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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610366
Report Date: 07/02/2024
Date Signed: 07/02/2024 04:36:33 PM

Document Has Been Signed on 07/02/2024 04:36 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:SAVANT OF TARZANAFACILITY NUMBER:
197610366
ADMINISTRATOR/
DIRECTOR:		RITA MELDONIANFACILITY TYPE:
740
ADDRESS:5711 RESEDA BLVDTELEPHONE:
(818) 996-2022
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY: 176CENSUS: 75DATE:
07/02/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Rita MeldonianTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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 12:00 p.m. on 07/02/2024, Licensing Program Analyst (LPA) Nicholas Reed and Los Angeles City Fire Inspector Linsay Pellegrini conducted an unannounced case management visit. LPA and Inspector met with the Executive Director (ED) and Maintenance Director (MD) and disclosed the reason for the visit.

The reason for today’s case management visit comes from Inspector Pellegrini’s review of the facility’s fire safety compliance on 06/27/2024 in which multiple fire protection systems were deemed past due of their testing or retesting dates. Records reviewed indicated that the facility’s Stored Electrical Energy System and Automatic Closing Fire Assemblies failed tests in February 2024 and have not been retested since. Interview with the MD at approximately 12:20 p.m. today revealed the required corrections were made within a week, and the facility has been waiting for retesting appointments. Record review also revealed the rear elevator and emergency power generator were due for testing in January 2024. Interview with the ED at approximately 12:45 p.m. today confirmed that the facility was waiting on reinspection appointments. Also, the generator was working and the rear elevator contract had been created and is in process. The rear elevator repairs would take some time. At 12:30 p.m., LPA, Inspector, ED, and FM toured the facility inside and out to review known fire safety issues. All Stored Electrical Energy Systems appeared to be in working order. All but one (01) fire door was in working order. At approximately 1:50 p.m. the fire door near Room #105 was tested and observed to not close all the way. The MD made the necessary repairs to the fire door by 4:00 p.m. today. The inspector, MD, and ED all agreed that the main issue was a lack of communication due to an incorrect email address and lack of paperwork from the company in charge of retesting the facility’s fire protection systems. However, due to past due tests and retests of fire protection systems, the facility is in violation of Title 22, Division 6, Chapter 8, Article 04, Subsection 87203 Fire Safety. Therefore, a deficiency is issued and a $500 immediate civil penalty is assessed today for a violation of the facility's fire clearance. The ED was informed that additional civil penalties might be assessed based on Health and Safety Code 1569.49(e) or (f), or 1548(e) or (f), 1568.0822(e) or (f).

Exit interview conducted. Appeal rights discussed. Civil penalty issued. Copy of report provided.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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 07/02/2024 04:36 PM - It Cannot Be Edited


Created By: Nicholas Reed On 07/02/2024 at 04:11 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SAVANT OF TARZANA
FACILITY NUMBER: 197610366

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
08/07/2024
Section Cited
CCR
87203

1
2
3
4
5
6
7
87203 Fire Safety
All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
In addition to a retesting appointment tomorrow, 07/03/2024, the Executive Director has agreed to submit in writing a plan and timeline of repairs for the rear elevator and all other necessary fire protection systems by the POC due date.
8
9
10
11
12
13
14
Based on interviews, record review, and observations, the licensee did not comply with the section cited above in at least two (02) fire protection systems which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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 Margaryan
LICENSING EVALUATOR NAME:Nicholas Reed
LICENSING EVALUATOR SIGNATURE:
DATE: 07/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/02/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2