<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197605175
Report Date: 10/07/2022
Date Signed: 10/07/2022 11:44:41 AM

Document Has Been Signed on 10/07/2022 11:44 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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:GOCHIN CARE FACILITYFACILITY NUMBER:
197605175
ADMINISTRATOR:RHODA GOCHINFACILITY TYPE:
735
ADDRESS:8112 LOMA VERDE AVENUETELEPHONE:
(818) 349-1767
CITY:CANOGA PARKSTATE: CAZIP CODE:
91304
CAPACITY: 4CENSUS: 4DATE:
10/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Rhoda Gochin, LicenseeTIME COMPLETED:
12:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Shira Stamps met with Rhoda Gochin (Licensee) at approximately 10:27 am for a case management visit.

Entrance interview conducted.

The purpose of the case management is to check the census of the facility and to issue any deficiencies observed during the course of today’s visit. LPA conducted a physical plant tour at 11:30 am and collected relevant documents. LPA previously contacted the Licensee regarding late annual fees. The Licensee informed the LPA that she had paid all fees and provided a picture of the check for verification. After further review of the facility payment history it was found that on 3/26/19, the Licensee put in a request to change the capacity from six (6) to four (4) clients, but did not pay the $25 processing fee. As a result, the facility was charged late fees due to the unpaid $25 processing fee. A year later on 4/20/20, the Licensee provided a letter stating she changed her mind and did not want to do a capacity change. It was found that no application or $25 processing fee was provided to the Department; therefore, the capacity change back to six (6) was never completed and the facility capacity remained at four (4) clients. During today’s visit, all clients were attending their day programs, but LPA observed belongings in the client rooms for four (4) clients only. LPA explained the late fees and capacity change fee to the Licensee. The Licensee did not agree with the late fee and spoke to a Supervisor over the phone. The Licensee was advised to send a letter to the Regional Manager to address further concerns regarding the late fees.

Exit interview conducted. Copy of report delivered to the Licensee.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Shira Stamps
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2022
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 1