<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610335
Report Date: 02/20/2026
Date Signed: 02/20/2026 11:15:00 AM

Document Has Been Signed on 02/20/2026 11:15 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:A PLACE FOR USFACILITY NUMBER:
197610335
ADMINISTRATOR/
DIRECTOR:		PASCASIO, JOEYFACILITY TYPE:
735
ADDRESS:6639 CAPISTRANO AVETELEPHONE:
(818) 854-5448
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY: 4CENSUS: 4DATE:
02/20/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Joey PIcasioTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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
At approximately 8:30 a.m. on 02/20/26, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with staff and disclosed the reason for the visit. Staff called the licensee at approximately 8:45 a.m. to disclose the reason for the visit.

The facility was last visited on 12/11/24 for an annual visit. It is a single story building with four (04) bedrooms, two (02) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for four (04) residents, of which three (03) may be nonambulatory in Bedrooms #1, #2, and #3, and one (01) ambulatory in Bedroom #4.

At the main entrance, LPA observed postings for the administrator certificate, facility license, facility sketch, confidential complaint contacts, personal rights, house rules, staff list, resident list, emergency contacts, emergency disaster plan, grievance policy, and COVID precautions. A screening station was present near the front and contained a digital thermometer, masks, hand sanitizer mounted on the wall, and a visitor log. LPA called the house phone at approximately 8:55 a.m. and deemed it to be operational.

Walls, floors, windows, screens, and blinds were clean and in good repair. The living room contained a television, video game console, and furniture in good repair. A fireplace was turned off and appropriately grated. A linen closet at the end of the hallway contained adequate amounts of fresh linens and towels. At 9:05 a.m. LPA observed a fully charged fire extinguisher in the kitchen. It was fully-charged and purchased on 01/02/25.

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Nicholas Reed
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2026
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 3
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 3
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: A PLACE FOR US
FACILITY NUMBER: 197610335
VISIT DATE: 02/20/2026
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
26
27
28
29
30
31
32
LPA observed an adequate supply of perishable and non-perishable foods in the refrigerator, freezer, and pantry. At 9:15 a.m., the kitchen refrigerator and freezer temperatures were measured to be 40 degrees and 0 degrees Fahrenheit, respectively. The stove hood was clean. Appliances were in good condition. A weekly menu was posted on the refrigerator. Sharps were locked below the counter top. Medications were locked above the counter top. Cleaning solutions were locked and stored below the staff bathroom sink. A medication review was conducted at 9:20 a.m. All doses of medications were maintained in the correct quantities. At approximately 9:30 a.m., smoke and carbon monoxide detectors were tested and operational.

The garage was locked and contained an operational washer and dryer, client belongings, emergency water, locked detergents and cleaning supplies, and an extra refrigerator.

LPA observed a covered patio area in the rear of the facility. The patio contained furniture in good condition and a gas grill. Trash cans were in good condition and present on the driveway due to scheduled trash pickup. The emergency exit path was free from obstructions. Two (02) out of two (02) exit gates were unlocked with self-closing latches.

The facility has four (04) bedrooms. One (01) bedroom is designated as a staff room. The staff room was locked and free of hazards. All client bedrooms contained a chair, lamp, nightstand, storage, and a bed with adequate bedding. All furnishings were clean and in good condition.

The facility has two (02) bathrooms. One (01) bathroom is private, and one (01) is shared. All bathrooms contained liquid soap, paper towels, handwashing instruction sign, trash can with a tight fitting lid, grab bars near the toilet and shower, and a non-skid mat in the shower. At approximately 9:50 a.m. LPA measured the water temperature in the shared bathroom to be 107.2 degrees Fahrenheit.

At 10:30 a.m. LPA reviewed staff and resident files. All files were complete and available for audit.

During today's inspection, the facility was in compliance with Title 22 regulations. No immediate health or safety hazards were observed.

Exit interview conducted. Copy of report provided.

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Nicholas Reed
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026
LIC809 (FAS) - (06/04)
Page: 3 of 3