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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850496
Report Date: 08/29/2025
Date Signed: 08/29/2025 05:59:18 PM

Document Has Been Signed on 08/29/2025 05:59 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:OHANA RECOVERY CENTERFACILITY NUMBER:
195850496
ADMINISTRATOR/
DIRECTOR:		DRAKE, MELINDAFACILITY TYPE:
772
ADDRESS:1952 HAZEL NUT COURTTELEPHONE:
(818) 571-9841
CITY:AGOURA HILLSSTATE: CAZIP CODE:
91301
CAPACITY: 6CENSUS: 3DATE:
08/29/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:12 PM
MET WITH:Amy Spahr, Clinical DirectorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Zabel Chochian conducted a required annual visit to the above noted facility. The LPA met with staff and Clinical Director Amy. Reason for the visit was explained.

This is a Social Rehabilitation Facility (SRF) - physical plant is a two (2) story single family dwelling located in a residential neighborhood of Agoura Hills, CA; fire cleared for a maximum capacity of six (6) ambulatory clients (an all-female facility). There are no staff rooms – ‘awake night staff only’.



At approximately 3:45pm, LPA and the Clinical Director toured the physical plant areas inside and outside.
The first floor consists in one (1) single master bedroom, an office, a group room, a coffee/tea bar, a dining room and a living room (common areas), a kitchen, a half (1/2) bathroom and a garage. The common areas including the coffee/tea bar, living room and the dining room were appropriately furnished, and the lighting was adequate. There are television and other entertainment equipment in the living room and dining area. Also, facility has an office space and a group room for relaxation and/or other group activities. The emergency exiting plans/sketch, emergency telephone numbers, and other required postings observed posted in the common hallway. There are various fireplaces at the home appropriately screened; no tools accessible. The smoke and carbon monoxide detectors were tested and functioned properly during the time of visit. Fire extinguishers throughout the house observed to be fully charged last serviced on 11/15/2024.

Kitchen knives are stored inaccessible; supply of dishes, utensils, pots, pans and cups is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of perishable and nonperishable food observed adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen, laundry, and house cleaning supplies are inaccessible to clients. (Cont.)
NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Zabel Chochian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2025
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 3
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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: OHANA RECOVERY CENTER
FACILITY NUMBER: 195850496
VISIT DATE: 08/29/2025
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The LPA observed the garage door to be locked. Cleaning solutions, toxins, chemicals and hazardous items were inaccessible and locked away in the garage. Medications are centrally stored in a locked cabinet in the garage. Medicine cabinet and a two (2) medical refrigerator with locks were observed in the garage. The first aid kit observed inside the medication cabinet. Kit was complete. LPA observed sufficient emergency food supply at the time of the visit.

Second Floor:
The second floor consists in 4 bedrooms, 3 bathrooms, a laundry room and a sitting room. Bedrooms 2-5 were set up with a bed, night stand, lamp, chair and closet space. The bed was furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. All bedrooms are large enough to allow for easy passage between the beds and furniture. Room #2 is a master bedroom for single occupancy. Room #3 and #4 share a restroom. Room #5 is a master shared room with a balcony. All bathrooms have a shower with non-skid materials; all fixtures observed functional at the time of the visit.
LPA observed a sitting area with a television and chairs for activities and relaxation. LPA observed two (2) closets with extra bed and bath linens supplies. All rooms were free of odors.

Laundry room was observed unlocked. Laundry supplies and chemicals are stored inaccessible to residents in care. Facility staff assist clients to do their laundry when necessary.

Exterior:
The Front Yard includes a driveway, paved walkways, and landscaped areas. The backyard is fenced and includes both paved and landscaped areas, a covered patio, furniture appropriate for outdoor use. There is one (1) side gate door with self-latching mechanisms. The exterior passageways were clean and clear of any obstructions. The garage is accessible from the backyard; the door was locked. There was sufficient space to accommodate outdoor activities. All window screens were clean and maintained in good repair.

Due to time constraints the LPA will return to complete the annual at a later date.

No citations issued during today's visit. Exit interview held and copy of report provided.

NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Zabel Chochian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
LIC809 (FAS) - (06/04)
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