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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197600299
Report Date: 04/13/2023
Date Signed: 04/13/2023 02:51:47 PM

Document Has Been Signed on 04/13/2023 02:51 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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:RICHWAL CENTER II, THEFACILITY NUMBER:
197600299
ADMINISTRATOR:FLORENCE ORIMOLOYEFACILITY TYPE:
735
ADDRESS:8915 WOODLEY AVE.TELEPHONE:
(747) 529-6514
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 4CENSUS: 4DATE:
04/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:12 AM
MET WITH:Brenda FrazierTIME COMPLETED:
03:00 PM
NARRATIVE
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At 10:12 am Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility. No answer after ringing doorbell/knocking. LPA Smith called facility at approximately 10:25 am, House manager Brenda Frazier answered phone and verified is at the facility and will open door. LPA was greeted by staff and disclosed the purpose of the visit. The administrator was contacted and arrived within approximately 10 minutes.

LPA conducted a tour of the physical plant at approximately 10:55 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Common areas were observed for the ability to safely serve the needs residents. These included the kitchen/dining room combination, living room and family room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished appropriately with adequate seating for residents.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The
kitchen food supply was observed and sufficient for the four (4) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Sharps, extra freezer and PPEs are stored in locked basement. The resident medications and first aid kit stored in locked cabinet above washer and dryer and observed to be inaccessible to residents.. There is one (1) fire extinguisher attached to wall in the kitchen and observed to be charged.

Laundry room is located in hallway. The appliances observed to be functional. Toxins stored above in
locked cabinet above washer and dryer was observed to be locked and inaccessible to residents.
(Cont to 809C)
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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 2
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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: RICHWAL CENTER II, THE
FACILITY NUMBER: 197600299
VISIT DATE: 04/13/2023
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(Cont from 809)
The facility has a total of four (4) bedrooms and two (2) bathrooms: two (2) shared bedrooms for residents and two (2) bedrooms for staff.

The resident bedrooms were properly furnished with at least one chair, night stand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. LPA observed a supply of linens in closets in family room.

Each bathroom has posted “wash your hands” signs and the following items available: hand soap, paper
towels, and trash cans. The hot water temperature was measured for the two (2) bathrooms to ensure it is
within the required range for residents’ comfort and safety. The water temperature range was between 122.5 and 123.9.6 degrees Fahrenheit.

Backyard has the following: (1) one patio table, umbrella with sufficient seating for the residents. Patio furniture observed to be in good repair.

Detached Garage with side room: Used for staff vehicle. Side room empty.
There is a gated pool in backyard. The pool observed to be locked and inaccessible to residents.
Storage shed used for storage in backyard observed to be locked and inaccessible to residents.
Smoke detectors/carbon monoxide detector were tested and operable at time of visit.

Facility grounds were free of hazards. There were no immediate health and safety hazard observed during the day of inspection.

At approximately 12:30 pm, LPA reviewed files for the four (4) residing residents. Resident files included medical assessments and individual program plans. Staff files reviewed for all three (3) staff. Staff files had the appropriate training's to include DSP1 and 2, and First aid/AED/CPR.

No deficiencies cited.

Exit Interview Conducted / A Copy of the Report Issued
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC809 (FAS) - (06/04)
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