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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609342
Report Date: 09/26/2025
Date Signed: 09/26/2025 04:47:37 PM

Document Has Been Signed on 09/26/2025 04:47 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:LOS FELIZ GARDENSFACILITY NUMBER:
197609342
ADMINISTRATOR/
DIRECTOR:		SHAPIRO, NONNAFACILITY TYPE:
740
ADDRESS:205 E LOS FELIZ ROADTELEPHONE:
(818) 241-2273
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY: 199CENSUS: 103DATE:
09/26/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Administrator/Licensee Nonna ShapiroTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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At 10:00a.m., Licensing Program Analyst (LPA), Antonia Alvizar-Ettima and Regional Manager (RO), Angela Whittaker conducted a Required One (1) Year Annual visit. LPA and RO met with Manager and granted entry. Staff called the Administrator, and the purpose of visit was stated. Later the Administrator/Licensee joined us.

At about 10:35a.m., LPA, RO and manager conducted a tour of the physical plant. Required postings were observed throughout the facility. This is an RCFE with a capacity of 199. The census is currently 103. The facility consists of a three (3) floor building with a total of 100 resident bedrooms (50 bedrooms on the second level and third level), each having its own bathroom. The first floor consists of the following: a lobby area, administrative offices, function room, dining area, activities room, television room, laundry room, staff lounge, family visiting room, guest restrooms, storage rooms, kitchen, and a sitting garden. There are two operable elevators, one designated for residents and the other for staff. The temperature of the facility wall thermostat was set at 72°F and observed to be within required range. The most recent fire and disaster drills were conducted on 09/03/2025. Care and supervision to meet the resident’s needs was observed. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools during the inspection and observed the following:

Bedrooms: Bedrooms in the 2nd floor has non-ambulatory residents and the 3rd floor has ambulatory residents. Bedrooms were toured and observed to be clean and properly furnished with appropriate dresser, bedding, and linens with sufficient lighting. Linen storage was also checked and observed to have an ample supply of clean linen and towels.

Cont. on LIC 809-C

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Antonia Alvizar-Ettima
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2025
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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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: LOS FELIZ GARDENS
FACILITY NUMBER: 197609342
VISIT DATE: 09/26/2025
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Bathrooms: Bathrooms were observed to be properly supplied and working fixtures, with appropriate grab bars, and non-slip mats were present. Hot water temperature was measured at a range of 109.9°F to 113.1°F which meets Title 22 regulations. Adequate supply of hygiene supplies available stored in supply room.

Emergency Phone numbers, exit plan and menu: Posted and readily available for review in the lobby floor hallways. All fire extinguishers are fully charged with service tag date of 06/25/25.

Smoke Detectors: Resident rooms and common areas have a manual smoke detector. Carbon monoxide detectors are located in each facility floor hallway. Fire inspection including smoke detectors, bells, door magnets, strobes, mini horns and full fire inspection was last done on 04/16/25.

Common Areas: These include a lobby area, function room, dining area, activities room, television room, staff lounge, family visiting room, physical therapy room, guest restroom, and a sitting garden. There are two operable elevators, one designated for residents and the other for staff. The common areas were properly furnished. Furniture in common areas was observed to be in good repair. No obstructions or tripping hazards throughout the facility.

Kitchen: Kitchen was observed to be clean and sanitary and free of pets. The kitchen appliances and fixtures were functional. Food: LPA observed at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. All food was properly wrapped, labeled, and stored. Food storage and preparation areas are clean and inaccessible to pests. Knives, cutlery and other sharp kitchen utensils are stored in the kitchen and only accessible for staff. All toxins and cleaning agents are locked in storage rooms.

Laundry Room: Located on the 1st floor and inaccessible to residents. Detergent is kept in the laundry room locked. All toxins were stored and locked in the supply room.

Surrounding Grounds: Entry and exits were free of obstruction. Outdoor areas were clean, with appropriate furniture and no hazards noted. The facility does not have a swimming pool or other body of water.

Due to time constraints, LPA were unable to complete today's annual inspection. LPA will complete the inspection at a later date. There was no immediate health or safety hazard were observed.

Exit interview conducted and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Antonia Alvizar-Ettima
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025
LIC809 (FAS) - (06/04)
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