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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197605589
Report Date: 04/18/2024
Date Signed: 04/18/2024 12:34:58 PM

Document Has Been Signed on 04/18/2024 12:34 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:RAWATES INC.FACILITY NUMBER:
197605589
ADMINISTRATOR/
DIRECTOR:
SUJATA RAWATEFACILITY TYPE:
735
ADDRESS:20131 LABRADOR STREETTELEPHONE:
(818) 718-7806
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY: 5CENSUS: 4DATE:
04/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Pradeep Rawate, Co-Administrator TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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At 10:00am, Licensing Program Analyst (LPA) Angela Panushkina arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA met with Staff #1, who granted access to the facility. Co-Administrator arrived shortly after and LPA explained the reason for the visit.

At 10:15am LPA conducted a tour of the physical plant and observed the following:

Facility is licensed for capacity of five (5) of which three (3) may be Ambulatory and two (2) Non-Ambulatory clients. There are five (5) bedrooms designated for clients use. Bedrooms are appropriately furnished and have appropriate lighting. The facility has awake staff. Bathrooms have soap, paper towels and hand washing signs were observed. The hot water temperature measured at 106.0°F. Extra towels and linens were readily available. During the LPA did not observe any immediate health and safety concerns. Facility maintains a temperature of 70°F. LPA observed there to be sufficient stock of one-week perishable foods and two-day non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Sharps, cleaning supplies and medications are centrally stored and are kept locked in a kitchen cabinets. The fire extinguisher was observed in the kitchen area and was last serviced on 01/23/2024. Laundry is located outside by the kitchen, and LPA observed all chemicals and detergents are kept locked and inaccessible to clients in care. LPA observed a clean covered patio and backyard furniture to accommodate the five (5) clients. Smoke detectors and carbon monoxide monitors were tested at 11:30am and observed to be functional. Between 11:30am to 12:30pm, LPA reviewed records of four (4) clients and one (1) staff. Resident and staff records appeared to be complete and updated. LPA collected Certificate of Liability Insurance and LIC500.

No citations issued during this visit.
Exit interview conducted and copy of this report signed and delivered.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2024
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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