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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608579
Report Date: 07/25/2024
Date Signed: 07/25/2024 03:26:17 PM


Document Has Been Signed on 07/25/2024 03:26 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:NO PLACE LIKE HOME FOR GOLDEN AGESFACILITY NUMBER:
197608579
ADMINISTRATOR:EMMA TOPADZHIKYANFACILITY TYPE:
740
ADDRESS:1459 WESTERN AVENUETELEPHONE:
(818) 245-6799
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY:6CENSUS: 4DATE:
07/25/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Alla Abajyan, CaregiverTIME COMPLETED:
03:30 PM
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A Required One (1) year - Annual visit was conducted today by Licensing Program Analyst (LPA) Rosaura Valenzuela. LPA met with staff Alla Abajyan and explained the reason for the visit. LPA observed that four (04) residents were at the facility during visit.

A tour of the physical plant was conducted at 2:30 PM and the following was noted:

The front main door is the only entrance being utilized at the facility. The facility is a single story home with four (04) private client bedrooms and three (3) bathrooms. There is no body water in the facility.
Bedrooms were toured and observed to be clean and properly furnished. Linen storage was also checked and observed to have ample supply of clean linen and towels.
Bathrooms were observed to be clean and sanitary with necessary supplies. Hot water temperature measured at a range of 105.6°F to 117.8°F and within the required range.
Physical plant was checked for cleanliness and condition. Facility was in good repair and observed to be clean and free of clutter during today's visit.
Living, dining & family room furniture were also checked for functionality (wear and tear). Furniture was observed to be in good condition.

Kitchen area was observed to be clean and sanitary. All toxins, cleaning solutions and disinfectants are locked in the cabinet below the kitchen sink. Knives and sharps are kept in the a locked storage located near the dining area.

Food. The facility is observed to have sufficient food supply for the clients both perishable and non-perishable. .
Temperature of facility wall thermostat is set at 75.0°F and observed to be within the required range.
Fire extinguishers. The facility has a fire extinguisher in the living room next to the kitchen. Carbon monoxide and smoke alarms are hardwired and interconnected, tested and observed to be operable.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:
DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2024
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: NO PLACE LIKE HOME FOR GOLDEN AGES
FACILITY NUMBER: 197608579
VISIT DATE: 07/25/2024
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Garage is attached to the house and access has to go through the Laundry room. Garage was observed to be locked and inaccessible to residents. The garage is also used as a storage for PPE and other supplies.

Resident records were reviewed for physician report, admission agreements, etc. Resident records appeared to be complete and current.

Medication was observed to be inaccessible to residents and stored in a secured cabinet. There is a complete First Aid kit.

Staff records were reviewed. Staff present records were observed to be current and updated.

No health and safety issues were noted at the time of this visit.

Exit interview conducted and a copy of the report was issued..
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024
LIC809 (FAS) - (06/04)
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