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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608846
Report Date: 05/03/2022
Date Signed: 05/03/2022 05:07:19 PM


Document Has Been Signed on 05/03/2022 05:07 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:OASIS SENIOR LIVINGFACILITY NUMBER:
197608846
ADMINISTRATOR:GRANT ABADZHYANFACILITY TYPE:
740
ADDRESS:7001 GARDEN GROVETELEPHONE:
(818) 697-5253
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:6CENSUS: 6DATE:
05/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:35 PM
MET WITH:Dinah PascoTIME COMPLETED:
05:16 PM
NARRATIVE
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At 4:35 p.m. on 05/03/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced case management visit. LPA met with Administrator and disclosed the reason for the visit.

On 04/29/2022, Community Care Licensing received notice of a denied fire clearance due to unpermitted electrical work. LPA reviewed pertinent documents on 05/02/2022 and conducted interviews with Fire Inspector on 05/03/2022. From record review and interviews, it is determined that the licensee did not acquire permits from the Los Angeles Department of Building and Safety (LADBS) prior to facility alterations.

Exit interview conducted. Citation issued on LIC 809-D page. Appeal rights and copy of report provided.

SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 05/03/2022 05:07 PM - 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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364


FACILITY NAME: OASIS SENIOR LIVING
FACILITY NUMBER: 197608846

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/03/2022
Section Cited

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87305(a) Alterations to Existing Building or New Facilities Prior to construction or alterations, all facilities shall obtain a building permit.

This requirement is not met as evidenced by:
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Based on record review and interview, the licensee did not obtain permits before facility alterations. This poses a potential Health, Safety, and Personal Rights risk to residents in care.
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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: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2022
LIC809 (FAS) - (06/04)
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