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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609117
Report Date: 03/27/2024
Date Signed: 03/27/2024 02:45:29 PM


Document Has Been Signed on 03/27/2024 02:45 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 N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364



FACILITY NAME:SILVERADO SENIOR LIVING - CALABASASFACILITY NUMBER:
197609117
ADMINISTRATOR:TANA MCMILLONFACILITY TYPE:
740
ADDRESS:25100 CALABASAS RDTELEPHONE:
(818) 222-1000
CITY:CALABASASSTATE: CAZIP CODE:
91302
CAPACITY:110CENSUS: 53DATE:
03/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kendall MesaTIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Sandra Urena conducted an unannounced required annual visit. Along with the required annual visit, the purpose of today’s visit was to address two self-reported Incident Reports. The LPA met with Administrator Kendall Mesa and explained the reason for the visit.

The LPA, the Administrator and the Family Ambassador toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN: Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. The dining rooms furniture appeared to be in good condition.

BEDROOMS: The LPA observed a random selection of resident rooms, and rooms were furnished appropriately with clean linens, furnishings and sufficient lighting.

RESTROOMS: The LPA observed a random selection of resident restrooms. Restrooms were clean, sanitary and in operating condition with grab bars and non-skid surfaces. Restrooms were stocked with soap and paper towels. Hand washing signs promoting good hand hygiene were observed in the common restrooms.

COMMON SPACES: Walls and flooring were checked for cleanliness and good condition. Department required postings were found lobby near the restrooms. Fire extinguishers were charged and serviced on 11/03/023.

EXTERIOR: The facility has several enclosed courtyards with appropriate outdoor seating for resident use. The swimming pool on the premises was observed to be locked.

Due to time constraints, the annual inspection will be completed on a follow-up visit.



No deficiencies cited at this time. Exit interview conducted. Signatures obtained.
SUPERVISOR'S NAME: Kasandra LopezTELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Sandra UrenaTELEPHONE: 747-230-3919
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2024
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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