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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850344
Report Date: 04/11/2026
Date Signed: 04/11/2026 04:08:34 PM

Document Has Been Signed on 04/11/2026 04:08 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:OAKMONT OF AGOURA HILLSFACILITY NUMBER:
195850344
ADMINISTRATOR/
DIRECTOR:		CHAPARYAN,LILITFACILITY TYPE:
740
ADDRESS:29353 CANWOOD STREETTELEPHONE:
(747) 755-5700
CITY:AGOURA HILLSSTATE: CAZIP CODE:
91301
CAPACITY: 102CENSUS: 83DATE:
04/11/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Kimberly Vanderwall, Activities Director and
Mark Lagasca, Maintenance Director		TIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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Licensing Program Analysts (LPAs) Zabel Chochian arrived at the facility unannounced to conduct a required annual visit. Upon arrival LPA met with staff. LPA introduced self and staff contacted the Executive Director (ED) Lilit Chaparyan. LPA spoke with the ED and reason for the visit was explained.  ED stated that the facility Maintenance Director will assist LPA with the physical plant inspection.

LPA observed required postings on the wall. There is a dedicated area for the posting directly by the main entrance and hallway. LPA met with Mark Lagasca, Maintenance Director. LPA requested to see the facilities last annual fire inspection record. Last inspection was conducted by Cal Building Systems for the facility fire system alarms and smoke/carbon monoxide detectors on 01/02/2026. Last disaster drill was conducted on 3/25/2026.

The LPA along with the facility's Maintenance Director toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The inspection began at approximately 12pm - Kitchen/dining room toured - Kitchen appliances were observed to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food.  Dining room furniture observed to be in good  condition and appeared to be clean. Emergency food and water supply is stored on the second floor. The common areas observed included the facility activity rooms, lobby area, library, lounge, café, fitness center, and movie theater   All the common areas observed appropriately furnished and clean during todays visit. The facility maintained a comfortable temperature.  All exits in Memory care have functioning auditory devices and were operational at the time of the visit.

From approximately 1pm-3:30pm, a total of nine (9) randomly selected bedrooms were toured - six (6) rooms in the assisted living and three (3) rooms in the memory care unit.  (Continue to LIC809c)

NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Zabel Chochian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2026
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: OAKMONT OF AGOURA HILLS
FACILITY NUMBER: 195850344
VISIT DATE: 04/11/2026
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During the resident room tour the LPA interviewed five (5) residents. The resident bedrooms were properly furnished with all required furniture and had sufficient lighting. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. LPA observed all bathrooms in each residents bedroom  were properly supplied with hygiene and paper products; all fixtures worked properly. The hot water was measured in each bathroom within 105 - 120 degrees Fahrenheit.

Due to time constraints, the LPA will return at a later date to review staff and resident records including medication procedures and record keeping for the assisted living side.

(Continue to LIC809c)
NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Zabel Chochian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2026
LIC809 (FAS) - (06/04)
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