Senior Care Records.A MITRYXA product
For operatorsSign in

Facility Evaluation Report

Age Well Assisted Living Facility, Van Nuys11/03/2025Licence 197608986

Capacity6
Census2
Date signed11/03/2025 02:08:30 PM
Name of licensing program analystBrian Balisi
Name of licensing program managerDesaree Perera
The inspector’s account

Licensing Program Analyst (LPA) Brian Balisi and Martha Arroyo conducted an unannounced case management visit - other to ensure the health and safety of the residents in care. Upon arrival at approx 10:00 a.m., LPA met with staff and explained the reason for the visit. Licensee was contacted and stated they can only be at the facility at approx. 4pm.

At approx 10:02 a.m. LPA's conducted physical plant, interviewed staff, residents and reviewed and obtained copies of facility documents. LPA's observed a sufficient supply of perishable and non-perishable food properly stored at this time. LPA's and staff inspected produce that was stored in fridge drawers. LPA's observed produce to appear fresh and free of any signs of mold at this time. At approx 10:30 a.m. LPA's observed staff mopping floor.

On 10/16/2025, during a case management visit conducted from 9:30 a.m. to 4:00 p.m., LPA observed Staff #1 (S1) present inside the facility. At that time, S1 was not associated. S1 was instructed to leave the facility. On 10/31/2025 , LPA received information indicating that S1 continued to provide services to residents in care. During interviews with Resident #1 (R1) and Resident #2 (R2), both residents stated that they have observed S1 on multiple evenings, sleeping in Bedroom #1, since the LPA’s visit on 10/16/2025

Interviews with residents today indicated that S1 was present and on duty at the facility from the morning through the evening on Saturday 11/01/2025, at which time Staff #2 (S2) arrived to provide relief. It was further reported that S2 has remained on duty without relief since assuming the evening shift on Saturday.

LPA's contacted the tentative new Administrator regarding pending documentation and they stated they will provide documents today, however they can't provide the LIC 308 until after their Doctor's appointment on Wednesday 11/05/2025. At approx 12:12 p.m. LPA observed staff preparing lunch.

LPA's records review indicated the following: S2 does not have a valid / first aid CPR on file to review.

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