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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609933
Report Date: 02/26/2025
Date Signed: 02/26/2025 12:43:56 PM

Document Has Been Signed on 02/26/2025 12:43 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:BZ HOMES, INCFACILITY NUMBER:
197609933
ADMINISTRATOR/
DIRECTOR:		AKSELRUD, ZINAIDAFACILITY TYPE:
735
ADDRESS:20601 BRYANT STREETTELEPHONE:
(310) 308-4820
CITY:WINNETKASTATE: CAZIP CODE:
91306
CAPACITY: 4CENSUS: 3DATE:
02/26/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Muhammad Kayizzi - House managerTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 2/26/2025 at 9:00am Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct a required Annual Inspection. Upon arrival LPA was greeted by the Caregiver/DSP Kayizzi Muhammad who granted access to the facility. LPA introduced herself by showing her badge and explained the reason for the visit. LPA Khurshudyan reviewed the required postings on a wall next to the kitchen area. The Co-Administrator arrived at approximately 11:00am.
The inspection tool was used to complete the visit.

At 9:25am. LPA with the help of the caregiver began a physical plant tour of the facility and the following was observed: This is a single-story building with four (04) bedrooms, two (02) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for four (4) clients. Facility is operating level 3 clients.

Kitchen: LPA observed a seven-day supply of non-perishable food and a two-day supply of perishable foods properly stored and labeled. Facility stores knives, sharps, first aid kit, emergency supply of food / water and clients’ medications inside separate kitchen cabinets which are always locked and under supervision. Facility records are kept inside locked commercial cabinets next to the office area. LPA observed fully charged one (1) fire extinguisher located in the kitchen by the pantry door. Fire extinguisher service date is 09/20/2024. A weekly menu was also available.

Common Areas: These include living and dining areas. LPA observed dining, living areas clean and clear of clutter. Furniture is generally new and in a good repair Dining and living room furniture sits the capacity of the facility. Walls, floors, windows, screens, and blinds were clean and in good repair. At 11:00am. LPA measured the room temperature to be 69 degrees Fahrenheit. There is a linen closet in the hallway with an adequate supply of fresh linens ready to use. No obstructions and or tripping hazards throughout the facility. Facility has landline, LPA checked it was operational. Continue on LIC809-C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
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: BZ HOMES, INC
FACILITY NUMBER: 197609933
VISIT DATE: 02/26/2025
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LPA observed a gated fireplace in the living room and got informed that the fireplace is non operational. There was a television and various activities, games, board games stored inside the cabinet located in the living room.

Bedrooms: There are four (4) bedrooms designated for clients use. LPA observed bedrooms to be properly furnished with beds, linens, night stands, a chairs, drawers, closet, and adequate lighting. All bedrooms appeared organized and clean.

Bathroom: There are two (2) bathrooms in the facility. The bathrooms contained hand soap, paper towels, toilet paper and trash bins with lids. Hot water temperature was taken in both bathrooms at approximately 11:30am measured 113 degrees Fahrenheit. LPA also observed required signs on the bathroom walls and non-skid mat in the shower.

Smoke and Carbon Monoxide Detectors: The smoke and carbon monoxide detectors were tested by a staff at 11:32pm and were observed operational.

Laundry Room & Garage: LPA observed the garage is attached to the facility and has access from the kitchen area. Disinfectants, laundry detergents and hygiene supplies were stored and inaccessible in a separate locked cabinet in the garage. Also in the garage were extra emergency supplies of food and water, PPE supplies functioning washer and dryer was observed at laundry room.

Backyard: LPA observed sufficient yard space with fenced backyard. Appropriate outdoor furniture, with covered shaded area available for clients to rest and enjoy outside weather. LPA discussed the importance of maintaining the care and supervision to meet the needs of clients. Exit doors were unlocked and free of obstructions. The facility does not have a swimming pool or body of water.

Staff/Client File review: At 11:10am-12:00pm. LPA conducted records review of six (6) staff files and three (3) out three (3) clients records. Files were complete and updated.

Medications: At approximately 12:05pm. LPA reviewed Centrally Stored Medication Destruction Records for proper documentation. Facility also maintains Medical Administration Records (MAR). LPA observed centrally stored medication, and First Aid kit locked in the kitchen cabinet and inaccessible to clients in care. LPA observed First-aid kit is complete and has new manual. PRN medications have written orders from a physician. Potentially dangerous items are kept inaccessible to residents in care. Facility operates with three (3) shifts and has two or three staff members for each shift.


An emergency exit plan/sketch is posted on the wall along with other posting requirements.
LPAs collected LIC500, LIC9020 and Administrators certificates.
No deficiency cited on today’s visit. Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025
LIC809 (FAS) - (06/04)
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