Facility Evaluation Report

Licensing Program Analyst (LPA) Abeye Duguma and Licensing Program Manager (LPM) Naira Margaryan conducted unannounced case management to the facility to follow up with recent request of fire clearance regarding the designation of the residents’ rooms due to recent changes made to the physical plant.

LPA and LPM met the Administrator and explained the purpose of this visit. Shortly after the fire inspector, Linsey Pellegrini arrived to the facility to conduct an inspection based on the fire clearance request submitted by the Licensee.

On 04/17/2023, Woodland Hills South Adult and Senior Care Regional office received a request of new fire clearance and copies of LIC 200 and two (02) facility sketches (previous and proposed).

Upon Departmental review of submitted documents, the following issues were noted.

As per original sketch submitted to CCL, there were three (03) shared residents’ bedrooms for total of six (06) residents. All three (03) bedrooms used for the residents were approved for non-ambulatory fire clearance and one of the rooms can be used for bedridden resident.

A new sketch submitted with the fire clearance request is showing two (02) shared room and three (03) private room. The total capacity of the facility is still six (06). Licensee is requesting five (05) non-ambulatory and one (01) bedridden fire clearance.