINISTRATOR:	DELA VEGA RAMIREZ, ROBERTO		FACILITY TYPE:	740
ADDRESS:	1355 JUANITA AVE		TELEPHONE:	(805) 278-4043
CITY:	OXNARD	STATE: CA	ZIP CODE:	93030
CAPACITY:	6	CENSUS: 5	DATE:	02/13/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Roberto De La Vega Ramirez		TIME COMPLETED:	01:45 PM

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Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct a required annual visit at 11:30 a.m. This annual inspection had a specific emphasis on infection control practices and procedures. The LPA was greeted by staff, and staff contacted the Administrator via telephone to inform them of the visit. The LPA met with Administrator Roberto De La Ramirez and discussed the reason for the visit.

The LPA, and the Administrator, toured the physical plant areas inside and outside at 11:45 a.m. to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations.

BEDROOMS: The resident bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Currently there are five residents in the facility. Two bedrooms are share bedrooms, and one is single occupancy.

RESTROOMS: Restrooms were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. The LPA observed sufficient amounts of soap in each restroom, as well as hand washing posters.

COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common hallway. Fire extinguishers were observed to be serviced within the last year.

The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water noted. Laundry room was locked and contained storage cabinets for laundry supplies. The garage was observed locked.The emergency food supply was located in the kitchen cabinet.

Continued LIC -809 C…

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Sandra Urena	TELEPHONE: 747-230-3919
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023

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: REESEJOY CARE HOME	FACILITY NUMBER: 567609703
	VISIT DATE: 02/13/2023

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KITCHEN: Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. All knives and cleaning supplies were observed to be locked and properly stored at the time of the visit.

INFECTION CONTROL: During today’s visit, the LPA spoke with the Administrator regarding the facility’s infection control practices at 01:05 p.m. There is 1 entry into the facility. Upon entry, the facility has a central point for symptom screening. LPA noted that the facility is allowing visitors for both indoor and outdoor visitation. The LPA observed an adequate supply of Personal Protective Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility’s policies and procedures as it pertains to infection control are adequate.

Exit interview was conducted. Report was reviewed with Administrator. Copy of the report was issued

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Sandra Urena	TELEPHONE: 747-230-3919
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2023

LIC809 (FAS) - (06/04)

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