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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610854
Report Date: 12/26/2025
Date Signed: 12/26/2025 02:47:50 PM

Document Has Been Signed on 12/26/2025 02:47 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:SLASHT HEALTH AND SAFETYFACILITY NUMBER:
197610854
ADMINISTRATOR/
DIRECTOR:
MOVSISYAN, LIANAFACILITY TYPE:
740
ADDRESS:915 E CEDAR AVENUETELEPHONE:
(747) 717-0355
CITY:BURBANKSTATE: CAZIP CODE:
91501
CAPACITY: 6CENSUS: 0DATE:
12/26/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Liana Movsisyan-AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Nadia Shahbazian conducted a Pre-Licensing Inspection and met with Liana Movsisyan-Administrator at 10:15am. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on July 10, 2025. A fire clearance was approved on August 19, 2025 for four (4) Non-ambulatory and two (2) bedridden residents for total capacity of six (6).

Facility is an one-story rental house, in a residential area. There is a privately owned, two story Additional Dwelling Unit (ADU) in the back and the facility uses the first floor of the ADU as storage. The second story of the ADU is currently vacant and is not associated with the facility. The ADU has a separate entry, completely inaccessible to the facility.

The main house has been completely remodeled, all appliances and furnishings are brand new. The required posting were posted in dining room, accessible to residents. The smoke alarms and carbon monoxide detectors are dual and inter-connected. At 11:41am, smoke and carbon monoxide detectors were tested and observed to be functional. In addition facility has fire sprinklers throughout the entire house. The facility has one fire extinguisher, purchased on 08/01/2025, located in the dining room, near entry door.

With the assistance of the administrator, a tour of the physical plant was initiated at 11:00am and the following was observed:

KITCHEN: The kitchen is equipped with brand new appliances, including a refrigerator, stove/oven, microwave and dishwasher. Knives were observed locked in a kitchen drawer. There was an adequate supply of non-perishable food items and supply of dishes in kitchen cabinets. Perishable food items are not required at this time, as there are no residents. Administrator was advised that facility needs to carry perishable food items once they admit residents for care.

NAME OF LICENSING PROGRAM MANAGER: Troy Agard
NAME OF LICENSING PROGRAM ANALYST: Nadia Shahbazian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/26/2025
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: SLASHT HEALTH AND SAFETY
FACILITY NUMBER: 197610854
VISIT DATE: 12/26/2025
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COMMON AREAS: The living/dining area is located upon entry. The living room is furnished with a television set, a coffee table and couches, appropriate for number of the residents. LPA observed a cabinet stocked with games and puzzles, in the living area. The dining room is furnished with a table and six chairs. In addition there is a family room, furnished with sofas. Facility has land-line telephone, internet and Wi-Fi access for resident's use.

BEDROOMS/BATHROOMS: There are six (6) private bedrooms designated for client use and one (1) bedroom designated as staff room. All bedrooms are equipped with self-closing fire doors. Bedrooms #1 and #2 as designated as the bedridden rooms. All the bedrooms were furnished with beds, night-stands, chairs, closets, television sets and supply of bedding and linens. All resident bedrooms have exit doors, leading to the backyard. The staff bedroom is located next to the office and facility will have living staff. Facility will ensure that there is always awake staff during all shifts. There are total of three (3) bathrooms for resident use, one bathroom across bedroom #4 and one bathroom in bedrooms # 5 and #6. All resident bathrooms were observed to have proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured between 109.6 and 110.8 degrees Fahrenheit.

OFFICE/STAFF ROOM: Office area is located next to the entry door and is kept locked. There is filing cabinet, to maintain all resident and staff records. Medications will be kept locked in the office as well. LPA observed a complete first aid kit and first aid manual in the living room.

LAUNDRY ROOM: LPA observed a locked laundry room next to bedroom #4. There is a brand new stackable washer and dryer in the laundry room. All detergents/chemicals are kept locked in a cabinet.

SURROUNDING GROUNDS: The passageways and entrance to the home was clear of any obstruction. All entry and exit doors have a functional auditory alerts, when the doors open. The backyard of the facility is large enough to hold outdoor activities. The patio furniture included a set of tables, chairs, located underneath a gazebo. There is no swimming pool or body of water. The garage is located underneath the ADU and is currently used as storage. There are multiple exits doors, including exits in each bedroom but facility will use the rear exit in the hallway as the emergency exit.

In addition to the Pre-Licensing inspection, a Component III power point presentation was held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report was provided to the administrator.

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

DATE: 12/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2025
LIC809 (FAS) - (06/04)
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