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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197603303
Report Date: 03/18/2025
Date Signed: 03/18/2025 11:35:10 PM

Document Has Been Signed on 03/18/2025 11:35 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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:VALLEY VILLAGE ADULT DAY CARE - SUNLANDFACILITY NUMBER:
197603303
ADMINISTRATOR/
DIRECTOR:		SOUSAN AYYADFACILITY TYPE:
775
ADDRESS:8727 FENWICK STREETTELEPHONE:
(818) 446-0366
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY: 80CENSUS: 34DATE:
03/18/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Gary James, Program DirectorTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Leizl de la Cerra conducted an unannounced annual inspection. LPA de la Cerra met with Program Director, Gary James at 10:30AM LPA explained the purpose of today's visit and requested staff roster and client roster.

LPA de la Cerra conducted a physical plant tour at 11:00AM. LPA was escorted through the facility by Program Director Gary James. The facility is comprised of two programs an Adult Day Program and Adult Day Health Care. The property consists of one large building, which includes the administration office area, a nurse station, and the reception area. Required postings were observed in the office area. First-aid kit located in the nurse station has all proper items and is current. All smoke alarms and carbon monoxide detectors are hardwired. Facility has a sprinkler system this also hardwired. There are a total of eight (8) fire extinguishers, observed to be fully charged and all were inspected on 06/25/2024. Emergency Fire Drill was recently conducted on 03/06/2025.

Facility has six (6) gender neutral bathrooms and six (6) activity rooms. The facility's activity rooms were designated as a sensory room, a physical therapy/exercise room, a computer & communication room, an arts and craft room, and a large activity room which also serves as a dining area. LPA observed all rooms were being used by clients. All clients were engaged in their specific group activities. LPA observed good participation among the clients at their specific activities.

The kitchen which is only accessible through a door that was locked, is fully stocked and operational. Knives and sharp objects are locked, inaccessible to clients. There is also a laundry room which is only accessible through a door that was locked adjacent to the kitchen. LPA observed the facility uses (2) main entrances/exits. The facility provides hot meals, snacks, and drinks.

Continue to LIC809-C.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leizl De La Cerra
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: VALLEY VILLAGE ADULT DAY CARE - SUNLAND
FACILITY NUMBER: 197603303
VISIT DATE: 03/18/2025
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The bathrooms/changing areas are designated for client use. The hot water temperature was measured at 112.5 degrees Fahrenheit. Bathrooms were checked for cleanliness and proper operation.
The outside area of the facility provides a patio area with appropriate outdoor furniture. Entry and exits were free from obstruction. The facility does not have a swimming pool or body of water.
Client records and Staff Files were reviewed for requirements, legibility and to ensure forms and training are up to date and in compliance with licensing forms. Proof of liability insurance coverage effective until 3/22/25 was provided to the LPA.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies observed during the visit.

Exit interview conducted and a copy of the report issued.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leizl De La Cerra
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025
LIC809 (FAS) - (06/04)
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