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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801896
Report Date: 08/05/2026
Date Signed: 08/05/2026 02:48:31 PM

Document Has Been Signed on 08/05/2026 02:48 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 N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:LAND OF ENCHANTMENT BOARD AND CAREFACILITY NUMBER:
565801896
ADMINISTRATOR/
DIRECTOR:		ROXANA LARAFACILITY TYPE:
740
ADDRESS:346 E. GAINSBOROUGH ROADTELEPHONE:
(805) 379-2185
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY: 6CENSUS: 6DATE:
08/05/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Tiffany Sanchez-LaraTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Erica Mosley conducted a case management - Deficiencies visit due to deficiencies observed during an initial visit conducted on 08/05/2026. Upon arrival at 10:30 a.m. LPA was greeted by staff and explained the reason for the visit. The LPA met with Tiffany Sanchez-Lara, Facility Designee and explained the reason for the visit. LPA was informed that Administrator, Roxana Lara had a family matter to attend to and was unable to make today's visit but was available telephonically throughout the visit.
During today’s visit, LPA conducted a physical plant tour to ensure there are no immediate health and safety concerns. At 12:23 p.m. LPA conducted a medication audit and observed all six (6) residents to have their medications pre-pored. LPA observed Resident #1 (R1) to have their medications pre-pored three (3) days in advance and all other five (5) residents to have their medications pre-pored two (2) days in advance. LPA reviewed the facility Centrally Stored Medication and Destruction Record (CSMDR) and the Medication Administration Record (MAR). Based on the review, no discrepancies were observed in the medication count, taking into account the pre-poured medications.LPA was advised that R1 had three (3) days of medications because they were transported to the hospital on Monday morning, and the medications had already been prepared that day. This is why all other residents only have two (2) days of medications.
LPA was advised by the Designee that the Administrator pre-pored the medications to ensure they were all given correctly since they were not going to be on site to over see medication distribution. LPA educated Designee on the regulation 87465(h)(5) where medications shall be stored in its originally received container. No medications shall be transferred between containers. Designee stated they understand the regulation and will ensure that medications will not be pre-pored and will abide by the regulation. Pursuant to Title 22 CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D):Exit interview conducted/Citations issued/ Appeal Rights Discussed/ Copy of this report issued.
Kasandra Lopez
Erica Mosley
DATE: 08/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2026
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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Document Has Been Signed on 08/05/2026 02:48 PM - It Cannot Be Edited


Created By: Erica Mosley On 08/05/2026 at 02:03 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: LAND OF ENCHANTMENT BOARD AND CARE
FACILITY NUMBER: 565801896

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/19/2026
Section Cited
CCR
87465(h)(5)

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(h) The following requirements shall apply to medications which are centrally stored: (5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers. This requirement is not met as evidenced by:
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Administrator agreed to discontinue to prefill medications and review section cited then provide LPA with a written plan to ensure future compliance and send to LPA via email by POC due date. Additionally Administrator will provide LPA will a plan on who will be medication
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Based on observation the licensee did not comply with the section cited above as (6) residents had their medications pre-pored in cassettes, which poses a potential health, safety or personal rights risk to persons in care.
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trained in their absence to ensure future compliance and provide LPA with the staff who is trained and required documentation by POC due date.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kasandra Lopez
NAME OF LICENSING PROGRAM MANAGER:
Erica Mosley
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/05/2026


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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