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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
197608998
Report Date:
10/29/2021
Date Signed:
10/29/2021 12:38:09 PM
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:
CANYON TRAILS AT TOPANGA SENIOR LIVING
FACILITY NUMBER:
197608998
ADMINISTRATOR:
SUSAN WEISBARTH
FACILITY TYPE:
740
ADDRESS:
7945 TOPANGA CANYON BLVD
TELEPHONE:
(818) 716-9900
CITY:
CANOGA PARK
STATE:
CA
ZIP CODE:
91304
CAPACITY:
120
CENSUS:
76
DATE:
10/29/2021
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
11:30 AM
MET WITH:
Susan Weisbarth
TIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Wendell Smith conducted a case management visit go over a Decision and Order. The decision and order was served on 1/14/21 and is effective immediately. LPA met with administrator Susan Weisbarth and read over the Decision and Order in all aspects to ensure understanding.
Exit interview conducted.
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
10/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/29/2021
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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