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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197607866
Report Date: 02/29/2024
Date Signed: 02/29/2024 11:06:24 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 02/29/2024 11:06 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:MCLENNAN M. MANOR IIFACILITY NUMBER:
197607866
ADMINISTRATOR:LALAINE P. MORENOFACILITY TYPE:
740
ADDRESS:8839 MCLENNAN AVENUETELEPHONE:
(818) 830-5857
CITY:NORTHRIDGESTATE: CAZIP CODE:
91343
CAPACITY:5CENSUS: 0DATE:
02/29/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Melanie BaltazarTIME COMPLETED:
11:07 AM
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Licensing Program Analyst (LPA) Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at approximately 10:00 am and observed surroundings. LPA contacted the administrator due to no one at the facility. The Administrator revealed is unable to come to the facility and revealed the facility has no clients but will have a staff member open facility. Staff member Melanie Baltazar arrived at approximately 10:30 am.

LPA Smith conducted plant tour and did not observe any clients in the facility. LPA observed remodeling efforts inside the home. LPA contacted Administrator again regarding work being done in home and to send a letter explaining to Community Care Licensing what work is being done, the time frame and information regarding status of operating as the department should be notified prior to making any to the facility.

Administrator revealed does not intend to close facility at this time and will notify the licensing office if they decide to close the facility.

Exit interview conducted copy of report given
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha SmithTELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024
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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