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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608749
Report Date: 03/24/2025
Date Signed: 03/24/2025 07:18:48 PM

Document Has Been Signed on 03/24/2025 07:18 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:AMERICAN SWEET HOMESFACILITY NUMBER:
197608749
ADMINISTRATOR/
DIRECTOR:		ANAIT DOMIOFACILITY TYPE:
735
ADDRESS:6932 TOBIAS AVENUETELEPHONE:
(818) 646-0266
CITY:VAN NUYSSTATE: CAZIP CODE:
91405
CAPACITY: 4CENSUS: 4DATE:
03/24/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:36 AM
MET WITH:Anait Domio, AdministratorTIME VISIT/
INSPECTION COMPLETED:
07:25 PM
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Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection using the entire CARE Inspection Tool. LPA Yee was let into the home by Ofelya Zakaryan, Staff. Anait Domio, Administrator was contacted by staff and she arrived at 11:01am to conduct the visit. Marine Hakobyan, Licensee, arrived a little later to participate in today's visit. The reason for today's visit was explained.

The home is a single story family home consisting of a living room, dining room, kitchen, 3 bedrooms of which one is used for live-in staff, 2 full bathrooms, a laundry room and a attached garage that is used as office and storage. The facility is fire cleared for 4 AMBULATORY clients. The facility is vendorized by the North Los Angeles County Regional Center as a Level 3 home.

All 12 domains of the CARE Inspection Tool was reviewed. Staff and client files were randomly reviewed.
The following were observed:
  • the living room was furnished with the appropriate seating and furnishing suitable for 4 residents. The fireplace was covered with a wire screen.
  • the dining room was furnished with a long dining room table and 8 chairs
  • the kitchen equipped with a refrigerator, oven, microwave and a dishwasher.
  • the laundry room was observed with a washer and dryer. Also located in the laundry is a second refrigerator for vegetables and additional foods. Bell peppers, tomatoes, cabbage, bread, yogurt and milk were observed
  • Sufficient perishables for a minimum of 2 days and non-perishables foods for a minimum of 7 days were observed in the kitchen and the laundry room.
  • The only fire extinguisher purchased on 2/10/25 is located in the kitchen.
  • Bedroom #1 located at the back of the home was observed with 2 beds, 3 chairs, 2 lamps, 2 night
Kristin Heffernan
Christine Yee
DATE: 03/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2025
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: AMERICAN SWEET HOMES
FACILITY NUMBER: 197608749
VISIT DATE: 03/24/2025
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  • stands, a shared dresser and 2 closets. Located inside the room is a private bathroom equipped with a bath tub, a toilet and a 2 sink vanity. Observed was a slip resistant mat in the bath tub. The hot water was tested and read 106.4 degrees Fahrenheit. Mattress covers, fitted sheets, a blanket and a comforter were observed. Per licensee and clients, they do not want a flat sheet or a comforter.
  • Bedroom #2 located closest to the front door was observed with 2 beds, 2 night stands, 2 chairs, 2 lamps, a shared dresser. Mattress covers, fitted sheet, comforters were observed. No flat sheet or blankets were observed on the bed, per the clients' choice.
  • Extra blankets, towels and bedding were observed in the linen closet located in the hallway.
  • Bedroom #3, also located in the front adjacent to bedroom #2 is utilized for the live- in staff.
  • Night light was observed in the hall way.
  • the common bathroom, located by the front door is equipped with an enclosed shower stall, a toilet and a single sink. Paper towels were observed. The water temperature was tested and read 108.5 degrees Fahrenheit.
  • Centrally stored medications were locked in a cabinet located in the kitchen island.
  • the interconnected smoke detectors located in the residents' bedrooms, living room, dining room and the combination smoke/carbon monoxide detector located by the kitchen and front door were tested and were operational.
  • the facility has current general liability insurance with limits of $1 million per occurrence and $3 million annual aggregate.
  • the facility also has a current surety bond up to $6,000.
  • The back yard and front yard were toured. A table with chairs and an umbrella were observed under the covered patio. Trash cans located in the front were observed to be tightly sealed. Overall, the inside and outside of the facility were observed to be clean.


No citations were issued on today's visit.

Exit interview was conducted with Marine Hakobyan and Anait Domio.
SUPERVISOR'S NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2025
LIC809 (FAS) - (06/04)
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