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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610466
Report Date: 04/09/2026
Date Signed: 04/09/2026 03:18:41 PM

Document Has Been Signed on 04/09/2026 03:18 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.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:VALLEY SILVERTOWNFACILITY NUMBER:
197610466
ADMINISTRATOR/
DIRECTOR:		MOHAMMAD ALQAMFACILITY TYPE:
740
ADDRESS:6833 FALLBROOK AVETELEPHONE:
(818) 883-4123
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY: 183CENSUS: 120DATE:
04/09/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:59 AM
MET WITH:Mohammad AlqamTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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At approximately 9:00 a.m. on 04/09/26 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual inspection. LPA met with staff and later the licensee and disclosed the reason for the visit.

A file review was conducted prior to today’s visit. The facility was last visited on 02/18/26 for a complaint visit. It is a two-story building with assisted living and memory care units, shared and private rooms, common areas, offices, beauty salon, theatre room, medication room, and outdoor areas. It has an approved fire clearance for one hundred eighty three (183) non-ambulatory residents of which eight (08) may bedridden. Approved hospice waivers for twenty-five (25). A Change of Management to include Valley Silvertown LLC as a partial manager was approved on 09/23/25.

Facility postings at the main entrance included the facility license, Ombudsman contact, confidential complaint contact, Emergency Disaster Plan, personal rights in English and Korean, monthly and daily activity calendar, and the facility sketch with evacuation routes clearly labelled. Sprinkler systems and fire alarms are located throughout the building. Sign-in sheets are available for residents, agencies, and other visitors at the reception area. Walls, floors, ceilings, windows, screens, and blinds were clean and in good repair. Linen closets with adequate supplies of fresh linens, locked janitorial and electrical closets, and public restrooms were located on the first and second floor.

The upstairs activity room contained card games, art supplies, reading materials, seating in good condition, and adequate space. Between 9:00 a.m. and 9:30 a.m. today, LPA observed the activity director providing a physical exercise routine for about seven (07) residents. At 10:30 a.m., LPA observed church services provided in the upstairs activity room.

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Nicholas Reed
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2026
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.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: VALLEY SILVERTOWN
FACILITY NUMBER: 197610466
VISIT DATE: 04/09/2026
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At approximately 10:35 a.m. LPA observed the room temperature to be 72 degrees Fahrenheit. Evacuation chairs were observed at the top of each stairway.

LPA and the licensee inspected rooms on the first and second floors. The pull cord system in Room #106 was tested at 12:06 p.m., and staff responded by 12:08 p.m. At 12:10 p.m. the hot water in the bathroom was measured to be 112.5 degrees Fahrenheit. The pull cord system in #114 was tested at 12:12 p.m. and staff responded by 12:13 p.m. The hot water in the bathroom was measured to be 113.0 degrees Fahrenheit.

Business offices and a staff training room were located on the first floor near the main entrance. At 12:15 p.m., LPA observed fully charged fire extinguishers on the first and second floor hallways which were last inspected on 05/22/25. Two (02) emergency exits on the southern perimeter of the building were unlocked and alarmed. The alarms were tested to be operational at 12:25 p.m. Emergency exit paths were unobstructed and free of debris. At 12:30 p.m. and 12:35 p.m., LPA measured the hot water in room #237 and the upstairs public restroom to be 109.6 degrees Fahrenheit. At 12:40 p.m. the memory care portion was surveyed. The memory care unit is equipped with 15-second delayed egresses at four (04) locations. The activity room in memory care contained art supplies, exercise equipment, and furniture in good repair. Resident bedrooms contained a chair, nightstand, appropriate lighting, storage, and bedding in good condition. At 12:45 p.m. LPA tested a delayed egress door to be operational.

The patio area in the middle and rear of the facility contained maintained lawn areas, a smoking area, and shaded seating with furniture in good repair. Two (02) storage sheds near the parking lot were locked and contained chemicals and tools. The laundry area contained three (03) washers and three (03) dryers. Detergents were made inaccessible in an adjacent storage room. The facility elevator was functional. The dining room contained adequate seating. Daily and alternative menus were posted at each table. The kitchen area contained functional equipment and sanitary surfaces. Resident specialized diets were posted on the wall along with temperature logs. The pantry, refrigerator and freezer contained adequate supplies of perishable, non-perishable, and emergency foods. At 3:10 p.m. LPA measured the walk-in refrigerator and freezer temperatures to be 39 degrees and -11 degrees Fahrenheit, respectively.

Due to time constraints, LPA to return to the facility tomorrow, 04/10/25 for an ANNUAL – CONTINUATION visit to complete the annual inspection. No immediate health or safety hazards were observed during today’s visit. Exit interview conducted. Copy of report provided.

NAME OF LICENSING PROGRAM MANAGER: Naira Margaryan
NAME OF LICENSING PROGRAM ANALYST: Nicholas Reed
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
LIC809 (FAS) - (06/04)
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