<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191601239
Report Date: 02/12/2025
Date Signed: 02/12/2025 02:08:26 PM

Document Has Been Signed on 02/12/2025 02:08 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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:MIKO INNFACILITY NUMBER:
191601239
ADMINISTRATOR/
DIRECTOR:
NAWAL SFEIRFACILITY TYPE:
740
ADDRESS:3017 MALCOLM AVETELEPHONE:
(310) 446-1714
CITY:LOS ANGELESSTATE: CAZIP CODE:
90034
CAPACITY: 6CENSUS: 11DATE:
02/12/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Nawaz Sfeir, Administrator TIME VISIT/
INSPECTION COMPLETED:
02:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 02/12/25, Licensing Program Analyst (LPA) Yolanda Rosser conducted an unannounced visit regarding the relocation of Five (5) residents from The Palisades Villa, #197607174, 16629 W. Sunset Blvd. Pacific Palisades, CA 90272 to the facility listed above due to mandatory evacuation orders from Fire Advisory. LPA met with Nawaz Sfeir, Administrator explained purpose of the visit. LPA was provided entrance to facility by Administrator.

Miko Inn's last fire drill was on 05/15/2024. Per Administrator, five residents are currently residing from the relocation /evacuation order. One resident will be leaving facility today.

The facility has sufficient beds, bedding, hygiene supplies and linens. The facility has five bathrooms. Per Administrator, residents eat at the same time in their rooms and in the large family room. The kitchen has sufficient two-day perishable and seven-day non-perishable food supplies.

Medications and MARS of The Palisades Villa residents have been transferred to Miko Inn and located in the living room. Residents require incontinence care and are non-ambulatory requiring wheelchairs.

The Administrator stated each resident use different vendors, pharmacy and home health agencies, the facility is able to maintain the same level of continued care for the residents. There is sufficient staffing available to provide care for residents of both facilities. The Administrator stated that current Miko Inn residents will not be affected by this relocation.

An exit interview was conducted with the Administrator Nawaz Sfeir and a copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: Eva M Alvarez
NAME OF LICENSING PROGRAM ANALYST: Yolanda Rosser
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2025
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 1