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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
197493523
Report Date:
08/12/2021
Date Signed:
08/13/2021 02:30:06 PM
COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO
,
CA
90245
FACILITY NAME:
MANOUKIAN FAMILY CHILD CARE
FACILITY NUMBER:
197493523
ADMINISTRATOR:
MANOUKIAN, EILEEN
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(818) 621-8532
CITY:
TARZANA
STATE:
CA
ZIP CODE:
91356
CAPACITY:
14
CENSUS:
DATE:
08/12/2021
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
01:04 PM
MET WITH:
Eileen Manoukian
TIME COMPLETED:
01:40 PM
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SUPERVISOR'S NAME:
Peter Flores
TELEPHONE:
(424) 301-3077
LICENSING EVALUATOR NAME:
Laticia S Thompson
TELEPHONE:
(424) 301-3048
LICENSING EVALUATOR SIGNATURE:
DATE:
08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/12/2021
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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