<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609798
Report Date: 06/29/2022
Date Signed: 06/29/2022 05:24:20 PM

Document Has Been Signed on 06/29/2022 05:24 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:PARADIGM MALIBU - BEACH HOUSEFACILITY NUMBER:
197609798
ADMINISTRATOR:JONATHAN SANCHEZFACILITY TYPE:
772
ADDRESS:29245 CLIFFSIDE DRTELEPHONE:
(310) 457-9002
CITY:MALIBUSTATE: CAZIP CODE:
90265
CAPACITY: 6CENSUS: DATE:
06/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:TIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Jonathan Sanchez and explained the reason for the visit.

At 10:15am, with the assistance of the administrator, LPA took a tour of the physical plant. The facility is a short term crises residential treatment program. The physical plant is a two story building. Required postings were observed in the entry area. The smoke alarms are hardwired and interconnected. The carbon monoxide detector is located in the kitchen. It functions properly. There are five (5) fire extinguishers throughout the physical plant, on both the first and second floors. The charge date is 11/17/2021.

Kitchen: The kitchen appliances and fixtures are functional. LPA found a sufficient amount of perishable and non-perishable food maintained in the kitchen that were properly stored. Licensee also maintains an additional emergency food supply in the storage area. Knives were stored in a locked drawer in the kitchen.

Bedrooms: There are three (3) shared bedrooms designated for residents use. The bedrooms were properly furnished with appropriate beddings and linens with sufficient lighting.

Bathrooms: Each shared bedroom has its own bathroom that is properly supplied and had functional fixtures. The bathroom in the master bedroom has a bath tub, which is not in use for the clients. Licensee had the water for the tub shut down. Hot water temperature was measured at 108 degrees Fahrenheit. No cleaning supplies are stored in the bathrooms. Facility maintains a separate storage area for cleaning supplies, which is kept locked and inaccessible to the clients.

Common Areas: These included the living room and dining area. The common areas were properly furnished and passageways were clear of any obstruction.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2022
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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: PARADIGM MALIBU - BEACH HOUSE
FACILITY NUMBER: 197609798
VISIT DATE: 06/29/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Surrounding Grounds: Entry/exits were also free of obstruction. There are furniture in both the front and back yard, that is appropriate for outdoor use. The backyard has a swimming pool. It is geared with a five foot fence all around the parameters, with a self closing door. The pool was observed in use by clients with close supervision. LPA did observe a padlock at each gate door leading to the pool. The outdoor area was free of hazards. The laundry area and detergents are located in an area by the kitchen.

Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms.

Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms.

Medications: The medication room/office is located near the kitchen area. This room remains locked and inaccessible to clients throughout the day. Medication and Medication Records were reviewed for proper documentation.

Pursuant to Title 22 of the CA Code of Regulations, there were no no deficiencies observed during the visit.

Exit Interview Conducted / Appeal Rights Discussed / A Copy of the Report Issued.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2