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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609117
Report Date: 06/07/2021
Date Signed: 06/07/2021 02:50:49 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. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:SILVERADO SENIOR LIVING - CALABASASFACILITY NUMBER:
197609117
ADMINISTRATOR:GIUNTO, TAYLORFACILITY TYPE:
740
ADDRESS:25100 CALABASAS RDTELEPHONE:
(818) 222-1000
CITY:CALABASASSTATE: CAZIP CODE:
91302
CAPACITY:110CENSUS: 51DATE:
06/07/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Taylor Giunto, AdministratorTIME COMPLETED:
03:00 PM
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Licensing Program Analysts (LPAs) Aja Richardson and Salia Walker conducted a Case Management inspection regarding a self reported incident. LPAs met with the Administrator Taylor Giunto at 1:08 pm and explained the reason for the visit.

On 06/07/2021, LPAs Aja Richardson and Salia Walker began an investigation regarding a self-reported incident pertaining to Resident #1 (R1) and Resident #1 (R2). According to LPAs review of the incident report on 11/14/2020, R1 and R2 was found by staff engaging in sexual intercourse in a resident room.


On 6/7/2021, at 1:08 pm, LPAs conducted an interview with the Administrator. At 1:15 pm, LPAs conducted a facility tour with the Administrator and observed R1 sleep in room. At 1:30 pm, LPAs reviewed R1 and R2's facility file.

Additional investigation is needed. No immediate health and safety concerns observed during this visit,


Exit Interview Conducted. No citations Issued on today's date. Report emailed to the Administrator.
SUPERVISOR'S NAME: Jeralyn Ann PfannenstielTELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Salia WalkerTELEPHONE: 818-596-4379
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021
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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