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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191220527
Report Date: 12/27/2024
Date Signed: 12/27/2024 12:27:29 PM

Document Has Been Signed on 12/27/2024 12:27 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:AMIGO HOMEFACILITY NUMBER:
191220527
ADMINISTRATOR/
DIRECTOR:		BIJOU, ELIZABETHFACILITY TYPE:
735
ADDRESS:8238 AMIGO AVENUETELEPHONE:
(818) 993-9432
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
12/27/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:40 AM
MET WITH:Armando Frank Colon, StaffTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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At 11:40 AM, Licensing Program Analyst (LPA) Huma Rahimi made an unannounced case management- annual continuation visit to continue the Annual Required visit that was started on 12/26/2024. LPA met with the staff Armando Colon.The staff contacted the Administrator Elizabeth Bijou via phone and LPA explained the reason for this visit.
LPA was unable to issue civil penalties during the initial visit on 12/26/2024, due to the time constrains. Today's visit consisted of issuing civil penalties for citations issued on 12/26/2024.

Civil penalties issued. Appeal rights explained.

Exit interview conducted. Copy of report provided.

Nichelle GillyardTELEPHONE: (818) 596-4370
Huma RahimiTELEPHONE: (818) 304-2399
DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/27/2024
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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