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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609544
Report Date: 07/19/2024
Date Signed: 07/26/2024 11:05:00 AM

Document Has Been Signed on 07/26/2024 11:05 AM - 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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:EPT BETTER LIVINGFACILITY NUMBER:
197609544
ADMINISTRATOR/
DIRECTOR:		TABACH, ELENAFACILITY TYPE:
735
ADDRESS:18217 WELBY WAYTELEPHONE:
(818) 457-4199
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY: 4CENSUS: 4DATE:
07/19/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Loreto Baguio, StaffTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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At 11:30 AM Licensing Program Analyst (LPA), Huma Rahimi, conducted an unannounced annual inspection at the facility mentioned above. LPA met with Loreto Baguio, Staff, and the Administrator Paul Tabachnikov was contacted via phone by the staff and LPA explained the reason for the visit. The Administrator designated the staff to sign the report. Physical tour was conducted with the Staff and LPA observed the following:

The facility is a single-story home located in a residential neighborhood, contains a total of (4) client bedrooms, one (1) staff bedroom, three (3) full bathrooms, a living room/activity area, office area, kitchen, dining area, backyard, and attached garage.

Kitchen: At 12:00 PM, LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps observed to be locked in a kitchen cabinet. The laundry room is located at the end of the kitchen and LPA observed all laundry detergents and other cleaning supplies locked in a cabinet.

Bedrooms: The facility is fire cleared for four (4) ambulatory residents. LPA observed total of five (5) bedrooms of which one (1) designated for staff, and four (4) designated for clients use. LPA observed that the staff room is always looked and inaccessible to clients in care. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Facility has awake staff.

Continue on LIC809-C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: EPT BETTER LIVING
FACILITY NUMBER: 197609544
VISIT DATE: 07/19/2024
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Bathrooms: LPA observed three (3) bathrooms and both appeared to be clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and client's bathroom had non-skid mat. LPA observed appropriate hand washing signs posted in each bathroom. At 12:13 PM, hot water temperature measured at 114.8°F.

Medications: At approximately, 12:15 PM, LPA observed medications are centrally stored and locked in a cabinet in the office area of the facility as well as clients and staff records/files.

Common Areas: The facility maintains a comfortable temperature at 77°F. The living room and dining area appeared clean and were properly furnished. The living room has a television, comfortable furniture. No obstructions and or tripping hazards throughout the facility. LPA observed a screened fireplace in the living room.
Smoke detectors/carbon monoxide. Smoke detectors were located throughout the facility, and at 12:41 PM, smoke alarms and carbon monoxide were tested and operable.

Outside areas: At approximately, 12:18 PM, LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for clients. Exit doors are free of any obstruction and there are no pools or large bodies of water.



Between 1:00 PM to 2:00 PM, LPA reviewed records of two (2) clients and two (2) staff. Client and staff records appeared to be complete and updated.

Administrative: LPA collected Certificate of Liability Insurance, and LIC500.

No deficiency cited during today’s visit.

Exit interview conducted and copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2024
LIC809 (FAS) - (06/04)
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