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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191202138
Report Date: 02/28/2025
Date Signed: 03/01/2025 01:38:46 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/01/2025 01:38 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:TIERRA DEL SOLFACILITY NUMBER:
191202138
ADMINISTRATOR/
DIRECTOR:		NANCY BISSONETTE-ANDREWFACILITY TYPE:
775
ADDRESS:9919 SUNLAND BOULEVARDTELEPHONE:
(818) 352-1419
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY: 304CENSUS: 65DATE:
02/28/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:29 PM
MET WITH:Sandy Lara, Program DirectorTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analysts, (LPA) Leizl de la Cerra made an unannounced site visit to this facility as a continuation of the Required 1 Year Annual Inspection conducted on 12/11/2024. LPA met with program director, Sandy Lara, and the purpose of visit was disclosed.

The following remaining inspection domains were observed, reviewed and inspected:

Client files: LPA conducted a file review for ten (10) client files to ensure compliance of licensing forms between 12:30pm to 1:30pm.

No deficiencies cited during today's visit. . Exit Interview Conducted. Copy of this report issued.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leizl De La Cerra
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2025
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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