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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610423
Report Date: 07/26/2023
Date Signed: 07/26/2023 11:31:26 AM

Document Has Been Signed on 07/26/2023 11:31 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 S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:TOUCHING HEARTS BOARDING CARE 1FACILITY NUMBER:
197610423
ADMINISTRATOR:MKRTCHYAN, MARGARITAFACILITY TYPE:
740
ADDRESS:5149 LA CANADA BLVD.TELEPHONE:
(424) 216-0864
CITY:LA CANADA FLINTRIDGESTATE: CAZIP CODE:
91011
CAPACITY: 6CENSUS: DATE:
07/26/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Margarita MkrtchyanTIME COMPLETED:
11:15 AM
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On 7/26/2023, Licensing Program Analyst (LPA) Melissa Spaeth conducted an announced Pre-Licensing visit to this facility and met with the Licensee. This is a new application and a fire clearance dated 05/01/2023 was received for five (5) non-ambulatory and one (1) bedridden resident. The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6.

Component III was conducted with the applicant from 9:15 am until 10:00 am.

Today’s site visit consisted of LPA touring the physical plant inside and outside from 10:00 am until 10:30 am and LPA observed the following:

Living Room - LPA observed comfortable seating in the living room and a dining room table with dining room chairs.

Kitchen - The facility contained a seven day supply of non-perishable food and a two day supply of perishable foods. A locked kitchen cabinet underneath the kitchen sink contained the cleaning supplies. There is a designated locked cabinet for resident medications and also contained the first aid kit. There is a locked drawer for knives. A fire extinguisher is also located in the kitchen. Appliances in the kitchen appeared to be functional. The kitchen also contained an additional dining room table and chairs.

Backyard - The backyard contained comfortable seating for residents. The side gate leading from the backyard to the front yard was not locked. A pool is located in the backyard and the gate leading to the pool was locked.

Continued - 809C
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Melissa Spaeth
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: TOUCHING HEARTS BOARDING CARE 1
FACILITY NUMBER: 197610423
VISIT DATE: 07/26/2023
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Bedrooms - There are three bedrooms which contained bed, linens, night stand, lamp, chest of drawers, chairs and a closet. Bedrooms #2 and #3 are designated shared rooms. Room #4 is the master bedroom and master bath combination. Room #4 is the designated bedridden room.

Administrator/Staff Member Living Quarters – LPA observed the facility and Administrator living quarters are attached to the facility. The door leading from the facility to the Administrator’s living quarters is in the living room and was locked. LPA observed the designated staff room and the washer/dryer are located within the Administrator’s living quarters.

Bathrooms- There are two bathrooms which contained hand soap, paper towels, trash can, grab bars, and slip resistant mats. The water temperature was recorded at 10:20 am and was 109.7 F.

Hallway - The hallway closet was locked and contained resident hygiene items, PPE and disinfectant cleaning supplies. There are drawers also located in the hallway which contained linens.

The smoke and carbon monoxide detectors were tested at 10:30 am. The necessary precautions have been made to the facility to safely house dementia residents such as auditory alarms on all exit doors. The facility was clean and appears to be in good repair.

This report will be forwarded to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. Exit interview was conducted with Licensee. A copy of this report was signed and delivered.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Melissa Spaeth
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023
LIC809 (FAS) - (06/04)
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