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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850535
Report Date: 08/29/2024
Date Signed: 08/29/2024 10:03:23 AM


Document Has Been Signed on 08/29/2024 10:03 AM - 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:CARING CARE CENTERFACILITY NUMBER:
195850535
ADMINISTRATOR:OHANYAN, ANAHITFACILITY TYPE:
740
ADDRESS:23275 SYLVAN STRTELEPHONE:
(747) 747-2501
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY:6CENSUS: 0DATE:
08/29/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Anahit Ohanyan and Armen JenjoyanTIME COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA) Angela Barutyan conducted a Pre-licensing visit. Upon arrival LPA met with Administrator Anahit Ohanyan and Licensee Armen Jenjoyan. Administrator shares duties and responsibilities at one (1) other facility. Applicant currently operates one (1) other licensed facilities therefore Component III was waived for applicant. Fire Clearance for this facility is approved for four (4) non-ambulatory rooms, of which one (1) may be bedridden. Bedroom #1 is designated as a bedridden room for single use with an exit to the exterior and a fire door. Bedroom #2 is designated for shared use and has an exit to the exterior. Bedroom #3 is designated as a private room. Bedroom #4 is designated for shared use and has an attached bathroom. The facility has a hospice waiver for five (5). Upon arrival, a tour of the physical plant was conducted with Anahit Ohanyan; the LPA inspected facility for Fire Safety, Personal Accommodations and Services, Medication Procedures, and Food Service. New complete first-aid kit observed; facility has adequate linen, water, and nonperishable food supplies. Facility has four (4) non-ambulatory resident bedrooms, one (1) staff office, and two (2) full bathrooms. Hot water temperatures were measured in resident bathrooms and kitchen between 09:27AM-09:30AM and measured between 114.7-116.0 degrees Fahrenheit. Resident bathrooms were observed with grab bars and non-skid shower mats. The kitchen, dining, and living areas observed appropriately furnished. There are no bodies of water on the premises. Facility has working alarms on all exits and Smoke/Carbon Monoxide detectors. All medications, chemicals and sharp objects are in locked cabinets/drawers. Laundry area observed in the attached locked garage that will be utilized for additional storage. Backyard is completely fenced and gated. There is a covered area in the backyard for outdoor activities. Side emergency exit was observed free of obstruction and was equipped with self-closing and self-latching gates.

Applicant will be notified by the CAB Analyst when license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted and copy of report provided.

SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Angela BarutyanTELEPHONE: 747-922-1234
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024
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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