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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801434
Report Date: 10/30/2025
Date Signed: 10/31/2025 08:07:32 AM

Document Has Been Signed on 10/31/2025 08:07 AM - 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 N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:STARSHIPFACILITY NUMBER:
565801434
ADMINISTRATOR/
DIRECTOR:		LISA OVIEDOFACILITY TYPE:
772
ADDRESS:1760 SOUTH LEWIS ROADTELEPHONE:
(805) 383-3669
CITY:CAMARILLOSTATE: CAZIP CODE:
93012
CAPACITY: 15CENSUS: 15DATE:
10/30/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:16 AM
MET WITH:Francine FigueroaTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Valeria Conway conducted a required annual inspection today at 9:23 A.M. Upon arrival, LPA met with Case Manager I (CMI), Tallulah Hearon. CMI explained that Program Manager/Administrator, Lisa Oviedo and Assistant House Coordinator (AHC), Dante Goglia will not be present during today’s visit. At 9:28 A.M. CMI contacted AHC via telephone. CMI transferred the call to LPA and explained the reason for the visit. AHC authorized Program Team Lead (PTL) from “House of Transition”, Francine Figueroa to sign today’s report. LPA met with PTL at 10:10 A.M. and the reason for the visit was explained, Entrance interview conducted.

At 9:58 A.M., LPA, PTL and facility’s nurse, Wendy McCain conducted a physical plant tour inside and outside areas to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed:

KITCHEN: The facility is equipped with two separate kitchens. Kitchen A is used to cook clients’ meals by staff. Kitchen B is used by clients to store their own food as well as leftovers. Kitchens were equipped with fixtures and appliances that appeared clean and functional. Knives and sharps are stored in a locked cabinet in Kitchen A. There is a sufficient supply of perishable and non-perishable food. Refrigerator and pantry were checked for proper labels and expiration dates and food labels. Starting at 9:58 A.M. hot water in Kitchen A and B measured within regulations.

BEDROOMS: There were 15 single occupancy bedrooms designated for client use. Client bedrooms were observed properly furnished, including adequate supplies of bedding and linen, with sufficient lighting.

Continued on LIC 809-C

NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Valeria Conway
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2025
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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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 N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: STARSHIP
FACILITY NUMBER: 565801434
VISIT DATE: 10/30/2025
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Continued from LIC 809

BATHROOMS: Each client bedroom includes an individual half bathroom. All bathrooms observed were properly supplied with paper products and personal hygiene items and fixtures were observed to be functional at the time of the visit. LPA observed four (4) showers designated for client use. Starting at 10:05 A.M., the hot water temperature was measured in various bathrooms throughout the facility, and they measured within regulation range.

COMMON AREAS: Common areas included two (2) dining areas and two (2) living rooms. All common areas were adequately furnished for client use. There is also an unlocked and accessible laundry room, which clients utilize. Staff provide cleaning detergent upon request. During the inspection, the LPA noted a cleaning chemical dispenser mounted on the laundry room wall adjacent to the A/C unit closet. The dispenser contained hard surface sanitizer and disinfectant that were accessible to clients under staff supervision. Technical Violation issued (TV). LPA advised the PTL and the nurse to secure these items immediately. There are two locked storage hallway closets. One stores dishwashing detergent, Clorox and laundry detergent pods and the other one stores emergency food and water.

SURROUNDING GROUNDS: There are several shaded areas with adequate furniture for client use.

MEDICATIONS: A medications review of four (4) randomly selected clients was conducted. Medication are stored in a locked cart inside the Program Manager's office. All medications reviewed were stored and documented per regulation.

RECORD REVIEW: LPA reviewed Client Records at 10:40 A.M. and Personnel Records at 2:15 P.M.

Seven (7) client files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, Consent for Treatment form, and current needs and services plan. All records were in order.

Continued on LIC 809-C

NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Valeria Conway
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025
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 N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: STARSHIP
FACILITY NUMBER: 565801434
VISIT DATE: 10/30/2025
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Continued from LIC 809-C

Five (5) personnel files were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. Staff files were complete. A comparison of the current LIC 500 and the Guardian Background Check System was conducted during today’s visit. The review revealed that five (5) staff members, including the Program Manager/Administrator, were not associated with this facility. However, they were associated with a facility that shares the same mailing and physical address. Technical Violation (TV) will be issued at this time. LPA requested Office Coordinator II, Marleen Aganon, to inform HR Compliance, Mandy Molina, via Microsoft Teams that future observations of this issue may result in a deficiency citation and assessment of civil penalties.

INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control plan. The facility’s policies and procedures as they pertain to infection control are adequate. LPA also reviewed the facility's emergency disaster plan, which was observed to be complete and recently reviewed/updated. There are several fire extinguishers throughout the facility; they all were fully charged and were last serviced 11/06/2024. Emergency disaster drills conducted quarterly as per regulation; the last one conducted on 10/13/2025. During today’s visit, LPA requested the most recent fire inspection report dated on 10/15/2025. Staff stated the fire alarm system was disabled due to false alarm activations and that 15-minute fire watch rounds are being conducted throughout the property. Staff reported the property is owned by Ventura County and the issue has been reported. Per Ventura County, General Services Agency (GSA) supervisor, Eric Urias, a repair company has been contacted, and all agencies are working to resolve the problem. Once the issue is corrected, LPA will receive documentation verifying that the fire alarm system is fully operational. Technical Violation (TV) issued.

CASH RESOURCES: Facility does not safeguard client cash resources.

No citations issued. Exit interview conducted. Report was reviewed and issued.

NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Valeria Conway
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025
LIC809 (FAS) - (06/04)
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