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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850386
Report Date: 05/12/2026
Date Signed: 05/12/2026 02:23:51 PM

Document Has Been Signed on 05/12/2026 02:23 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:ELEVATION BEHAVIORAL HEALTHFACILITY NUMBER:
195850386
ADMINISTRATOR/
DIRECTOR:		MICHELE CLARKFACILITY TYPE:
772
ADDRESS:5182 GARRETT CT.TELEPHONE:
(858) 695-4069
CITY:CALABASASSTATE: CAZIP CODE:
91302
CAPACITY: 6CENSUS: 5DATE:
05/12/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Gregory AllenTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Angela Barutyan conducted an unannounced required annual inspection at the facility. LPA arrived at 10:30AM and met with Program Director Michele Clark and Human Resources Director Gregory Allen who arrived during the visit. Entrance interview conducted.
LPA, along with the Program Director, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The Property is a two (2) story single family dwelling. The following was observed:

KITCHEN: LPA toured the kitchen at 10:47AM. Appliances and fixtures appeared clean and functional. There was a sufficient supply of nonperishable food and perishable food. Knives and other sharps are stored in the locked pantry. Cleaning supplies were not stored with food. Foods were labeled and checked for expiration dates. There were no visible immediate hazards observed.

BEDROOMS: There are five (5) bedrooms, of which four (4) are designated for private resident use and one (1) is a shared room. All bedrooms were equipped and supplied with appropriate furniture, bedding and linens, as well as emergency lighting. There were no visible hazards or discrepancies observed.

BATHROOMS: There are six (6) total bathrooms, three (3) on the ground floor and three (3) on the second floor. Five (5) restrooms are designated for private resident use and one (1) is designated as a staff bathroom. Bathrooms were clean, sanitary, and in operating condition. Water temperature was measured in client bathrooms and measured at 133.0 degrees F; staff adjusted water temperature during visit. Hot water was re-tested and measured within the required range of 105 F to 120 F at the time of the visit. LPA also observed caution hot water signs above the bathroom faucets. Report Continued on LIC809-C.
NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Angela Barutyan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: ELEVATION BEHAVIORAL HEALTH
FACILITY NUMBER: 195850386
VISIT DATE: 05/12/2026
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COMMON AREAS: On the first floor, include the living room, dining room, breakfast nook, and laundry room. On the second floor, there is a theater room and a yoga room. There are several fireplaces throughout the facility, which were adequately screened. Cleaning supplies and emergency food and water are stored in the locked garage. There were no immediate hazards observed. Fire extinguishers were observed throughout the facility; all were observed to be fully charged and last serviced on 04/27/2026; hardwired combination smoke and carbon monoxide detectors were tested at 11:56AM and all were functional at the time of the visit.
TREATMENT/THERAPY & OFFICE AREAS: There is a staff office on the lower level, and the medication area/staff office located in the attached garage. There is a group room and sitting room on the second floor.

SURROUNDING GROUNDS: The ground includes various terraced landscaped areas and paved walkways/areas, including a courtyard with access from the dining room and staff office areas, and an in-ground pool. LPA observed furniture appropriate for outdoor use. The pool is kept inaccessible to clients with the use of fencing and a locked gate. No immediate hazards were observed outdoors.

MEDICATION REVIEW: Medications are centrally stored in the locked garage. At 11:22AM, medications were reviewed for two (2) clients. Medications observed were properly labeled. LPA observed the centrally stored medication and destruction records (CSMDRs) incomplete as some medications had medication fill dates but were missing start dates. Staff use an electronic medication administration record (e-MAR) tracking system which was up to date and provided the missing information. No errors observed.

RECORD REVIEW: Staff and client files are stored electronically. Beginning at 12PM, LPA reviewed five (5) out of five (5) client files and four (4) staff files for documents including, but not limited to: admission agreements, health screening, TB test, staff training records, fingerprint clearance, needs and service appraisal, personal rights, and first aid/CPR training. All staff and client records reviewed were in compliance with Title 22 regulations at the time of the visit.

INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, LPA reviewed the facility's infection control policy and emergency disaster plan. Drills are conducted quarterly as is required, with the last documented drill on 04/15/2026. All documents reviewed were updated and in compliance.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was provided.
NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Angela Barutyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026
LIC809 (FAS) - (06/04)
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