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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610432
Report Date: 02/28/2025
Date Signed: 03/02/2025 05:58:17 PM

Document Has Been Signed on 03/02/2025 05:58 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:HOLLYWOOD ROYALE GARDEN ASSISTED LIVINGFACILITY NUMBER:
197610432
ADMINISTRATOR/
DIRECTOR:		JOGANI, PINKALFACILITY TYPE:
740
ADDRESS:6054 FRANKLIN AVE.TELEPHONE:
(323) 466-2411
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY: 120CENSUS: 0DATE:
02/28/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Pinkal JoganiTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 02/28/25, 9:20 am, Licensing Program Analyst, (LPA) Raymond Comer, arrived to conduct an unannounced annual inspection of the Facility. LPA met with Facility Administrator, Pinkal Jogani, and reason for the visit was disclosed.

Facility is licensed as a two story building. Fire clearance approved for sixty (60) non-ambulatory, and sixty (60) ambulatory, for total capacity of one hundred and twenty (120) residents. Hospice waiver approved for ten (10). Currently, the facility is non-operational, as plumping repairs are nearing completion. Per the Administrator, operations are estimated to commence in late March, 2025.

At 10:10 am, LPA conducted a tour of the physical plant with the Administrator and observed the following:

Physical plant was inspected for cleanliness and condition. Facility’s main door is the primary entry/exit access. Screening area is located immediately upon entrance. Hand washing, coughing etiquette, and other necessary signage are posted throughout the facility. Room temperature is comfortable; wall thermostat displays a setting of 74.0°F., within the required range. Facility maintains an approved Mitigation and Infection Plan. Required postings are prominently displayed and observed to be current.

Fire Detection/Protection system is present in the facility. Multiple dual smoke/carbon monoxide alarms are installed, hardwired, and interconnected throughout the Facility. Fire extinguishers were observed on all floors of the facility; last serviced on May 2024. Evacuation chairs were observed atop the facility's two (2) stairwells. Roof access is inaccessible to residents. Evacuation routes are clearly labelled and prominently posted.

[Continued on LIC 809-C]
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2025
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.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: HOLLYWOOD ROYALE GARDEN ASSISTED LIVING
FACILITY NUMBER: 197610432
VISIT DATE: 02/28/2025
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Kitchen: At 10:25 AM, LPA observed kitchen appliances and fixtures as functional. Sufficient amounts of non-perishable food observed at the facility and properly stored. Perishable food items are not required at this time as there are no residents. Knives will be stored in a locked cabinet.

Medications: Medication room is located on first floor, directly across from rooms #118 and #119; room is securely locked and will be inaccessible to residents.



Laundry: LPA observed the laundry room, located on the first floor by the kitchen area; room observed as clean and clear of obstruction. Laundry room is securely locked and will be inaccessible to residents.

Commons: First floor maintains one (1) dining room, and (1) activity room. Second floor maintains two (2) activity rooms and one (1) theater room. Common areas observed to be clean. Furnishings observed to be in good condition. No obstructions, nor tripping hazards observed.

Bedrooms: LPA observed random resident bedrooms and bathrooms for safety, privacy, and comfort. Rooms were inspected and observed to maintain required furnishing and sufficient lighting, bed linens, and blankets. Bedrooms were observed to be clean and clear from obstruction.

Bathrooms were observed to be clean and sanitary with necessary supplies and required safety fixtures (grab bars, anti-slip surfacing). Hot water temperature measured between 116.5°F. and 118.0°F; Within the required range.

Outdoor patio area observed to be shaded, with tables with sufficient seating for the residents. Outdoor furniture observed to be in good condition. All trash cans were observed to be covered. There are no bodies of water in the facility.

Resident records: Records room is located on the first floor, which is locked and inaccessible. There are no residents records, as facility is currently non-operational.



Staff records: Records room is located on the first floor, which is locked and inaccessible. There are no staff records, as facility is currently non-operational.

There were no immediate health and safety hazards observed at the time of this inspection. Exit interview conducted and a copy of this report was given to facility representative, Administrator Pinkal Jogani.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
LIC809 (FAS) - (06/04)
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