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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608382
Report Date: 02/26/2025
Date Signed: 02/26/2025 10:17:10 AM

Document Has Been Signed on 02/26/2025 10:17 AM - 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:BE WELL SENIOR LIVING II INC.FACILITY NUMBER:
197608382
ADMINISTRATOR/
DIRECTOR:		ELINA ROOTFACILITY TYPE:
740
ADDRESS:5104 VARNA AVENUETELEPHONE:
(818) 646-3412
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91423
CAPACITY: 6CENSUS: 6DATE:
02/26/2025
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Edward Manaluz, staffTIME VISIT/
INSPECTION COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Emily Peraldi arrived unannounced for a Collateral visit. At 9:30 a.m., the LPA met with staff and explained the reason for the visit. At 9:35 a.m., the LPA spoke with Co- Administrator, Ruslan Melnikov. The Co-Administrator authorized staff, Edward Manaluz to sign the report.

Today's visit is in regard to the investigation of complaint control 29-AS-20240312085646 which is unrelated to this facility. At 9:38 a.m., the LPA spoke with Resident #1 (R1).

No health and safety concerns were observed during this visit.

Exit interview conducted. A copy of the report was provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
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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