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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610439
Report Date: 01/29/2025
Date Signed: 01/29/2025 03:15:28 PM

Document Has Been Signed on 01/29/2025 03:15 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
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:PARADISE SENIOR LIVINGFACILITY NUMBER:
197610439
ADMINISTRATOR/
DIRECTOR:		APOYAN, ANGELAFACILITY TYPE:
740
ADDRESS:8435 AURA AVETELEPHONE:
(747) 202-0457
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY: 6CENSUS: 5DATE:
01/29/2025
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:ANGELA APOYANTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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An Informal Conference was conducted today in the Woodland Hills Adult and Senior Care Regional office. The purpose of this meeting was to discuss recent issues of non-compliance.

Present at today's meeting is the following:

-Eva Miller, Licensing Program Manager (LPM)
-Mariana Agban, Licensing Program Analyst (LPA)
-Angela Apoyan – Administrator / Licensee

The informal conference process was explained to the Licensee. The Licensee was also informed that this Informal Conference is a part of the administrative action process. Further citations may result in a Non-Compliance Conference, which could lead to a referral to the Department's Legal Division for possible license revocation or other administrative actions.

BRIEF HISTORY: On 6/18/24 the license for PARADISE SENIOR LIVING-1 – 197608745 was closed and a license issued to PARADISE SENIOR LIVING – 197610439. License 197608745 was forfeited due to a change of ownership of the licensed corporation, “Paradise Senior Living, INC”. The Administrator for PARADISE SENIOR LIVING-1 – 197608745, Angela Apoyan, is the Licensee Representative and Administrator for PARADISE SENIOR LIVING – 197610439.

(Continue on 809C)

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: PARADISE SENIOR LIVING
FACILITY NUMBER: 197610439
VISIT DATE: 01/29/2025
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On 01/25/25 LPA Mariana Agban conducted a case management visit at PARADISE SENIOR LIVING – 197610439 for deficiencies discovered during a complaint investigation for PARADISE SENIOR LIVING-1 – 197608745. During the investigation of complaint 31-AS-20250115122223, it was determined that the Licensee/Administrator had rented a bedroom designated for facility staff on the approved facility sketch. The Licensee/Administrator stated that the Landlord had rented the room because no staff were currently living in the facility. The Licensee/Administrator also stated that the tenant might be interested in obtaining employment as a night shift caregiver for the facility. LPA advised the Licensee/Administrator that, by renting a room to a tenant outside of the scope of the license, the Licensee/Administrator had altered the purpose of the facility to that of a Boarding House or Hotel. LPA obtained the identity of the tenant and upon review of the Licensing Information System Personnel Report Summary, determined that the tenant did not have a Criminal Record Clearance properly associated to the facility license. The facility was cited and an immediate civil penalty assessed/ The Licensee/Administrator advised that the tenant would be removed from the facility until such a time as the tenant obtained a Criminal Record Clearance associated to the facility license.

During today's meeting, LPM Miller discussed and expressed concerns regarding the health and safety of the residents. LPM advised the Administrator/Licensee of the terms of their facility license and encouraged the Administrator/Licensee to review Title 22 regulations.

The Licensee was informed that Community Care Licensing (CCL) shall continue to frequently monitor the facility as often as necessary to ensure the Licensee's compliance with Title 22 Regulations



Exit interview conducted, and a copy of the report was given.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC809 (FAS) - (06/04)
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