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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610040
Report Date: 01/21/2025
Date Signed: 01/21/2025 08:29:47 PM

Document Has Been Signed on 01/21/2025 08:29 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 CANYON 2FACILITY NUMBER:
197610040
ADMINISTRATOR/
DIRECTOR:		PAIGE PORTERFACILITY TYPE:
772
ADDRESS:2890 KANAN DUME RDTELEPHONE:
(203) 823-8588
CITY:MALIBUSTATE: CAZIP CODE:
90265
CAPACITY: 10CENSUS: 4DATE:
01/21/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Paige Porter, Administrator TIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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At 11:00am, Licensing Program Analyst (LPA) Angela Panushkina arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA met with Susana Cortez, who granted access to the facility. Administrator arrived shortly after, and LPA explained the reason for the visit.

At 11:10am LPA conducted a tour of the physical plant and observed the following:

Facility is licensed for capacity of ten (10) Ambulatory clients. There are five (5) bedrooms and eight (8) bathrooms designated for clients’ use. 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. The hot water temperature measured at 109.6°F. 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. At 11:30am, LPA observed all medications and knives were locked in a room, by the kitchen. LPA observed the door had a keypad entry. The facility has eight (8) fire extinguishers located throughout the facility and were last serviced on 07/15/24. At 11:40pm, LPA observed the medication room and medication carts were properly locked and inaccessible to clients in care. Laundry is located in the garage. Two (2) washers and two (2) dryers appear to be in good condition. All laundry supplies are kept inaccessible when not in use with supervision. Smoke detectors and carbon monoxide monitors and tested/inspected by a Fire Inspector on an annual bases. Facility also test all smoke alarms monthly and it is observed to be operational. At 11:50am, LPA toured the outside area and observed appropriate outdoor furniture, with a covered shaded area for clients. There is 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. Between 12:00pm to 1:30pm, LPA reviewed records of five (5) client and three (3) 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 2
FACILITY NUMBER: 197610040
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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