197606107-5-22-2026-31-AS-NSHN-DUBSYC-20260522141718

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197606107
Report Date: 05/22/2026
Date Signed: 05/22/2026 02:17:42 PM

Document Has Been Signed on 05/22/2026 02:17 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	RICH-WAL CENTER #3, THE		FACILITY NUMBER:	197606107
ADMINISTRATOR/ DIRECTOR:	SHIRLEY A. WALKER		FACILITY TYPE:	735
ADDRESS:	15832 BAHAMA STREET		TELEPHONE:	(747) 529-6498
CITY:	NORTH HILLS	STATE: CA	ZIP CODE:	91343
CAPACITY: 6		CENSUS: 6	DATE:	05/22/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Shirley Walker - Administrator		TIME VISIT/ INSPECTION COMPLETED:	02:15 PM

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Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced Required - 1 Year annual inspection visit. Upon arrival at 8:30 am, LPA met with Shirley Walker - Administrator and explained the purpose of the visit. The program is vendorized through the North Los Angeles Regional Center. The Adult Residential Facility (ARF) is licensed for six (06) ambulatory clients ages 18 through 59. Current census is six (6) ambulatory clients.

LPA toured the facility with the Administrator at 10:40 am and observed the following:

Required postings were observed in the dining room. The front entry is the main exit door. There is an exit door in the kitchen with two additional sliding exit doors in the family room. The physical plant appeared clean, sanitary and with no visible immediate hazards. There is one (1) fully charged fire extinguisher in the dining room, which was serviced on 04/07/26. Facility conducts quarterly fire and earthquake drills. The last drill was conducted on 05/21/2026. LPA reviewed the facility liability insurance which expires on 11/12/2026. The dual smoke alarms and carbon monoxide detectors are hardwired and interconnected. At 11:49 am the smoke/carbon monoxide detectors were tested and observed to function properly.

Kitchen: There is a refrigerator, stove, microwave and dishwasher in the kitchen with a breakfast nook with a round table and chairs. Knives and other sharp kitchen utensils are stored and locked in a kitchen cabinet. Food storage and preparation areas are clean and sanitary. LPA found a sufficient amount of perishable food (2 days) and non-perishable food supplies (7 days) in kitchen cabinets and refrigerator. All food supplies were properly dated and stored. LPA observed a water filtering system underneath the kitchen sink.

Bedrooms: There are three (3) bedrooms designated for clients’ use and one bedroom for live-in staff, there is always awake staff at night. All bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space.

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NAME OF LICENSING PROGRAM MANAGER: Mary G Flores
NAME OF LICENSING PROGRAM ANALYST: Nadia Shahbazian
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

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

FACILITY NAME: RICH-WAL CENTER #3, THE	FACILITY NUMBER: 197606107
	VISIT DATE: 05/22/2026

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Bathrooms: Facility has three (3) bathrooms for clients' use. The bathroom inside the kitchen is used by all clients but there is a separate bathroom for women and one for men. The hot temperature ranged between 112.8 and 114.8 degrees Fahrenheit. All toilets and sinks are maintained in sanitary, operating condition.

Common Areas: The living room is located by the door and leads to the dining room. There is a family room, with two sliding doors, next to the dining room. Two properly glass covered functional fireplaces were observed in the living room and the family room. LPA observed all common areas to be furnished with adequate furniture to accommodate a maximum capacity of six (6) clients. There is a closet in the hallway to store office supplies and printer and another closet for linens. There is functioning telephone, internet and cable on the premises.

SURROUNDING GROUNDS: There are no bodies of water in the facility. The front and back yards were nicely maintained and all walkways were free of obstruction. The back of the facility has sufficient yard space. LPA observed appropriate outdoor furniture, with an umbrella. The garage is attached and is accessible through the kitchen. Garage is used as storage and staff use street parking. The laundry washer and dryers are located in the garage. There is a locked cabinet in the garage to store all chemicals and detergents; in addition there are two refrigerators with perishable food supplies and emergency food/water and an electrical generator.

Medication/Files: All medications, clients/staff files are kept in the kitchen cabinet and observed to be locked and inaccessible to clients in care. There is a complete first-aid kit in the cabinet with all required supplies and a first aid manual.

LPA reviewed records of all six (6) clients and three (2) staff. Clients and staff records appeared to be complete and updated. Clients’ files contain signed admission agreements, medical assessment, and all other required documentation. Medications for three (3) clients were counted and verified for accuracy of administration based on physician orders. Staff files were reviewed to ensure all forms and training certificates are up to date. LPA reviewed the Infection Control Plan and the Emergency and Disaster Plan.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies observed during the visit.

Exit Interview Conducted / A Copy of the Report provided to Administrator.

NAME OF LICENSING PROGRAM MANAGER: Mary G Flores
NAME OF LICENSING PROGRAM ANALYST: Nadia Shahbazian
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

LIC809 (FAS) - (06/04)

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