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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017226
Report Date: 06/28/2022
Date Signed: 06/28/2022 02:16:34 PM


Document Has Been Signed on 06/28/2022 02:16 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:MAMBREIAN FAMILY CHILD CAREFACILITY NUMBER:
198017226
ADMINISTRATOR:MAMBREIAN, VARDOUIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 663-6625
CITY:LOS ANGELESSTATE: CAZIP CODE:
90027
CAPACITY:14CENSUS: 0DATE:
06/28/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Vardoui Mambreian, LicenseeTIME COMPLETED:
02:30 PM
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CASE MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN

Licensing Program Analysts (LPA) Anomeh Eivazian and Veronica Martinez Garza conducted an unannounced case management inspection to the above facility on 06/28/2022 to amend the Annual inspection report second page line 14 dated May 03, 2022. LPAs arrived at the facility at 2:00 PM and met with Vardoui Mambreian, Licensee who guided analyst on a tour of the facility. During this inspection no children were present in the home.

A copy of the amended report was discussed and a copy of the amended report was provided to Licensee, Vardoui Mambreian during this inspection.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today from the areas that were inspected today.


Exit interview conducted and report was reviewed with the Licensee, Vardoui Mambreian at 2:30 p.m..
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022
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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