197606431-1-24-2025-31-AS-NRED-DD8SWE-20250124131413

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197606431
Report Date: 01/24/2025
Date Signed: 01/24/2025 01:14:40 PM

Document Has Been Signed on 01/24/2025 01:14 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.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	SAILS FALLBROOK		FACILITY NUMBER:	197606431
ADMINISTRATOR/ DIRECTOR:	JAMIE CALLEJAS CHAVEZ		FACILITY TYPE:	735
ADDRESS:	7453 FALLBROOK AVE		TELEPHONE:	(818) 233-8963
CITY:	WEST HILLS	STATE: CA	ZIP CODE:	91307
CAPACITY: 4		CENSUS: 3	DATE:	01/24/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Jaime Callejas		TIME VISIT/ INSPECTION COMPLETED:	01:15 PM

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At approximately 9:45 a.m. on 01/24/2025, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with the administrator and disclosed the reason for the visit.

The facility was last visited on 12/13/2023 for an annual inspection. It is a single story building with four (04) bedrooms, four (04) bathrooms, kitchen, laundry room, common areas, office, gym, and outdoor areas. It has an approved fire clearance for four (04) nonambulatory residents.

LPA observed a maintained front yard and a ramp with secure hand rails leading to the main entrance. Postings at the front included COVID precautions, facility license, confidential complaints contacts, emergency disaster plan, monthly activity calendar, and the facility sketch.

Walls, floors, windows, screens, and blinds were clean and in good repair. At 10:00 a.m. LPA measured the room temperature to be 70 degrees Fahrenheit. Two (02) residents were observed in the dining room doing a drawing activity. Two (02) staff members were observed cleaning and preparing lunch.

The living room contained a television and furniture in good repair. A fireplace was appropriately covered and turned off. At approximately 10:10 a.m. LPA observed a fully charged fire extinguisher in the kitchen. It was last tested on 01/09/2025 with a tag attached. An office near the kitchen contained confidential resident and personnel files. LPA called the house telephone at 10:15 a.m. The phone was deemed operational. A gym contained exercise equipment and emergency water and food supplies. A closet near the southwest bedrooms contained an adequate supply of fresh linens.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025

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.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAILS FALLBROOK	FACILITY NUMBER: 197606431
	VISIT DATE: 01/24/2025

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The facility has four private (04) bedrooms. All bedrooms contained a chair, lamp, nightstand, storage, and a bed with adequate bedding. All furnishings were clean and in good condition. The facility has four (04) bathrooms. All bathrooms are private and contained liquid soap, paper towels, trash can with a tight fitting lid, a handwashing instruction sign, grab bars near the toilet and shower, and a non-skid mat in the shower. At approximately 10:20 a.m. LPA measured the water temperature in the southwest bathroom to be 118.4 degrees Fahrenheit. The toilet was clogged, and an outside vendor came to repair the clog at approximately 11:00 a.m.

LPA observed an adequate supply of perishable and non-perishable foods in the kitchen and the garage refrigerator and freezer. Appliances were in good condition. Sharps, cleaning solutions, medications, and a fully-stocked first aid kit were locked in a closet. The stove surface and hood were clean. A weekly menu was posted on the refrigerator.

The garage contained a washing machine and dryer. Both were in working order. Detergents and cleaning supplies were locked near the appliances. LPA observed a patio area in the rear of the facility. The patio contained furniture in good condition.

Two (02) out of two (02) emergency exit paths were free from obstructions. The front and rear exit gates were unlocked. At approximately 10:45 a.m., smoke and carbon monoxide detectors were tested and operational.

At 11:30 a.m. LPA reviewed staff and resident files. All files were complete and available for audit.

At 12:00 p.m. three (03) out of three (03) resident cash ledgers were counted and deemed accurate.

During today's inspection, the facility was in compliance with Title 22 regulations. No immediate health or safety hazards were observed.

Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025

LIC809 (FAS) - (06/04)

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