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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425802122
Report Date: 12/16/2020
Date Signed: 02/17/2021 10:42:29 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:THRIVE FAMILY CAREFACILITY NUMBER:
425802122
ADMINISTRATOR:LISA M GRIFFITHSFACILITY TYPE:
740
ADDRESS:910 PARK ROADTELEPHONE:
(805) 272-8009
CITY:OJAISTATE: CAZIP CODE:
93023
CAPACITY:6CENSUS: 0DATE:
12/16/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Lisa GriffithsTIME COMPLETED:
05:11 PM
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Licensing Program Analyst (LPA) Kelly Dulek initiated a Case Management Visit in reference to the reported closure of the facility. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s visit was conducted virtually with the use of "FaceTime" with Licensee/Administrator Lisa Griffiths.

.A Virtual Tour of the Physical Plant was conducted and the following observed:

KITCHEN: There was no indication of current occupancy in the dwelling..

BEDROOMS: There was no indication of current occupancy in the dwelling.

BATHROOMS: There was no indication of current occupancy in the dwelling..

COMMON AREAS: There was no indication of current occupancy in the dwelling..

The Licensee advised the last resident moved out earlier today. Based on the LPA's observations during the virtual visit the LPA concluded that all operation of the Residential Care Facility for the Elderly has ceased. The Licensee advised that she would mail the License to the Woodland Hills Regional Office for surrender. A copy of the licensing report was provided for signature and return to CCL.
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly DulekTELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2020
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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