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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610045
Report Date: 12/22/2021
Date Signed: 12/27/2021 09:47:40 AM

Document Has Been Signed on 12/27/2021 09:47 AM - 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 ON THE HILLFACILITY NUMBER:
197610045
ADMINISTRATOR:HOWARD, IANFACILITY TYPE:
772
ADDRESS:4156 SUNSWEPT DRTELEPHONE:
(203) 823-8588
CITY:STUDIO CITYSTATE: CAZIP CODE:
91604
CAPACITY: 6CENSUS: DATE:
12/22/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:NobodyTIME COMPLETED:
10:44 AM
NARRATIVE
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***This document has been amended to remove deficiency. Licensee informed LPA on 12/24/2021 the facility currently has no clients and never had clients****

At approximately 9:50 AM Licensing Program Analyst (LPA) Nicholas Reed arrived to Montare on the Hill for a Case Management visit. No Administrator, staff, or residents were observed at the facility.

LPA saw a streetside mailbox overflowing with mail.

LPA toured the outside of the facility at approximately 9:55 AM. LPA observed an open garage with no vehicles inside. LPA observed the garage door was broken and dented in. LPA observed a locked and gated pool at the entrance, though LPA found a side door to the pool which had no lock. The side access was a gate door with a self-latching mechanism which swung inward towards the pool. LPA observed an accessible bottle of Evaporator Coil Cleaner outside.

LPA knocked on the front door 3 separate times and nobody answered. LPA knocked on 3 side doors as well, yet nobody answered. LPA observed lights on in 2 rooms. LPA observed an office area in the back and a shared room with two beds on the facility’s south side.

At 10:08 AM, LPA attempted to call Administrator, yet LPA received no answer. LPA left a voicemail disclosing the reason for today’s Case Management visit. LPA called back at 10:40 AM to discuss citation and appeal rights.

LPA to email a copy of today’s report, citations, and appeal rights to Administrator.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE: DATE: 12/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/22/2021
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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Document Has Been Signed on 12/27/2021 09:46 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 12/27/2021 09:43 AM


Created By: Nicholas Reed On 12/22/2021 at 10:31 AM
Link to Parent Document Below:
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 ON THE HILL
FACILITY NUMBER: 197610045

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/22/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/23/2021
Section Cited
CCR
00000

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****This document has been amended. Licensee informed LPA the facility is vacant and has no clients. Therefore, hazardous material observed by LPA was not a health and safety risk to anyone****
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No deficiency.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Cassandra Harris
LICENSING EVALUATOR NAME:Nicholas Reed
LICENSING EVALUATOR SIGNATURE:
DATE: 12/27/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/22/2021


LIC809 (FAS) - (06/04)
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