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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850387
Report Date: 10/22/2025
Date Signed: 10/22/2025 03:54:17 PM

Document Has Been Signed on 10/22/2025 03:54 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:LOVE & CARE BOARDING HOMEFACILITY NUMBER:
195850387
ADMINISTRATOR/
DIRECTOR:		VANOYAN, ERNAFACILITY TYPE:
740
ADDRESS:11949 STRATHERN STREETTELEPHONE:
(818) 389-1303
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY: 6CENSUS: 5DATE:
10/22/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:49 AM
MET WITH:Erna VanoyanTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct the required annual visit at 10:17 AM. LPA met with Administrator Erna Vanoyan. Entrance interview conducted and the reason for the visit was explained.

Beginning at 10:17 AM the LPA, along with facility Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

KITCHEN/LAUNDRY: The LPA observed the kitchen area to be clean. Kitchen appliances appeared to be in operable condition. The facility had a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPA observed a secured drawer to contain knives and other sharp objects. LPA observed a secured cabinet located under the sink which contained cleaning supplies. LPA observed resident medications to be locked in a cabinet located in the kitchen. LPA observed a fire extinguisher located in the kitchen to be fully charged and purchased on 08/04/2025. LPA observed the laundry to be located adjacent to the kitchen. LPA observed a secured cabinet in the laundry to contain detergent and extra cleaning supplies. LPA observed the laundry to contain adequate emergency food and water supplies.

Continued on LIC 809C.

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Trevor Byrne
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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.

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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: LOVE & CARE BOARDING HOME
FACILITY NUMBER: 195850387
VISIT DATE: 10/22/2025
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BEDROOMS: There are four (4) bedrooms in the facility; two (2) are single occupancy rooms and two (2) are dual occupancy rooms. Bedroom number one (1) is designated as the bedridden approved room. LPA and facility Administrator toured all four (4) resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Auditory alarms were observed on all facility exits. LPA observed bedroom #4 to contain a direct exit to the outdoors of the facility. This exit was observed to be partially blocked by a resident bed. LPA informed the Administrator who rearranged the layout of the resident beds at the time of the visit to allow easy passage for residents.

BATHROOMS: There are two (2) bathrooms at the facility. One (1) hallway bathroom is designated as shared resident bathroom. And one (1) bathroom is designated as a private resident bathroom. All bathrooms were observed to be clean and in good repair and all were equipped with nonskid surfaces. Grab bars were observed in all showers and near all toilets, all were properly secured. The water temperature was measured between 105.4 and 110.1 degrees Fahrenheit, which is in compliance regulation.

COMMON AREAS: This includes the living room and hallway. LPA observed the living room to be clean and properly furnished at the time of the visit. The living room contained an appropriately screened fireplace, a couch, and activities for resident use. LPA observed a hallway closet to contain extra linens and care supplies. LPA observed all required postings for the facility near the entry way. The facility’s combination fire and carbon monoxide alarms along with the facility’s fire doors were tested at 11:00 AM and functioned properly at the time of the visit.

OUTDOOR SPACE: The facility has two (2) emergency exit gates located in the front yard, one (1) is utilized as an emergency exit gate and one (1) is utilized as the main entry gate. LPA observed clear passageways for emergency exit use. The facility had adequate shaded seating outdoors for resident use.

Continued on LIC 809C.

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Trevor Byrne
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
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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: LOVE & CARE BOARDING HOME
FACILITY NUMBER: 195850387
VISIT DATE: 10/22/2025
NARRATIVE
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RECORD REVIEW: Record review began at 11:02 AM. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, first aid certification, consent forms, and personal rights. Three (3) staff files were reviewed. All staff files contained all required documentation and trainings. Five (5) resident files were reviewed. All resident files were observed to contain Appraisal Needs and Services Plans that contained identical information. LPA informed the Administrator that Appraisal Needs and Services Plans should identify the needs specific to the individual the plan is created for. The Administrator expressed understanding and agreed to complete updated Appraisal Needs and Services Plans for all residents specific to the individuals.

MEDICATION REVIEW: Medication review began at 01:13 PM. Medications for five (5) residents were observed. All medications observed were stored properly and were documented appropriately on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review.



INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the
facility's infection control practices and the facility's emergency disaster plan. Emergency disaster drills are conducted quarterly; the facility’s last emergency disaster drill was conducted on 09/29/2025. The facility’s emergency disaster plan and infection control plan are up to date and are adequate. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility's Administrator.

INTERVIEWS: LPA interviewed one (1) staff and two (2) residents. Both residents interviewed stated that the staff treat them well and are attentive to their needs. No residents interviewed had any concerns with the facility. The staff member interviewed was knowledgeable on their role and responsibilities, the resident rights, the different forms of abuse, and the appropriate reporting procedures for suspected abuse.

During today’s visit LPA obtained a copy of the facility’s LIC 500, resident roster, and current liability insurance.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted and copy of the report was issued and appeal rights provided.
NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Trevor Byrne
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
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Document Has Been Signed on 10/22/2025 03:54 PM - It Cannot Be Edited


Created By: Trevor Byrne On 10/22/2025 at 03:07 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: LOVE & CARE BOARDING HOME
FACILITY NUMBER: 195850387

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87307(d)(6)
Personal Accommodations and Services
(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as bedroom #4's exit to the outdoors of the facility was partially blocked by a resident bed which posed an immediate safety risk to persons in care.
POC Due Date: 10/22/2025
Plan of Correction
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Administrator rearranged the bedroom furniture in room number 4 at the time of the visit to ensure clear passageways to the exterior sliding door. POC cleared.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kasandra Lopez
NAME OF LICENSING PROGRAM MANAGER:
Trevor Byrne
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2025


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Document Has Been Signed on 10/22/2025 03:54 PM - It Cannot Be Edited


Created By: Trevor Byrne On 10/22/2025 at 03:07 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: LOVE & CARE BOARDING HOME
FACILITY NUMBER: 195850387

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87463(a)
Reappraisals
(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as five of five resident's appraisal needs and services plans contained identical information in some sections including other resident's names which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/05/2025
Plan of Correction
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Administrator agreed to redo all appraisal needs and services plans for all five residents of the facility and to ensure that the plans are developed for the specific individual. Administrator agreed to submit the revised Appraisal needs and services plans to CCLD no later than POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kasandra Lopez
NAME OF LICENSING PROGRAM MANAGER:
Trevor Byrne
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2025


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