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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610233
Report Date: 03/05/2024
Date Signed: 03/05/2024 10:54:10 AM


Document Has Been Signed on 03/05/2024 10:54 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
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364



FACILITY NAME:OASIS SENIOR LIVINGFACILITY NUMBER:
197610233
ADMINISTRATOR:DANIELIAN, KHATCHIKFACILITY TYPE:
740
ADDRESS:7001 GARDEN GROVE AVENUETELEPHONE:
(310) 666-2392
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:0CENSUS: 0DATE:
03/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Khatchik DanielienTIME COMPLETED:
11:00 AM
NARRATIVE
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At 10:15 a.m. on 03/05/2024, Licensing Program Analysts (LPAs) Nicholas Reed and Raymond Comer conducted an unannounced case management visit to Leo's Assisted Living II (197610054). LPAs met with the applicant of Oasis Senior Living who is also the administrator of Leo's Assisted Living II and disclosed the reason for the visit.

Today's case management visit is conducted to amend a previous report and assess civil penalties.

LPA conducted a case management visit at 10:50 a.m. on 10/04/2023 to confirm facility operations ceased since the issuance of a Notice of Operation in Violation of Law (NOVL) Letter on 09/07/2023. When the NOVL was issued and during an Informal Conference held at the Woodland Hills Adult and Senior Care Regional Office on 08/23/2023, it was discussed that the facility needed to cease operations. Interview with the Operator at 11:00 a.m. on 10/04/2023 revealed 3 residents had resided in the facility from at least 09/07/2023 until 10/03/2023. Alternate placement was arranged for three (03) out of three (03) residents on the evening of 10/03/2023. Interview also revealed that the Operator was informed by their consultant to keep residents in place during the appeal process of the application denial. LPA and the Operator conducted a physical plant tour at 11:20 a.m. on 10/04/2023 to ensure no residents remained in the facility. It was confirmed through interview and plant tour that the facility has ceased operations as of 10/04/2023.

Due to continued facility operations after the issued NOVL, civil penalties are hereby assessed in the amount of $100 per resident per day for the first 15 days and $200 per resident per day on the 16th day and every day after. From 09/08/2023 to 09/22/2023, civil penalties are assessed in the amount of ($100 x 15 days x 3 residents) = $4,500. From 09/23/2023 to 10/03/2023, civil penalties are assessed in the amount of ($200 x 11 days x 3 residents) = $6,600. Total civil penalties assessed today are $11,100.

Exit interview conducted. Appeal rights discussed. Copy of report provided.

SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
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


Document Has Been Signed on 03/05/2024 10:54 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364


FACILITY NAME: OASIS SENIOR LIVING
FACILITY NUMBER: 197610233

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
03/06/2024
Section Cited
HSC
1569.485(a)

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§1569.485 Civil penalties; Appeals
(a) Notwithstanding... any person who violates Section 1569.10 or 1569.44... shall be assessed... an immediate civil penalty in the amount of one hundred dollars ($ 100) per resident for each day
This requirement is not met as evidenced by:
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The applicant removed all individuals from the facility on 10/03/2023. The deficiency is cleared and civil penalties are issued.
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Based on observations, interviews, and record review, the applicant did not comply with the section cited above in three (03) out of three (03) residents] which poses an immediate health, safety or personal rights risk to persons in care.
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Request Denied
Type A
03/06/2024
Section Cited
HSC1569.485(b)

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§1569.485 Civil penalties; Appeals
(b) The civil penalty authorized in subdivision (a) shall be doubled if an unlicensed facility is operated and... the licensure application is denied and the operator continues to operate the unlicensed facility
This requirement is not met as evidenced by:
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The applicant removed all individuals from the facility on 10/03/2023. The deficiency is cleared and civil penalties are issued.
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Based on observations, interviews, and record review, the applicant did not comply with the section cited above in three (03) out of three (03) residents] which poses an immediate health, safety or personal rights risk to persons in care.
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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: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2