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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850173
Report Date: 05/16/2024
Date Signed: 05/16/2024 04:16:32 PM


Document Has Been Signed on 05/16/2024 04:16 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364



FACILITY NAME:A'MORECARE HOME ASSISTED LIVINGFACILITY NUMBER:
195850173
ADMINISTRATOR:ANNETTE AMIRKHANIANFACILITY TYPE:
740
ADDRESS:23511 BERDON STREETTELEPHONE:
(818) 704-0012
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY:0CENSUS: 0DATE:
05/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Paramjit Kaur TIME COMPLETED:
04:17 PM
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Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced with the purpose of confirming closure of the facility. At 3:40 p.m., the LPA met with Paramjit Kaur to conduct a final walk-through of the facility.

On 04/11/2024, LPAs Zabel Chochian and Sandra Urena delivered a denial letter and notified Applicant Paramjit Kaur and Jagdeep Singh, that the licensure application for this property has been denied by Community Care Licensing’s (CCL) Centralized Applications Bureau, effective April 11, 2024. On 04/11/2024, Applicant, Ms. Kaur was served a second Notice of Operation in Violation of Law (NOVL). An initial NOVL was served to Paramjit Kaur and Jagdeep Singh on 2/21/2024. Per the NOVL, Ms. Kaur must relocate all individuals requiring care and supervision by April 26, 2024. It was also explained to Ms. Kaur that per Health and Safety Code 1569.16(b), re-submitting an application will not correct the citation, as an applicant does not have the right to re-apply for licensure for one year after the Department’s application denial. Therefore, individuals in the home that required care and supervision were relocated. The last resident to move out was on April 26, 2024.

During today’s visit, the LPA and Paramjit Kaur were not able to get access to the inside of the facility. However, the LPA observed facility throughout the windows and observed the facility to be vacant and verified that no care and supervision was being provided. The LPA requested for the License to be dropped off to Woodland Hills Regional Office (RO) by May 17, 2024. The facility is reflected as closed since May 15, 2024, in the Licensing Information System (LIS).

Exit interview conducted. A copy of report was issued.
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Emily PeraldiTELEPHONE: 818-421-4497
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2024
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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