197603165-1-24-2025-29-AS-SURA-DD8UG6-20250124143347

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197603165
Report Date: 01/24/2025
Date Signed: 01/24/2025 02:35:01 PM

Document Has Been Signed on 01/24/2025 02:35 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:	GLEN PARK AT VALLEY VILLAGE		FACILITY NUMBER:	197603165
ADMINISTRATOR/ DIRECTOR:	MARILOU MENDOZA		FACILITY TYPE:	740
ADDRESS:	5527 LAUREL CANYON BLVD		TELEPHONE:	(818) 769-6626
CITY:	VALLEY VILLAGE	STATE: CA	ZIP CODE:	91607
CAPACITY: 100	TOTAL ENROLLED CHILDREN: 0	CENSUS: 48	DATE:	01/24/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:55 AM
MET WITH:	David Aguiniga and Virginia Sumulong		TIME VISIT/ INSPECTION COMPLETED:	02:45 PM

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Licensing Program Analyst (LPA) Sandra Urena arrived unannounced to conduct a required annual inspection. The LPA met with the Executive Director David Aguiniga and the Executive Assistant Virginia Sumulong and explained the reason for the visit.

LPA Urena and the Executive Assistant toured the physical plant areas inside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

COMMON AREAS: The reception area and reception area furniture were observed to be in good and clean condition. The facility maintained a comfortable temperature of 74 degrees. The fire extinguishers were observed throughout the facility on the first and second floor. The fire extinguishers were fully charged and were last serviced on 10/15/2024. The LPA observed required postings throughout the common spaces. The smoke detector(s) and carbon monoxide detectors were tested by the company Fox Fire Life and Safety Inc. on 11/19/2024.

RESTROOMS: The facility has two common/visitors’ restrooms located on the first floor. The restrooms were observed to be clean and sanitary and in operating condition. The bathrooms were sufficiently stocked with soap and paper towels. The hot water temperature measured in the hallway restroom at 113.8 degrees Fahrenheit. Hallways were brightly lighted and are equipped with night lights.

LAUNDRY AREA: The washer and dryer were observed to be functional and are located on the second floor. All cleaning supplies and disinfectants are kept in locked cabinets.

BEDROOMS/ BATHROOMS: Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Each bedroom has a bathroom. Call system is functional.

Continues on LIC 809C...

Kasandra Lopez	TELEPHONE: (818) 596-4343
Sandra Urena	TELEPHONE: 747-230-3919
	DATE: 01/24/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: GLEN PARK AT VALLEY VILLAGE	FACILITY NUMBER: 197603165
	VISIT DATE: 01/24/2025

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KITCHEN/DINING ROOM: The kitchen area is located adjacent to the dining room. The facility has a sufficient supply of non-perishable and perishable food items. Appliances appeared to be in operable condition. The menu was posted. The kitchen and dining room area was observed to be clean and in good condition. The fire extinguisher in the kitchen was serviced on 10/15/2024. The refrigerator and freezer were observed to be within the required temperatures of 40 degrees and 0 to below 0 degrees. Overall dining room temperature was kept at 74 degrees. The dining room and dining room furniture were observed to be in good condition.

OUTDOOR AREA: The facility has an outdoor area next to the dining room. The outdoor area has tables with patio umbrellas for client use. No bodies of water noted.

This is part-one of the annual inspection; due to time constraints, a continuation annual inspection visit will be conducted at a later date.

Exit interview conducted. A copy of the report was provided.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Sandra Urena	TELEPHONE: 747-230-3919
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025

LIC809 (FAS) - (06/04)

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