197601283-11-2-2023-31-AS-GSAO-CWRRCV-20231019125459

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197601283
Report Date: 10/19/2023
Date Signed: 11/02/2023 08:07:23 AM

Document Has Been Signed on 11/02/2023 08:07 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	BETTER LIVING AND CARE		FACILITY NUMBER:	197601283
ADMINISTRATOR:	STELLA, EZROS		FACILITY TYPE:	740
ADDRESS:	734 NORTH LA JOLLA AVENUE		TELEPHONE:	(323) 651-2733
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	6	CENSUS: 1	DATE:	10/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Natalya Sadovskaya		TIME COMPLETED:	01:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA's) Gina Saucedo, Michael Cava and Angela Panushkina arrived at the facility at 10:30 am to conduct an annual. LPA's met with Natalya Sadovskaya and explained the purpose of this visit. She then called the administrator Stella Ezros whom arrived about ten minutes after. Stella Ezros walked us through the facility for our physical plant inspection. A tour of the physical plant was conducted at 10:55am and the following was observed: The facility has six (06) bedrooms and (06) bathrooms located in the bedrooms currently occupying (1) one residents. The facility has one main entrance being used, there are required Covid-19 prevention signage (handwashing, coughing etiquette, and physical distancing) posting in the entrance. The PPE screening station is located on a table at the entrance equipped with sufficient PPE readily accessible, a thermometer, hand sanitizer, gloves, mask, and sign in sheet at the time of visit. The facility maintains an overall temperature at 75 degrees Fahrenheit. Kitchen: The LPA's observed the kitchen to be clean and an adequate supply of perishables and non-perishable food. There is a pantry storing dry food, condiments, and can goods above the refrigerator. Food was properly labeled and stored. All appliances observed to be operational and in good repair. Fire extinguisher observed to be under the kitchen sink fully charged. Sharps and chemicals were observed to be stored in the kitchen pantry inaccessible to residents in care.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023

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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BETTER LIVING AND CARE	FACILITY NUMBER: 197601283
	VISIT DATE: 10/19/2023

NARRATIVE

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LPA's observed (6) bedrooms to be appropriately furnished with sufficient lighting. LPA observed appropriately bed linen and comforters on all beds. All bedrooms are single occupancy. All bedrooms observed to be clean and clear from obstruction.
LPA's observed (6) bathrooms which are located inside of the bedrooms to be
clean and in proper operation. Water temperature measured at 115.2 degrees Fahrenheit. LPA's observed appropriate grab bars in shower and toilet area with appropriate non-skid mats in six (6) out of (6) bathrooms. Bathrooms are stocked and equipped with soap and private towels use.

Medications: LPA's observed the locked medication cabinets in the medication room located in the hallway. LPA's observed the first aid kit and manual located and stored in the medication room.

Living, dining room and common areas: LPA's observed these areas to be appropriately furnished
with tables and chairs and adequate lighting. Observed to be neat and clean. The smoke detector was tested and observed to be working, it is not hard wired and interconnected throughout facility. The facility has does not have a carbon monoxide detector a Type A citation was issued.

Backyard: LPA's observed the outside area and surrounding the facility it was clean and clear from

obstruction and debris. The facility has a covered area with a table and chairs for seating, and additional table and chairs for lounging. LPA's observed a swimming pool with a self-latching gate measured a pad lock that requires a key located on the premises to be locked during the visit. LPA's observed a detached garage that is separated into two sections to be locked and storing extra personal care items, incontinent supplies, PPE in one section, and the laundry machines and toxins, extra wheelchairs, walkers, and mattresses on the second section of the garage.

Exit interview conducted. Copy of report, Type A citation issued.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 11/02/2023 08:07 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BETTER LIVING AND CARE	FACILITY NUMBER: 197601283
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

HSC

1569.311

Regulations

Every residential care facility for the elderly shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in one out of one carbon monoxide detector, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 10/20/2023
	Plan of Correction
1 2 3 4	The Licensee will agree to purchase and install a carbon monoxide detector. As proof of purchase, licensee will submit photo and invoice.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023

LIC809 (FAS) - (06/04)

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