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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610669
Report Date: 02/11/2025
Date Signed: 02/11/2025 02:17:30 PM

Document Has Been Signed on 02/11/2025 02:17 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:ZARA CARES RESIDENTIAL HOMEFACILITY NUMBER:
197610669
ADMINISTRATOR/
DIRECTOR:		ANUSIONWU, SCHOLASTICAFACILITY TYPE:
735
ADDRESS:2869 LAVIDA DRIVETELEPHONE:
(661) 367-0404
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 4CENSUS: 0DATE:
02/11/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Scholastica AnusionwuTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 02/11/2025 at 10:00 am, Licensing Program Analyst (LPA) Lorena Casillas conducted an announced Pre-Licensing Inspection with Licensee Scholastica Anusionwu. An application to operate an Adult Residential Facility (ARF) was received by Community Care Licensing (CCL) on 07/08/2024. A fire clearance was approved on 10/25/2024, for four (4) non-ambulatory clients for a total capacity of four (4). The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6.

The Component III presentation was conducted from 10:15 am until 12:00 pm with Licensee.

A tour of the physical plant was initiated at approximately 12:30 pm and the following was observed:

KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There will be an adequate supply of two (2) days perishable foods once clients are in the home. There was a seven (7) day supply of nonperishable foods and dining ware to accommodate a maximum capacity of four (4). Knives will be locked under the kitchen sink within a locked box. Medication will be locked in a kitchen cabinet. The facility has one fire extinguisher that was purchased on 10/18/2024 located in the kitchen dinning area.

COMMON AREAS: These included the living room and dining room areas, which were equipped with living room furniture, a television, tables, and chairs. The dining room table is large enough to accommodate up to four (4) clients. There were no visible immediate hazards. The smoke alarms are hard wired and inter-connected and are functional. The carbon monoxide detector is functional. The facility temperature was at a comfortable 70 degrees Fahrenheit. The first aid kit is in a locked hallway cabinet and is equipped with the necessary supplies.

Continued on LIC809-C
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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
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: ZARA CARES RESIDENTIAL HOME
FACILITY NUMBER: 197610669
VISIT DATE: 02/11/2025
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BEDROOMS: There are four (4) bedrooms designated for client use. The applicant furnished the client’s bedrooms with beds, nightstand, chairs, dresser, bedding, and linen. All rooms have sufficient lighting.

BATHROOMS: The facility has two (2) bathrooms. All bathrooms were observed to have the proper fixtures, and non-skid mats. The hot water delivered in the bathrooms measured 117.7 degrees F. Trash cans were observed to not have lids. Hallways leading to non private bathroom did not have nightlights.

LAUNDRY ROOM: Cleaning detergents and supplies are locked in the laundry room area in the garage.



GARAGE: The garage is used for storage. It holds emergency food containers and water. There is a staff room located within the garage not identified on the facility sketch. Licensee was informed to update the facility sketch and submit to LPA.

STAFF/CLIENT RECORDS: Staff and client records will be stored in a locked cabinet, located in the living room. The applicant was advised to ensure that client and staff records will be accessible to the licensing agency upon request or during inspection. Facility will have awake staff.

SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. The backyard of the facility has a patio with backyard furniture to include an umbrella for shade. The facility backyard has sufficient yard space to accommodate outdoor activities. There is no swimming pool or bodies of water.

Prior to licensure, the applicant needs to provide the following:

Trash cans with lids.
Hallway nightlights.
An updated facility sketch to include fire drill meeting point and staff room in garage.

The applicant was advised and will submit corrections by 2/14/25. Exit Interview was conducted, and a copy of this report was provided to Licensee.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC809 (FAS) - (06/04)
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