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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610432
Report Date: 01/29/2026
Date Signed: 01/29/2026 01:45:07 PM

Document Has Been Signed on 01/29/2026 01:45 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:
01/29/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Greta GezalyamTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 01/29/26, 10:00 am, Licensing Program Analysts, (LPAs) Raymond Comer and Nicholas Reed, arrived to conduct an unannounced annual inspection of the Facility. LPA met with Facility Administrator, 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 has no residents due to major infrastructure repairs that were recently completed in late 2025. Per Administrator, resident admissions are estimated to commence by May, 2026.

At 10:20 am, LPAs 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 72.0°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 2025. Evacuation chairs were observed atop the facility's two (2) stairwells. Roof access is inaccessible to residents. Evacuation routes are labelled and prominently posted.
[LIC 809-C]-Continued
NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Raymond Comer
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2026
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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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)
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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: 01/29/2026
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Kitchen: At 10:45 AM, LPA observed kitchen appliances and fixtures as functional. Sufficient amounts of non-perishable food observed at the facility. Perishable food items are not required at this time as there are no residents. Knives and sharps are inaccessible to residents.

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 (#115, #116, #120, #209, #211, #214) 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 as clean and sanitary with necessary supplies and required safety fixtures (grab bars, anti-slip surfacing). Water temp measured between 103°F. and 108.0°F; Within 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. A total of three (3) staff files were reviewed. Criminal record clearances were present and Staff are associated to this facility. Staff records appear to be complete and current.

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 provided.
NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Raymond Comer
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2026
LIC809 (FAS) - (06/04)
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