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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565802472
Report Date: 03/14/2025
Date Signed: 03/21/2025 11:09:21 AM

Document Has Been Signed on 03/21/2025 11:09 AM - 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 N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:VENTURA GRAND CHATEAUFACILITY NUMBER:
565802472
ADMINISTRATOR/
DIRECTOR:
MICHAEL DIMAGUILAFACILITY TYPE:
740
ADDRESS:5430 TELEGRAPH ROADTELEPHONE:
(805) 642-2567
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY: 49CENSUS: 30DATE:
03/14/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:48 PM
MET WITH:Sean Beharry, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Teresa Camara conducted a continuation of the annual visit to review resident and staff records, emergency disaster plan, and other documentation. LPA met with administrator Sean Beharry and explained the reason for the visit.

Resident Records: Resident records were checked for documents including but not limited to emergency identification form, consent forms, medical assessment, appraisal/needs and services plan, admission agreement and TB test results. These records appeared complete.

Staff Records: Staff records were reviewed for documents including but not limited to fingerprint/background clearance, health screening, TB test results, and training. These records appeared complete.

Medications: LPA reviewed medications for five residents. Medications appear to be given as prescribed based on the review of each centrally stored medication and destruction record and medications.

Emergency Disaster Plan: LPA reviewed the facility's emergency disaster plan which appeared sufficient. The facility has an agreement with a facility out of the area to accept residents in the event the facility must be evacuated. Emergency evacuation drills are conducted quarterly with all staff.

Infection Control Plan: LPA reviewed the facility's infection control plan which appeared sufficient.

No deficiencies were observed. Exit interview conducted and report issued.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2025
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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