197610341-6-13-2024-31-AS-NRED-D6822P-20240613170104

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197610341
Report Date: 06/13/2024
Date Signed: 06/13/2024 05:01:34 PM

Document Has Been Signed on 06/13/2024 05:01 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
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	CORAZON RESIDENTIAL		FACILITY NUMBER:	197610341
ADMINISTRATOR/ DIRECTOR:	SALVADOR, CHRIS		FACILITY TYPE:	735
ADDRESS:	7358 MAYNARD AVE		TELEPHONE:	(818) 455-3007
CITY:	WEST HILLS	STATE: CA	ZIP CODE:	91307
CAPACITY: 4		CENSUS: 0	DATE:	06/13/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	03:30 PM
MET WITH:	Chris Salvador		TIME VISIT/ INSPECTION COMPLETED:	05:00 PM

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At 3:30 p.m. on 06/13/24, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with the licensee and disclosed the reason for the visit.

LPA and licensee toured the facility inside and out. The licensee stated no clients had been admitted and therefore no staff were employed besides himself.

The facility was last visited on 05/26/2023 for a prelicensing 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) nonambulatory clients.

At the main entrance, LPA observed a maintained front yard and a ramp in good repair leading up to the entrance. Postings included facility license, facility sketch, personal rights, emergency disaster plan.

The facility has four (04) bedrooms. All bedrooms contained a chair, lamp, nightstand, storage, and a bed with adequate bedding. All furnishings were clean and in good condition. A fireplace in Bedroom #1 was locked and appropriately grated. The exit from Bedroom #1 was unlocked.

The facility has two (02) bathrooms. Both bathrooms are shared. All bathrooms contained liquid soap, paper towels, trash can with a tight fitting lid, grab bars near the toilet and shower, and a non-skid mat and surface in the shower. At approximately 4:10 p.m. LPA measured the water temperature to be 117.2 degrees Fahrenheit.

LPA observed adequate supplies of perishable, non-perishable, and emergency foods and water. The stove hood was clean. Appliances were in good condition. Sharps were locked above the counter top. Cleaning solutions, medications, and first aid kit were locked below the sink.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024

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
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: CORAZON RESIDENTIAL	FACILITY NUMBER: 197610341
	VISIT DATE: 06/13/2024

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Walls, floors, windows, screens, and blinds were clean and in good repair. At approximately 4:25 p.m. LPA measured the room temperature to be 71 degrees Fahrenheit. Night lights were located throughout the hallways. Surveillance cameras and motion detectors were placed on the exterior and common areas. Television, board games, and activities were available in the living room. An adequate supply of linens and hygiene supplies were stored in the closets.

LPA observed a covered patio area in the rear of the facility. The patio contained furniture in good condition. The back yard was free of debris and hazards.

All emergency exit paths were free from obstructions. Two (02) out of two (02) exit gates were unlocked with self-closing latches. At approximately 4:15 p.m. LPA observed a fully charged fire extinguisher in the kitchen. It was last inspected today, 06/13/24. At approximately 4:25 p.m. smoke and carbon monoxide detectors were tested and operational.

The garage was locked and contained an operable washer and dryer. detergents, and other cleaning supplies. The house phone was called and operational at 4:45 p.m.

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

Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024

LIC809 (FAS) - (06/04)

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