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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197606270
Report Date: 11/02/2023
Date Signed: 11/20/2023 05:36:24 PM

Document Has Been Signed on 11/20/2023 05:36 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:DENOGEAN ADULT RESIDENTIAL FACILITYFACILITY NUMBER:
197606270
ADMINISTRATOR:RICHARD W. DENOGEANFACILITY TYPE:
735
ADDRESS:10712 ARTRUDE STREETTELEPHONE:
(818) 353-8214
CITY:SHADOW HILLSSTATE: CAZIP CODE:
91040
CAPACITY: 4CENSUS: 4DATE:
11/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Rick DenogeanTIME COMPLETED:
02:00 PM
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On 11/02/23 at around 09:30 AM Licensing Program Analyst (LPA) Christopher Alemoh conducted an unannounced Required – 1 Year Inspection to Denogean Adult Residential Facility and met with LPA was greeted by Administrator Richard Denogean, who allowed LPA to enter. LPA’s temperature was taken upon entry, and a cleaning station, or sign-in/visitor record book was located at the front door. LPA explained the purpose of the visit and were accompanied by Administrator Richard Denogean inside and outside the facility during this inspection.
The facility is a single-story home, that is divided, with an additional separate living quarter used for clients. LPA observed the property, and there are (2) shared rooms, and a private bathroom.

This facility is licensed to serve 4 adults ages 18 – 59 years. A total of 4 clients are currently residing in this facility, 4 out of 4 clients are non-ambulatory. A total of 2 staff were present during this inspection.

Outside grounds were toured and no bodies of water were observed. Patio furniture under a shaded area was accessible to clients. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises.

2 out of 2 client’s bedrooms were checked. Mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly. Adequate lighting and toiletries accessible to clients. LPA Alemoh tested hot water temperature and it measured between 113.5- and 114.8-degrees Fahrenheit. This facility provides clients with residents with hygiene products such as feminine napkins, nonmedicated soap, toilet paper, toothbrush, toothpaste, and comb.

LPA observed supplies of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days in the Pantry behind the kitchen.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Christopher Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2023
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: DENOGEAN ADULT RESIDENTIAL FACILITY
FACILITY NUMBER: 197606270
VISIT DATE: 11/02/2023
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LPA observed that Medications and sharp objects were safe, locked and inaccessible in the kitchen cabinet. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated. Last Disaster drill was conducted on 10/31/2023. First aid kit is fully stocked with manual. Smoke and carbon monoxide detectors were in compliance and operational in the Administrator office. Four (4) Fire Extinguishers were observed throughout the facility purchase date is April 24th, 2023

Six (6) staff records were reviewed, 6 out of 6 staff records had current first aid certificates and had required criminal record clearances or criminal record exemptions.

Four (4) client records were reviewed and, 4 out of 4 client records had Admission Agreements, Medical Assessments, Pre-appraisals (or Reappraisals) and/or Needs & Services Plans. LPA Alemoh reviewed P&I money, 4 out of 4 residents P&I were intact and were not commingled with facility funds or petty cash.

No deficiencies cited.

An exit interview was conducted. A copy of this report and appeal rights were discussed and left with Administrator Richard Denogean.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Christopher Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023
LIC809 (FAS) - (06/04)
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