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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609496
Report Date: 04/18/2024
Date Signed: 04/18/2024 02:19:58 PM


Document Has Been Signed on 04/18/2024 02:19 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:ENCINO TERRACE SENIOR LIVINGFACILITY NUMBER:
197609496
ADMINISTRATOR:ARTEAGA, IRMAFACILITY TYPE:
740
ADDRESS:16025 VENTURA BLVDTELEPHONE:
(818) 986-8466
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY:85CENSUS: 48DATE:
04/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Sonia NaultTIME COMPLETED:
01:05 PM
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Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at approximately 11:25 am. LPA was greeted at concierge desk. The administrator was present at the facility and LPA disclosed the purpose of the visit to the administrator.

LPA conducted a tour of the physical plant at approximately 12:05 pm to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

The common areas were observed for the ability to safely serve the needs residents. The following areas were observed: Gym-three (3) activity areas, dining/private dining room, library, and two (2) patio areas. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be sanitary and furnished appropriately.

The facility has a total of seventy-three (73) bedrooms including private bathroom in each and four (04) public restrooms for both residents and staff use.

Due to time constraints this required annual will be completed at a later time.



Exit interview conducted/Copy of report given
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha SmithTELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024
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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