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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801544
Report Date: 02/17/2023
Date Signed: 02/19/2023 11:26:06 AM

Document Has Been Signed on 02/19/2023 11:26 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:ARC OF VENTURA COUNTY - OXNARD, THEFACILITY NUMBER:
565801544
ADMINISTRATOR:JUAN GARCIAFACILITY TYPE:
775
ADDRESS:416 NORTH "A" STTELEPHONE:
(805) 240-1620
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY: 90CENSUS: 57DATE:
02/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Juan GarciaTIME COMPLETED:
02:10 PM
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Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct a required annual visit. This annual inspection had a specific emphasis on infection control practice,s and procedures. The LPA met with Administrator Juan Garcia, and discussed the reason for the visit.

The LPA, along with Administrator, toured the physical plant areas inside and outside from 12:35 p.m. to 1:25 p.m. to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations.

RESTROOMS: Restrooms were observed to be clean and sanitary and in operating condition. The LPA observed sufficient amounts of soap and paper products 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 center outdoor patio has a covered area equipped with furniture for client use. There were no bodies of water noted.

Continues on LIC 809C…

Jeralyn Ann Pfannenstiel
Sandra Urena
DATE: 02/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2023
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: ARC OF VENTURA COUNTY - OXNARD, THE
FACILITY NUMBER: 565801544
VISIT DATE: 02/17/2023
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KITCHEN: The kitchen is used for teaching purposes, and only used under supervision with staff and participants. 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. Upon entry, the facility has a point for symptom screening. The LPA observed an adequate supply of Personal Protective Equipment (PPE) and the facility is able to obtain additional supplies as needed. The LPA also observed that the medication room was locked. 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.

No citations were issued during today’s visit. Exit interview conducted. A copy of the report was issued.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023
LIC809 (FAS) - (06/04)
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