195850240-7-11-2024-29-AS-ABAN-D73V8J-20240711161248

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195850240
Report Date: 07/11/2024
Date Signed: 07/11/2024 04:13:01 PM

Document Has Been Signed on 07/11/2024 04:13 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:	VARIEL OF WOODLAND HILLS, THE		FACILITY NUMBER:	195850240
ADMINISTRATOR:	JOYCE AQUINO		FACILITY TYPE:	740
ADDRESS:	6233 VARIEL AVE		TELEPHONE:	(818) 651-6018
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY:	436	CENSUS: 356	DATE:	07/11/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:17 AM
MET WITH:	Joyce Aquino		TIME COMPLETED:	04:15 PM

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Licensing Program Analysts (LPAs) Angela Barutyan, Kelly Dulek, and Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 9:17AM. LPAs met with Administrator Joyce Aquino. Entrance interview conducted.

Beginning at 10:25AM, the LPAs, along with Administrator Aquino, Director of Compliance (DC) Angel Ascencio, Director of Nursing (DN) Jessica Saks, and Maintenance Technician (MT) Mark Lagasca toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

FACILITY LAYOUT: The facility has 3 (three) buildings, which are named Building A, Building ,B and Building C. The facility has 336 (three hundred thirty-six) units. Building B has a Memory Care Unit on the 7th (seventh) floor and there are 3 (three) delayed egress doors on 7th (seventh) floor. At 1:27PM, LPAs tested 1 (one) delayed egress door and staff responded promptly. Buildings A and C are primarily for independent living, while Building B is for assisted living, mezzanine living, and memory care. The LPAs toured 5 (five) resident rooms in the Memory Care Unit. Rooms in the memory care unit are single occupancy and have no appliances. Lighting in the rooms appeared adequate. The rooms are equipped with beds, nightstands, lamps, chests of drawers, chairs and closet space. The bedrooms were large enough to allow for easy passage between the beds and furniture with a wheelchair or walker. The rooms in Building A, Building B, and Building C (excluding the 7th floor Memory Care Unit) are equipped with a refrigerator, microwave, and sink, and in-unit washer and dryer. The rooms in Building A, Building B and Building C are majority single occupancy, with the availability of double occupancy in some rooms. The LPAs toured 25 (twenty-five) additional resident rooms, with 9 (nine) in Building C, 7 (seven) in Building A, and 9 (nine) in Building B which were observed in compliance.

Report Continued on LIC 809-C

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Angela Barutyan	TELEPHONE: 747-922-1234
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024

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: VARIEL OF WOODLAND HILLS, THE	FACILITY NUMBER: 195850240
	VISIT DATE: 07/11/2024

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BATHROOMS: LPAs observed the bathrooms for assisted living residents to be equipped with grab bars near the toilet and shower/tub, and non-skid surfaces and mats were observed in the shower/tub. LPAs tested water temperatures in resident bathrooms and were measured to be between 107.6 and 119.3 degrees Fahrenheit, which is within the required range.

AMENITIES/COMMON AREAS: Building A has the following amenities and common areas: offices spaces, conference rooms, mail room and the bistro are located on the first floor. 1 (one) theater is located on the first floor and a 2nd (second) theater is located on the second floor. The main kitchen and dining area are located on the second floor. The second-floor amenities include: art room, the tavern with locked cabinets, the marketplace, the activity/simulator room, wine cellar, outdoor terrace, and Wellness center. The third floor has a covered outdoor area with outdoor furniture for resident use. Building B has the following amenities and common areas: pet washroom, salon, activities/conservatory room and a community garden. Throughout Building B there are community rooms and a covered outdoor area for resident use located on the third floor. Building C has the following amenities and common areas: a wellness center with gym equipment, a yoga room, a juice bar, a physical therapy room, a massage room, a laundry room and a salon. There is an in-ground pool which is kept locked on the first floor of Building C.

COMMON AREAS: The signal system can be activated in the resident bedrooms and restrooms by a pull cord. Residents also have pendants they can wear to signal staff. All systems go directly to a computer at the front desk and to hand-held devices. Designated staff carry a handheld device, which displays the location of the alarm that has been pulled. At 11:12AM and 12:12PM, LPAs pulled signal cords in resident restrooms and both times, staff arrived promptly in response. Staff also utilize walkie-talkies to communicate with staff accordingly. There are cameras observed in exterior perimeter. The community’s smoke detectors and carbon monoxide detectors are hard wired. The fire extinguishers are located on every floor in each building and were observed to be fully charged and serviced on 04/09/2024. There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted in the hallways. The emergency telephone numbers are posted in the entryway. Other required postings are posted on the first floor of Building A, near the mail room and the common hallway. The LPAs observed the Ombudsman Poster and DSS Complaint Poster throughout the community.

Report Continued on LIC 809-C

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Angela Barutyan	TELEPHONE: 747-922-1234
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024

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: VARIEL OF WOODLAND HILLS, THE	FACILITY NUMBER: 195850240
	VISIT DATE: 07/11/2024

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KITCHEN: The LPAs observed the kitchen to have a sufficient supply of perishable and non-perishable food at the time of the visit. Appliances in the kitchen were clean and appeared functional. Snacks and beverages are available for residents in the Bistro. Food is prepared in the main kitchen, which is located in Building A on the second floor and is delivered to the separate dining rooms. Emergency water supply is stored in locked storage rooms on every floor.

OUTDOOR AREAS: LPAs toured outdoor perimeter and observed self-latching gates. All exits were observed to be clear and free of hazards.

INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPAs reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. Emergency disaster drills are conducted quarterly, with the last drill conducted on 05/11/2024.\

RECORD REVIEW: 10 (ten) resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. All records reviewed were observed to be in compliance. Staff files will be reviewed during annual continuation.

MEDICATION REVIEW: Will be reviewed during annual continuation.

INTERVIEWS: During today's visit, LPAs interviewed 5 (five) residents. Staff interviews will be conducted during annual continuation.

During today's visit, LPAs obtained a copy of the facility's liability insurance.

Due to time constraints, the LPA will return at a later date to continue the inspection.

No citations issued. Exit interview conducted and a copy of the report was provided.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Angela Barutyan	TELEPHONE: 747-922-1234
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024

LIC809 (FAS) - (06/04)

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