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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419809
Report Date: 10/10/2023
Date Signed: 11/22/2023 04:12:01 PM


Document Has Been Signed on 11/22/2023 04:12 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:MANUKYAN FAMILY CHILD CAREFACILITY NUMBER:
197419809
ADMINISTRATOR:RUZANNA MANUKYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 398-6909
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91401
CAPACITY:14CENSUS: 14DATE:
10/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:RUZANNA MANUKYAN -LicenseeTIME COMPLETED:
04:20 PM
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On 10/10/2023 Licensing Program Analyst (LPA), Suzette Ornelas conducted an unannounced Annual Required Inspection. LPA was met by licensee, RUZANNA MANUKYAN. Days and hours of operation are Monday through Saturday 24 hours.

Entrance checklist was provided to licensee. This inspection will require a continuation visit to complete the inspection.


This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee RUZANNA MANUKYAN.
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Suzette OrnelasTELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2023
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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