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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603515
Report Date: 12/04/2023
Date Signed: 12/04/2023 04:47:36 PM

Document Has Been Signed on 12/04/2023 04:47 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:TOUCHING HEARTS BOARDING CAREFACILITY NUMBER:
198603515
ADMINISTRATOR:MKRTCHYAN, MARGARITAFACILITY TYPE:
740
ADDRESS:1010 LINDEN AVETELEPHONE:
(424) 216-0864
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY: 6CENSUS: 5DATE:
12/04/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:29 PM
MET WITH:Margarita Mkrtchyan, AdministratorTIME COMPLETED:
05:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced Case Management visit in conjunction with complaint control number 31-AS-2023110113303. The purpose of this Case Management visit is to issue a citation for a deficiency observed during the course of the complaint investigation that is not directly related to the complaint. LPA met with Margarita Mkrtchyan, Administrator.

During the investigation, LPA Valenzuela noted the following:

1) A resident was retained with a prohibitive health condition.

Pursuant to the California Code of Regulations, Title 22, the following deficiency was noted and cited during this visit.

Exit interview conducted, copy of the report and a citation was issued.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Rosaura Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2023
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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Document Has Been Signed on 12/04/2023 04:47 PM - It Cannot Be Edited


Created By: Rosaura Valenzuela On 12/01/2023 at 03:33 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: TOUCHING HEARTS BOARDING CARE
FACILITY NUMBER: 198603515

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/15/2023
Section Cited
CCR
87615(a)

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87615 Prohibited Health Conitions-(ja) Persons who require health services for or have a health condition including but not limited to, those specified bewlow shall not be admitted or retained at a residential care for the elderly; (1) Stage 3 and 4 pressure injuries. This requirement was not met as evidenced by:
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 The administrator will submit in writing to CCL by 12/15/23, how they will ensure that moving forward residents with stage 3 or 4 pressure injuries are not accepted or retained in the facility.
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Based on interviews and records review, the administrator retained a resident with stage 3 and 4 pressure injuries in the facility. This poses an immediate health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Naira Margaryan
LICENSING EVALUATOR NAME:Rosaura Valenzuela
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2023


LIC809 (FAS) - (06/04)
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