195850295-1-26-2026-29-AS-CYEE-DQQ5R2-20260126191026

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195850295
Report Date: 01/26/2026
Date Signed: 01/26/2026 07:10:42 PM

Document Has Been Signed on 01/26/2026 07:10 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME:	CALA HOMES		FACILITY NUMBER:	195850295
ADMINISTRATOR/ DIRECTOR:	JULIETTA MIRZOYAN		FACILITY TYPE:	740
ADDRESS:	7331 LEMONA AVENUE		TELEPHONE:	(818) 849-6645
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91405
CAPACITY: 6		CENSUS: 5	DATE:	01/26/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:55 AM
MET WITH:	Julietta Mirzoyan, Administrator		TIME VISIT/ INSPECTION COMPLETED:	07:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst(LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool. LPA Yee was let into the home by Avetis Keshishyan, Staff at 10:56am. Julietta Mirzoyan, Administrator was contacted by telephone and she arrived at 11:28am to conduct the visit. The reason for today's visit was provided. The facility is a single storey family home consisting of a living room, dining room, a kitchen, four resident bedrooms, 2 full bathrooms and a attached garage. The facility is fire cleared for 5 NON-AMBULATORY and 1 BEDRIDDEN resident. Bedroom #4 is designated for 1 bedridden resident use. Per verification with Avetis Keshishyan, there have been not alterations or additions made to the home as of this visit. On today's visit all 12 domains of the CARE Inspection tool was reviewed, 5 resident and 6 staff files were reviewed and a tour of the facility, inside and outside, was conducted. The living room was furnished with the appropriate furniture and seating for 6 residents. The fire place was sealed off with a cover. Above the fire place was a mounted television. The outside exiting door is equipped with a auditory device and leads out to a ramp. The front door is equipped with an auditory device that was operational. The dining room is furnished with a table and 6 chairs, The kitchen was observed with a stove with an oven, microwave, toaster oven, toaster and a refrigerator. A cabinet containing resident and staff files was observed. Cleaning solutions and dish soaps were stored in a locked cabinet under the sink. Knives were stored in a locked drawer. The only fire continued on LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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Document Has Been Signed on 01/26/2026 07:10 PM - It Cannot Be Edited

Created By: Christine Yee On 01/26/2026 at 06:03 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: CALA HOMES	FACILITY NUMBER: 195850295
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/26/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

87309(c)

Storage Space and Access

(c) Except as specified in subsection (d), the licensee shall implement reasonable interventions in order to ensure that nutritional supplements, vitamins, alcohol, cigarettes and other potentially toxic substances, such as certain plants, gardening supplies, and auto supplies, are stored so as not to pose a hazard to residents. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in 1 out of 5 count as it was observed that Resident #2 had multivitamins, prescribed creams, protein powders and various other items stored in baskets and left unsecured on their dresser and it has not been verified that the other residents can have access to them and that it could pose a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/02/2026
	Plan of Correction
1 2 3 4	The Licensee will review all the residents Physician's Report to determine if the mutlivitamins, prescribed creams, protein power if left on Resident #2's dresser would be a potential health risk to the other residents who would have access to the items or ensure that all supplements/multivitamins are secured in a locked cabinet by 2/2/26

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Kristin Heffernan
NAME OF LICENSING PROGRAM MANAGER:

	Christine Yee
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/26/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: CALA HOMES	FACILITY NUMBER: 195850295
	VISIT DATE: 01/26/2026

NARRATIVE

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extinguisher purchased on 11/21/25 was observed in the kitchen. Sufficient perishable foods for a minimum of 2 days and non-perishable foods for a minimum of 7 days were observed maintained on the premises.
Bedroom #1 was furnished with 2 hospital beds, 2 night stands, 2 chairs, 2 lamps, a shared dresser and a built in closet. Window dressings was observed.
The common bathroom was equipped with a shower, a single sink and a toilet. Grab bars and a slip resistant mat and shower chair was observed. The water temperature was tested and red 108.1 degrees Fahrenheit. Located inside is a locked linen closet with extra blankets, bed linens, bath towels and blankets were observed. Also located in the closet are the hygiene products.
Bedroom #2 was observed with a hospital bed with half a bed rail, a night stand, a lamp, a chair, a dresser and a built in closet was observed. The room is currently not in use.
The required posters were observed by the front door and the labor poster in the kitchen.
Bedroom #3 was observed with a hospital bed, a night stand, a lamp, a dresser and a built in closet. The outside exiting door was equipped with an operational auditory device and leads out to a ramp.
Bedroom #4 was observed with 2 hospital beds, 2 night stands, 2 lamps, 2 chairs, a shared dresser, 2 portable closets, and a fire place that has been sealed off. The outside exiting door was equipped with an operational auditory device and leads out to a ramp.
The first aid kit with the required dressings, bandages, tweezer, scissors and thermometer were observed. A first aid manual was also observed.
The hardwired smoke detectors located inside residents' room and the combination smoke/carbon monoxide detectors located in the dining room and resident hallway were tested and were operational.
The facility has current liability insurance that meets Title 22 requirements - 1 million per occurrence for a total annual aggregate of 3 million dollars.
The facility is completely enclosed on the outside and has a covered patio. A table and 6 chairs were observed for outside activities.
The trash cans were observed to be in good condition and were tightly sealed.
Overall, the backyard and the front yard was well maintained.

Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8

Exit interview was conducted, Appeals Rights discussed and a copy was given.

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

LIC809 (FAS) - (06/04)

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