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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425850481
Report Date: 07/12/2024
Date Signed: 07/12/2024 04:18:12 PM

Document Has Been Signed on 07/12/2024 04:18 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:ABOVE ALL CARE, LLCFACILITY NUMBER:
425850481
ADMINISTRATOR/
DIRECTOR:		ANDREICHENKO, VIKTORIIAFACILITY TYPE:
740
ADDRESS:4532 NUECES DRIVETELEPHONE:
(805) 403-7455
CITY:SANTA BARBARASTATE: CAZIP CODE:
93110
CAPACITY: 6CENSUS: 6DATE:
07/12/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Viktoriia Andreichenko, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Continuation of the Annual Inspection visit to the above-named facility. Upon arrival, LPA was greeted by Staff 1 (S1) and Staff 2 (2) and explained the purpose of the visit. Administrator Viktorria Andreichenko arrived at approximately 1:30 pm. At the time of arrival, there were 6 residents in care and 2 staff on duty.
The facility is licensed as a Residential Care Facility for the Elderly (RCFE) with a dementia diagnosis has a fire clearance for 6 non-ambulatory residents (of which one may be bedridden) and a hospice waiver for 3 residents. Currently there are 2 residents on hospice.
Medications are given as prescribed. First aid kits are complete. Staff records are complete and all staff trainings are up to date.
Exit interview conducted. Technical Violations issued. Copy of report issued at the time of the visit.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2024
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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