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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610328
Report Date: 05/22/2024
Date Signed: 05/22/2024 12:58:39 PM

Document Has Been Signed on 05/22/2024 12:58 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:LIFESYNC MALIBUFACILITY NUMBER:
197610328
ADMINISTRATOR/
DIRECTOR:		OHOP, RYELYFACILITY TYPE:
772
ADDRESS:5795 CALPINE DRIVETELEPHONE:
(310) 951-6340
CITY:MALIBUSTATE: CAZIP CODE:
90265
CAPACITY: 6CENSUS: 1DATE:
05/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Ryely Ohop, Administrator TIME VISIT/
INSPECTION COMPLETED:
12:55 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 Sasha Morris, 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 six (6) Ambulatory clients. There are four (4) bedrooms designated for clients’ use, of which two (2) bedrooms are private and two (2) bedrooms are shared. Bedrooms are appropriately furnished and have appropriate lighting. Facility has 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 120.0°F. Facility maintains a temperature of 73°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. The facility has seven (7) fire extinguishers located throughout the facility and were last serviced on 11/27/23. Laundry is located upstairs. The washer/dryer appear to be in good condition. Laundry supplies are kept inaccessible when not in use with supervision. All chemicals, detergents and medications are kept in the garage and inaccessible to clients in care. LPA observed the garage door had a lock that can be accessed with an individual employee thumb print. Smoke detectors and carbon monoxide monitors were tested at 11:30am and observed to be functional. At 11:50am, LPA observed appropriate outdoor furniture, with a covered shaded area for clients. There is a swimming pool that is fenced all around with a gate that will be kept locked at all times. The fence surrounding the swimming pool is approximately 5 feet high all around. You will need a key to gain entry to the swimming pool as it is kept locked at all times.
Continue on LIC809-C
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2024
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: LIFESYNC MALIBU
FACILITY NUMBER: 197610328
VISIT DATE: 05/22/2024
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LPA discussed the importance of maintaining the care and supervision to meet the needs of clients. Between 11:50am to 12:30am, LPA reviewed records of one (1) client and two (2) staff. Client and staff records appeared to be complete and updated. LPA collected Certificate of Liability Insurance and LIC500.

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: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
LIC809 (FAS) - (06/04)
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