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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197607859
Report Date: 12/17/2025
Date Signed: 12/17/2025 12:07:48 PM

Document Has Been Signed on 12/17/2025 12:07 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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:DIANA'S MARIAN RES. CARE FACILITY 1 LLCFACILITY NUMBER:
197607859
ADMINISTRATOR/
DIRECTOR:		DIANA SORIANOFACILITY TYPE:
740
ADDRESS:44047 RODIN AVENUETELEPHONE:
(661) 726-7674
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 6CENSUS: 3DATE:
12/17/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Diana SorianoTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 12/17/2025 at 9:20 am Licensing Program Analyst (LPA) Lorena Casillas arrived at the facility to conduct an unannounced one (1) year inspection. LPA was greeted by Administrator Diana Soriano, LPA explained the reason for the visit and an entrance interview was conducted.

INFECTION CONTROL and EMERGENCY PREPAREDNESS PLAN: LPA reviewed facility Infection Control Plan and Emergency Preparedness Plan to make sure facility is following protocols.

A tour of the physical plant was conducted with the Administrator at 09:45 am. The facility has four (4) bedrooms and two (2) bathrooms. It is currently occupied by three (3) clients. One (1) bedroom and one (1) bathroom are designated for staff use only.



Kitchen: LPA conducted a tour of the kitchen at 09:45 am and observed there to be sufficient stock of two-day perishable and seven-day non-perishable foods. Frozen foods are properly wrapped and stored. Food storage and preparation areas are clean and inaccessible to pests. Medication and knives are stored in locked cabinets. First aid kit furnished and fully equipped.

Common Areas: LPA observed the living room to be neat and clean along with the dining room. The facility maintains a comfortable temperature at 72°F. LPA observed staff and client files locked in the filing cabinet. The smoke detectors and carbon monoxide detectors were tested and observed to be operational at 10:00 am. There are three (3) fire extinguishers located in the kitchen, hallway, and garage. The fire extinguishers were observed to be full and last serviced on 04/11/2025.

Continued on LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Lorena Casillas
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2025
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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: DIANA'S MARIAN RES. CARE FACILITY 1 LLC
FACILITY NUMBER: 197607859
VISIT DATE: 12/17/2025
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Bedrooms: LPA observed rooms to have the appropriate bedding. There is a nightstand and sufficient lighting for each resident. LPA observed sufficient linens and towels in the hallway closet. All windows had adequate screens and egress was functioning in all the rooms.

Bathrooms: LPA observed bathroom to have the appropriated wash your hands signs posted. The bathroom was clean, with soap and paper towels for residents. Hot water was tested in the resident bathroom and measured 116.4˚F.

Surrounding Grounds: There were no visible hazards, and passageways were free from obstruction. The gate was unlocked and easily accessible. The driveway, passageways and entrance to the home were clear of obstruction. The backyard of the facility has a patio and backyard furniture. The facility backyard has sufficient yard space to accommodate outdoor activities. There are no bodies of water.

Garage: Garage entrance was locked and secure. Garage contains PPE equipment, laundry area and a freezer that has plenty of frozen food that was wrapped and stored appropriately. There is a storage area with additional canned items along with emergency food. Chemicals and household supplies were locked and stored in a locked cabinet in the garage.

Administrative: LPA collected LIC500, liability insurance, administrator certificate and resident roster. Annual fees are not due yet, however LPA provided PIN to Administrator.

Medications: At 10:30 am LPA and Administrator reviewed medication and records for proper documentation.



Staff and Resident Files: LPA conducted a file review of resident records at 10:45 am.

Staff and Resident Interviews: LPA interviewed staff and residents at 11:45 am.

No deficiencies cited. Exit interview conducted, and a copy of this report was provided to the Administrator.

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Lorena Casillas
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2025
LIC809 (FAS) - (06/04)
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