Senior Care Records.

Facility Evaluation Report

Fairhaven Home 1, Winnetka08/01/2025Licence 197610505

Capacity6
Census6
Date signed08/01/2025 11:03:15 AM
Name of licensing program analystPerchui Khurshudyan
Name of licensing program managerNichelle Gillyard
The inspector’s account

ON 8/1/2025 Licensing Program Analyst (LPA) Perchui Milena Khurshudyan conducted a Case Management visit at the above facility to review the current property floor plan. Upon arrival LPA met with the Comfort Oviri and explained the reason for the visit. Entrance interview conducted.

At approximately 10:15am LPA requested facility staff and clients’ rosters. This Case management visit was conducted to review and collect documents related to the facility’s proposed property floor plan change. During today’s visit, LPA conducted a physical plant tour inside and outside of the facility to review the current floor plan. LPA also requested a copy of the new facility sketch reflecting the proposed floor plan modifications.

During the physical plant tour LPA observed six (6) bedrooms, of which five (5) are designated for clients use and one (1) for staff use only, and three (3) bathrooms for clients and staff use. LPA observed second living room converted into two (2) new bedrooms, one for client's private use and one for staff use.

On 10/17/24 LPA Khurshudyan received an email with attached letter from the Licensee Joseph Jose dated 10/16/2024 notifying the Community Care Licensing CCL about the upcoming floor plan modifications. The letter states that permission has been received from the LA Department of Building and Safety. The letter also states that the contractor Evan House Construction Lic# 1087223 will be on site starting the construction on 10/18/24 to 10/22/24. The scope of work is to remodel the second family room into a bedroom. Additionally, Licensee stated that there will be no impact to current programming nor any need to relocate clients.

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