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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610039
Report Date: 01/21/2025
Date Signed: 01/21/2025 08:31:07 PM

Document Has Been Signed on 01/21/2025 08:31 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:MONTARE AT THE CANYONFACILITY NUMBER:
197610039
ADMINISTRATOR/
DIRECTOR:		PAIGE PORTERFACILITY TYPE:
772
ADDRESS:2900 KANAN DUME ROADTELEPHONE:
(203) 823-8588
CITY:MALIBUSTATE: CAZIP CODE:
90265
CAPACITY: 6CENSUS: 2DATE:
01/21/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Paige Porter, Administrator TIME VISIT/
INSPECTION COMPLETED:
03:40 PM
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At 2:30pm, Licensing Program Analyst (LPA) Angela Panushkina arrived at the facility to conduct an unannounced annual inspection. LPA met with the Administrator and explained the reason for the visit.

At 2:40pm, LPA conducted a tour of the physical plant and observed the following:

Facility is licensed for capacity of six (6) Ambulatory clients. There are three (3) bedrooms designated for clients’ use and seven (7) bathrooms. Bedrooms are appropriately furnished and have appropriate lighting. Facility has two (2) awake staff at night. Bathrooms have soap, paper towels and hand washing signs were observed. Extra towels and linens were readily available. LPA observed there to be sufficient stock of one-week perishable foods and two-day non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. At2:45pm, LPA observed a keypad entry door into the medication room. All medication carts and knives were observed to be locked and inaccessible to clients in care. The facility has eight (8) fire extinguishers located throughout the facility and were last serviced on 07/15/24. LPA observed three (3) washers and three (3) dryers appeared to be in good condition. All chemicals and detergents are kept locked and inaccessible to clients in care. At 2:55pm, LPA observed appropriate outdoor furniture, with a covered shaded area for clients. LPA also observed the facility has a swimming pool surrounded with, approximately 5 feet high fence, and you will need a key to gain entry to the swimming pool as it is kept locked at all times. LPA discussed the importance of maintaining the care and supervision to meet the needs of clients. Smoke detectors and carbon monoxide were tested at 3:15pm and observed to be operational. Between 3:00pm to 3:30pm, LPA reviewed records of two (2) client and two (2) staff. Client and staff records appeared to be completed and updated. LPA collected Certificate of Liability Insurance and LIC500.
Continue on LIC809-C
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE: DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: MONTARE AT THE CANYON
FACILITY NUMBER: 197610039
VISIT DATE: 01/21/2025
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On March 2024, the Licensee hired a consultant to provide training on Title 22 regulations for the facility Administrator and staff - a minimum of four (4) hours per month for the first three (3) months and for one (1) hour per month for the remaining year. Specific training topics include but not limited to:
a. Health Related Services
b. Personal Rights
c. Plan of Operation
d. Relevant Title 22 Regulations- Responsibility for Providing Care and Supervision.

Since March 2024 to present, the Licensee submitted and will continue submitting a copy of the documentation of staff training to Community Care Licensing (CCL) on a monthly basis by the 30th of each month.

No citations issued during this visit.
Exit interview conducted and copy of this report signed and delivered.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
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