567609703-2-23-2024-29-AS-TCAA-D2R2XD-20240223164659

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 567609703
Report Date: 02/21/2024
Date Signed: 02/23/2024 04:48:02 PM

Document Has Been Signed on 02/23/2024 04:48 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
WOODLAND HILLS N.ASC, 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: 6	DATE:	02/21/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:34 AM
MET WITH:	Roberto De La Vega Ramirez		TIME COMPLETED:	02:35 PM

NARRATIVE

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Licensing Program Analyst (LPA) Teresa Camara arrived at the facility unannounced to conduct a required annual visit at 11:34 a.m. LPA was greeted by staff, and staff contacted the Administrator via telephone to inform them of the visit. LPA met with Administrator Roberto De La Vega Ramirez and discussed the reason for the visit.

LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. Carbon monoxide and smoke alarms were tested and functioned properly. The fire extinguisher appeared fully charged and was purchased 2/13/2024. Hot water temperature was within regulatory requirements (105*F-120*F); it was measured at 110.9*F.

BEDROOMS: The resident bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Currently there are six residents in the facility. Two bedrooms are share bedrooms, and two are single occupancy. There is also a staff room.

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.

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. 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 on 809-C)

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 593-4347
LICENSING EVALUATOR NAME: Teresa Camara	TELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: REESEJOY CARE HOME	FACILITY NUMBER: 567609703
	VISIT DATE: 02/21/2024

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(continued from 809)

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. Medications were locked in a cabinet.

INFECTION CONTROL: LPA spoke with the Administrator regarding the facility’s infection control practices. 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. The facility’s policies and procedures as it pertains to infection control are adequate.

INTERVIEWS: LPA interviewed two residents and two staff; no concerns noted.

RECORDS: LPA reviewed medications; they appear to be given as prescribed and documentation was complete. LPA reviewed files for residents which appeared complete. LPA reviewed staff files. All staff are fingerprint cleared and associated to this facility. All staff have appropriate training. Disaster drills are conducted quarterly with all facility staff.

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

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 593-4347
LICENSING EVALUATOR NAME: Teresa Camara	TELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

LIC809 (FAS) - (06/04)

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