195850563-8-29-2025-29-AS-CYEE-DL23MN-20250829182237

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195850563
Report Date: 08/29/2025
Date Signed: 08/29/2025 06:22:55 PM

Document Has Been Signed on 08/29/2025 06:22 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:	7 HEAVEN		FACILITY NUMBER:	195850563
ADMINISTRATOR/ DIRECTOR:	NSHANIAN, HERMINE		FACILITY TYPE:	740
ADDRESS:	6215 BLUEBELL AVENUE		TELEPHONE:	(818) 732-7378
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY: 6		CENSUS: 5	DATE:	08/29/2025
TYPE OF VISIT:	Case Management - Annual Continuation	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:04 AM
MET WITH:	Kristine Abasyan, Applicant		TIME VISIT/ INSPECTION COMPLETED:	06:30 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 a subsequent announced Prelicensing and Component III visit to complete the inspection of the home to ensure that the home meets Title 22 requirements. LPA Yee met with Kristine Abasyan, Applicant and Ripa Tavitian, Consultant. On today's visit, the last domain of the CARE Inspection Tool - Physical Plant and Environmental Safety, was reviewed, all 4 Bedrooms, Kitchen, Garage and outside areas were toured and the following were observed: Bedroom #1 was re-organized and contains 2 beds, 2 night stands, 2 lamps, 2 dressers, 2 folding chairs and a built in closet. The window blinds were observed to be new. The private bathroom is equipped as previously noted. The water temperature in the private bathroom located inside the room was initially tested and read 131 degrees Fahrenheit and was later re-tested and read 104.4 degrees Fahrenheit when the thermostat was adjusted. Bedroom #2 is rented as a private room and contained a hospital bed, a night stand, a folding chair, a lamp, a dresser, a built in closet, a covered trash can and a flash light. Window blinds were replaced. Bedroom #3 is a shared room and contains 2 of each: beds, night stand, lamps, folding chairs, dressers and built in closet. New blinds were observed. Bedroom #4 is rented as a single room with one each of: a full sized bed, a night stand, a lamp, a folding chair and a built in closet. Located inside the room is a private bathroom with a shower stall with a shower chair, grab bars, a slip resistant mat, a toilet and a single sink vanity. The water temperature was initially tested and read 124.4 degrees and was later retested after adjusting the thermostat and read 109.6 degrees Fahrenheit. continued on LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: 7 HEAVEN	FACILITY NUMBER: 195850563
	VISIT DATE: 08/29/2025

NARRATIVE

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the common bathroom consists of a walk in shower, a toilet and a single sink vanity. Grab bars, shower chair and a slip resistant mat were observed. The water temperature when tested read 109.6 degrees Fahrenheit.
The kitchen was toured and is equipped with a stove, a microwave, refrigerator and toaster.
Per review of the food supply, perishable foods for a minimum of 2 days were observed in the refrigerator. Initially, insufficient non-perishable foods for a minimum of 7 days were observed in the garage and it was replenished during the visit. Sufficient water was also observed after additional water was purchased.
Disinfectant, cleaning solutions, hygiene products and laundry detergent is stored in a locked cabinet in the garage. Extra bedding, bath towels, face towels, hand towels, blankets, comforters are stored in a cabinet in another cabinet.
Centrally stored medications are kept in a locked cabinet located in the living room.
General Liability insurance was observed. The facility has insurance for $2 million per occurrence and a total annual aggregate for $4 million dollars from 9/24/24-9/24/25.
The required postings were shown to LPA and will be posted once license is issued. Current labor poster, Long Term Care Ombudsman Poster and Complaint were observed.
The facility visiting hours were posted on the front door.
The facility will retain the telephone # currently in place from the former owner.
The facility has an IPad dedicated for facility use and a written internet usage policy
Per tour of the backyard, a covered gazebo was observed furnished with a wicker sofa and 5 wicker arm chairs and 2 coffee tables.

The following corrections were addressed during this visit: the facility sketch has been updated to indicate assembly point, the rails in bedroom #2 were removed, the Emergency Disaster Plan was updated, fire arms policy was updated on the Admission Agreement to indicate that all firearms on the premises are prohibited, Rights of Family council, current labor poster and visiting hours were observed. The appropriate number of beds for the approved capacity was observed.

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

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: 7 HEAVEN	FACILITY NUMBER: 195850563
	VISIT DATE: 08/29/2025

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The following correction needs to be made prior to licensure:

the water temperature in the private bathroom located in bedroom #1 read 104.4 degrees Fahrenheit and needs to be within the range of 105 - 120 degrees Fahrenheit.
the hose in the backyard and front yard needs to rolled up.

Applicant will notify LPA Yee once the corrections have been completed.

The Applicant will ensure that files are created for all residents, volunteers and staff once they are licensed.

Component III was conducted with Kristine Abasyan, Applicant and Ripa Tavitian, Consultant.

Exit interview was conducted.

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

LIC809 (FAS) - (06/04)

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