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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850546
Report Date: 12/19/2024
Date Signed: 12/20/2024 09:55:30 AM

Document Has Been Signed on 12/20/2024 09:55 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:SAVANT OF WOODLAND HILLSFACILITY NUMBER:
195850546
ADMINISTRATOR/
DIRECTOR:		SIDNEY, KEVANFACILITY TYPE:
740
ADDRESS:21711 VENTURA BLVDTELEPHONE:
(818) 999-2610
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91364
CAPACITY: 322CENSUS: 103DATE:
12/19/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Kevan Sidney & Nirjara AcharayaTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility to conduct a Pre-Licensing visit at the proposed facility site. Upon arrival LPA met with Applicant Representative/Administrator Kevan Sidney and Savant of Woodland Hills - Vice President Nirjara Acharaya.

This is a change of ownership application from Commons at Woodland Hills, The to Savant of Woodland Hills - A Residential Care Facility for the Elderly (RCFE) with requested capacity of 322 residents. The facility is currently operating as Commons at Woodland Hills #197609641 with a current census of 103.
At 11:30am a tour of the physical plant was conducted. The Facility consist of a single building with three (3) levels. The Facility is equipped with climate control central air and heating (75*F at the time of visit today).

KITCHEN: The facility is equipped with a kitchen that is supplied with adequate dining and cook ware. Sufficient supplies of perishable and nonperishable food observed. Appliances and fixtures observed clean and functional. The walk-in refrigerator observed at 40 degrees and walk-in freezer at 0 degrees. They have a dishwashing machine that is used to clean the dishes. Emergency food storage and supplies observed on the 2nd floor.

BEDROOMS: There are 161 resident units total in assisted living side, with 12 rooms that are shared in the memory care area. The memory care rooms are 201 - 211 and 226- 240. There is a delayed egress door to both entrances to the memory care unit with a 15 second delay and key code entry. LPA observed the following resident rooms #103, 108, 115, 208, 210, 336, 310, 315, 325, and 317; all rooms observed appropriately furnished. All bedrooms were supplied with all required bedding and linens. There is sufficient lighting as well as closet and drawer space available. All resident bathrooms are properly equipped with grab bars and non-skid mats/strips for shower and walk in tubs. Hot water in the resident rooms was between 111.5-114.5 degrees Fahrenheit . All bathrooms are properly equipped with grab bars in the shower / walk in tub and by the toilet. The resident rooms have emergency pull cord system - pull cords tested during visit.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: SAVANT OF WOODLAND HILLS
FACILITY NUMBER: 195850546
VISIT DATE: 12/19/2024
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COMMON AREAS: These include the following on the first floor a library, multi-purpose / activity room, dinning room, hydration area, and the auditorium. On the second floor has the memory care area with patio, dining and activity area. The third floor has additional resident rooms. All the rooms have been appropriately furnished. There is a dedicated area for the posting of required documents directly by the main entrance and hallway. The facility has a fire alarm and sprinkler system in place. The facility smoke alarm system is hard wired and last tested on 11/7/2024 by Taasco Co.. All fire extinguishers are fully charged and last serviced on 03/08/2024. The facility has no fountain or swimming pool. There are no bodies of water.

BATHROOMS: There are several common bathrooms. The first floor has 2 bathrooms along the main hallway. The second floor has 1 bathroom located in the memory care unit. The third floor bathroom is along the main hallway by the elevator.

LAUNDRY ROOM / PARKING AREA / STORAGE: There is a laundry room located next to the kitchen. There are two laundry areas, the one with industrial washers and dryer that the facility staff use. There is also a smaller laundry area is equipped with 2 washers and 2 dryers for resident use. The staff break room is located next to the laundry rooms. There is no garage but there is limited parking at the back of the facility (north side). SURROUNDING GROUNDS: The property is equipped with gates west side of the building. There is no gate on the east side of the building leading to the parking area.

MEDICATION ROOM: Is located on the third floor and is locked and inaccessible to the residents. The room is also equipped with several first kits. FACILITY RECORDS: The facility records are kept in the office for both residents and staff members. The medication room also has resident records pertaining to health care needs.

Comp III conducted with the Administrator.

This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license.

Exit interview conducted. A copy of the report was issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
LIC809 (FAS) - (06/04)
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