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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610233
Report Date: 07/05/2022
Date Signed: 07/05/2022 10:56:55 AM


Document Has Been Signed on 07/05/2022 10:56 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:OASIS SENIOR LIVINGFACILITY NUMBER:
197610233
ADMINISTRATOR:KHAMBEKYAN, SANDYFACILITY TYPE:
740
ADDRESS:7001 GARDEN GROVE AVENUETELEPHONE:
(310) 666-2392
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:6CENSUS: 6DATE:
07/05/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Khatchik DanielianTIME COMPLETED:
11:03 AM
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At 10:00 a.m. on 07/05/2022 Licensing Program Analyst (LPA) Nicholas Reed conducted an announced case management visit. LPA met with Administrators Ovsanna and Khatchik (Hutch). Administrator Hutch and LPA toured the facility inside and out.

Entry: LPA observed signs regarding the facility’s COVID policies hung on the front door and inside.

Screening: LPA was not screened for temperature upon entry, though Administrator prompted LPA to sign in on visitor log. LPA advised to create three additional columns in the visitors log for temperature, symptoms, and vaccination status.

Kitchen: LPA observed sufficient supplies of perishable and non-perishable food. Thermometers located in the refrigerator and freezer showed temperatures of 38 degrees Fahrenheit and -1 degrees Fahrenheit. Sharps were locked below the counter. Medications were locked near the refrigerator. Detergents were locked in the laundry closet.

Bedrooms: LPA observed bedrails on 4 out of 6 beds. Administrator confirmed prescriptions for bedrails are on file.

2 residents were observed watching television in the common area. 4 residents were resting in bed.

2 out of 2 auditory alarms were detected. Ramps leading out from bedridden room (Bedroom #5) was free of hazards with secure handrails. Exit gate was unlocked with an inward facing latch. 2 out of 2 fire extinguishers were fully charged with receipts attached.

During today's inspection, the facility is in compliance with Title 22 regulations. No citations issued.

Exit interview conducted. Copy of report provided.

SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:
DATE: 07/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/05/2022
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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