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Facility Evaluation Report

Age Well Assisted Living Facility, Van Nuys10/22/2025Licence 197608986

Capacity6
Census2
Date signed10/22/2025 01:43:14 PM
Name of licensing program analystBrian Balisi
Name of licensing program managerDesaree Perera
The inspector’s account

Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced case management visit - other to ensure the health and safety of the residents in care. Upon arrival at approx 09:30 a.m., LPA met with staff and explained the reason for the visit. Licensee was contacted and stated they will be at the facility soon. Administrator Yuan Yuan Han arrived shortly after.

At approx 09:50 a.m. LPA conducted physical plant, interviewed staff, residents and reviewed and obtained

copies of facility documents. LPA observed a sufficient supply of perishable and non-perishable food properly stored at this time. Interviews with residents revealed they have been provided with sufficient meals and snacks since LPA's last visit on 10/20/2025. In addition, residents did not express any concerns at this time. Interview with Staff #1 (S1) revealed today was their first day and received some training from Staff #2 (S2), prior to the start of S1's shift.

At approx 11:02 a.m. LPA conducted records review and it was revealed S1 does not have a full facility file on site for review. At approx 01:30 p.m. LPA conducted medication review. All medications including PRNs were labeled, stored and inaccessible to residents in care. Medications were observed to be administered as prescribed at this time. During the visit, the LPA did not observe any immediate health or safety concerns. LPA reviewed the facility’s history of non-compliance and discussed ongoing compliance expectations with the Administrator and Licensee. Both the Administrator and Licensee acknowledged the discussion and affirmed their understanding of the need to maintain compliance.

The following deficiencies were cited from the Title 22 California Code of Regulations. (See LIC 809-D).

Civil penalties in the amount of $250 will be assessed today due to repeat violation. The Administrator was informed that failure to correct the deficiencies may result in additional civil penalties.

Exit interview conducted with Administrator, appeal rights discussed, and a copy of this report issued

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction