Follow-up on corrections·April 26, 2023

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. (CONT. on LIC 809-C) The original sketch is showing attached garage and proposed sketch is not showing the existing garage. At the time of this visit it was observed that the garage is converted to permitted Junior Accessory Unit (ADU). Based on review of both sketches, it was concluded that the Licensee altered the bedroom #3 to two (02) private rooms and one (01) of the room that used to be a storage is currently identified as another bedroom. At the time of this visit at (8:30 AM) LPA Duguma and LPM Margaryan conducted a full inspection of physical plant and observed the following. The Administrator was advised the following. · Alteration to existing building without proper notification to the Community Care Licensing Department, is a violation of Section 87305 California Code of Regulation Title 22, Division 6, Chapter 8 · To protect residents’ personal rights , The Licensee did not furnish the department with written notification, explaining the steps that you should have taken during construction, to ensure that residents continued to be accorded safe, healthful, and comfortable accommodations… During the inspection, Linsey Pellegrini inspected rooms and stated the following; facility needs permit for room #3 and the conversion of the additional rooms. The licensee needs to provide electrical permit for alarm switches in three (03) rooms. Based on inspection, observation and record review, the following deficiencies were cited and recorded on LIC809D. No other immediate health and safety hazard is noted during this visit. Exit interview is conducted, and a copy of report was issued.