197610115-1-12-2023-31-AS-MCAA-CMZU2S-20230112141224

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197610115
Report Date: 01/12/2023
Date Signed: 01/12/2023 02:12:29 PM

Document Has Been Signed on 01/12/2023 02:12 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:	SEASONS RECOVERY CENTERS, LLC.		FACILITY NUMBER:	197610115
ADMINISTRATOR:	SHEILA, SHILATI		FACILITY TYPE:	772
ADDRESS:	27901 WEST WINDING WAY		TELEPHONE:	(424) 234-2060
CITY:	MALIBU	STATE: CA	ZIP CODE:	90265
CAPACITY: 6		CENSUS: 3	DATE:	01/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Sheitla Shilati		TIME COMPLETED:	02:00 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, Sheila Shilati and explained the reason for the visit. At approximately 10:45am, with the assistance of the administrator, LPA took a tour of the physical plant. The facility is a two story building with four (4) bedrooms on the second floor, and one (1) bedroom on the first. The facility is a Transitional Rehabilitation Program, with a fire clearance approved for six (6) Ambulatory only clients. Required postings were observed in the entry area. The smoke alarms are hardwired and interconnected. There are carbon monoxide detectors that functions properly installed throughout the facility. There are also fire extinguishers located in common areas throughout the facility. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Bedrooms: There are five (5) bedrooms designated for client' use. One bedroom is shared, two are semi-private and two are private. All the rooms were were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are five (5) bathrooms designated for client use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 119 degrees Fahrenheit. Common Areas: These included the living room and dining area. The common areas were properly furnished, clean and well kept. Hallways and exits were clear of any obstruction.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: SEASONS RECOVERY CENTERS, LLC.	FACILITY NUMBER: 197610115
	VISIT DATE: 01/12/2023

NARRATIVE

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Surrounding Grounds: The facility has three (3) therapy rooms and a gym. LPA observed these rooms to be clear of hazardous items. The laundry room was observed adjacent to the therapy room. Clients are allowed to do their own laundry. There is a swimming pool, that was observed to have a five foot fence surrounding its parameters, and a locked gate at entry. LPA observed furniture appropriate for outdoor use. The outdoor, front and back yards were free of any obstruction.

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: Medication and Medication Records were review for proper documentation.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and Copy of the Report Issued.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

LIC809 (FAS) - (06/04)

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