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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609781
Report Date: 02/19/2025
Date Signed: 02/19/2025 12:54:18 PM

Document Has Been Signed on 02/19/2025 12:54 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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:ZELZAH COMPASSION HOMEFACILITY NUMBER:
197609781
ADMINISTRATOR/
DIRECTOR:		NASSANGA, FATUMAFACILITY TYPE:
735
ADDRESS:9200 ZELZAH AVETELEPHONE:
(818) 324-9589
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY: 4CENSUS: 3DATE:
02/19/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Stephen KamukamaTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
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On 02/19/25, at 9:40am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, annual visit. LPA was met by House Manager, Stephen Kamukama. Fatuma Nassanga, administrator arrived about 20 (twenty) minutes later.

LPA asked for the census, client, and staff files. The physical tour started at 10:20 am and LPA observed the following:

Temperature of facility wall thermostat is observed and set to 72 degrees Fahrenheit.



There is a garage that can be accessed from the living room area. There is an extra refrigerator, and the washer and dryer are kept in the garage.

Backyard: There is a table set and chairs for clients use. There is enough seating for three (3) clients. There is no pool or any bodies of water.

Medications are in a pantry locked and secured by the entrance of the facility on your right-hand side. The first aid kit and manual are also kept in this pantry. It is inaccessible to clients.



Bedrooms: There are three (3) client bedrooms that are private on the ground level. There is also one (1) staff bedroom on the ground level. There are two (2) bathrooms on the ground level. The bathrooms read a temperature between 115 and 118 Fahrenheit. All bedrooms are properly furnished. The bathrooms have proper toiletry and mats. There is an extra closet in the hallway with extra linen. On the top floor there are two (2) staff rooms not accessible to the clients.

809C-continued

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: ZELZAH COMPASSION HOME
FACILITY NUMBER: 197609781
VISIT DATE: 02/19/2025
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Kitchen area was observed to be clean. The refrigerator is fully stacked. There is enough food storage in the cabinets and supply seven (7) day of perishable and nonperishable foods. The kitchen food supply was observed and sufficient for the three (3) clients currently residing there.

The sharps and toxins/chemicals are kept in a pantry in the living room locked and inaccessible to the clients. There is a fire extinguisher in the living room that is dated and April 2025 and fully charged. The smoke detectors were functioning properly along with the carbon monoxide which are dual and interconnected.

Administrative: There is no annual fee due. The surety bond and the Insurance plan are updated expiration date is 12/13/25. In the dining room area next to the kitchen against the wall on your left-hand side is the Personal Rights, Facility Sketch, Rights of Individuals with Disabilities, YES sign and the Emergency Disaster Plan.


An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the administrator.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025
LIC809 (FAS) - (06/04)
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