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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609357
Report Date: 01/16/2026
Date Signed: 01/16/2026 02:58:58 PM

Document Has Been Signed on 01/16/2026 02:58 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:BIRMINGHAM VILLAFACILITY NUMBER:
197609357
ADMINISTRATOR/
DIRECTOR:		CHRISTINE LEKHLYANFACILITY TYPE:
740
ADDRESS:825 BIRMINGHAM RDTELEPHONE:
(818) 859-7777
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY: 6CENSUS: 3DATE:
01/16/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Christine Lekhlyan-AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced Annual Required visit and inspection of the facility. LPA met with Administrator - Christine Lekhlyan. LPA asked for copies of staff and resident rosters and files. The purpose of the visit was explained. The Residential Care Facility for the Elderly (RCFE) is licensed to serve 6 (six) non-ambulatory residents with hospice waiver for three (3) residents. Current census is three (3) and all residents receive services from the Frank D. Lanterman Regional Center. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools.

At 11:45am LPA toured the facility with the Administrator and observed the following:

Required postings were observed in the dining room and office area. The facility is located in a residential area and consists of 7 bedrooms, 2.5 bathrooms, living room and dining room. The physical plant appeared clean, sanitary and comfortable with no visible immediate hazards. There are several exits doors throughout, including the kitchen, living room and bedroom#6, but facility uses the living room exit as the main exit. There are two fully charged fire extinguishers, one in the kitchen, one in the dining room, both purchased on 02/05/2025. All exits were equipped with functional alarms. Facility conducts monthly fire and safety drills, the last fire drill was conducted on 12/01/2025 and the earthquake drill was conducted on 12/16/2025. Smoke alarms and carbon monoxide detectors are interconnected and were tested at 11:50am and observed to function properly. Facility is equipped with cable, internet and land line telephones.

Continued on LIC 809C

NAME OF LICENSING PROGRAM MANAGER: Troy Agard
NAME OF LICENSING PROGRAM ANALYST: Nadia Shahbazian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2026
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: BIRMINGHAM VILLA
FACILITY NUMBER: 197609357
VISIT DATE: 01/16/2026
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Common Areas: Include a living room, dining room and locked hallway closet for storing chemicals and linens/supplies. The office area is located near the living room. Laundry washer and dryer are located in the office area but the laundry chemicals are locked in the hallway closet. Dining room is furnished with a table, eight (8) chairs and three (3) small refrigerators. LPA observed a properly screened, non-functional fireplace in the dining room. The living room had a table and ample sitting for all the residents and staff and has an exit door leading outside. Television set and activity/gaming areas were observed in the living room.

Kitchen: There is a refrigerator, stove, microwave and toaster oven in the kitchen. Knives, cutlery and other sharp kitchen utensils are stored and locked in the kitchen cabinet. Food storage and preparation areas are clean and sanitary. LPA found a sufficient amount of perishable (2 days) and non-perishable (7 days) food supplies, properly stored in the kitchen and also in office area cabinet. Cleaning detergents were observed to be locked in the hallway cabinet.



Bedrooms: There were six (6) bedrooms designated for clients' use and one (1) bedroom for live-in staff but there is always awake staff at all times. All bedrooms in use by residents were properly furnished with appropriate beds, chairs, closets and linens with sufficient lighting. Currently bedrooms #1, #4 and #5 are vacant.

Bathrooms: There are two (2) full bathrooms and one (1) half bathroom designated for staff and residents. All bathrooms were properly equipped with required grab bars and non-skid mats and functional fixtures. Hot water temperature was tested between 107.2 and 109.6 degrees Fahrenheit.

Surrounding grounds: Entry/exit gates and pathways were free of obstruction. The outdoor area was free of visible immediate hazards. No bodies of water were observed at the facility. There was a covered patio area with furniture appropriate for outdoor use sufficient for number of clients. Facility has a detached garage with it's own separate exit. The garage was converted to a permitted Accessory Dwelling Unit (ADU), which is currently rented. Administrator will submit copies of the permits and a new facility sketch to LPA; a Technical Assistance advisory was provided.

Continued on 809-C

NAME OF LICENSING PROGRAM MANAGER: Troy Agard
NAME OF LICENSING PROGRAM ANALYST: Nadia Shahbazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026
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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: BIRMINGHAM VILLA
FACILITY NUMBER: 197609357
VISIT DATE: 01/16/2026
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Resident Files: A review of resident records to ensure compliance of licensing forms was conducted at 11:05am. All required admission reports and current physician reports were observed in the files.

Medication: First aid kit, first aid manual and medications are kept locked in a kitchen cabinet. Medications records for all three (3) residents were also verified for accuracy of administration based on physician orders. Medications for all three (3) residents were counted and compared to medication rosters.

Staff Files: Staff files for four (4) staff were reviewed to ensure all forms and training certificates are up to date.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies observed during the visit. A Technical Assistance advisory was provided to submit ADU permits and a new facility sketch.

Exit Interview Conducted / A Copy of the Report provided to Administrator.

NAME OF LICENSING PROGRAM MANAGER: Troy Agard
NAME OF LICENSING PROGRAM ANALYST: Nadia Shahbazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026
LIC809 (FAS) - (06/04)
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