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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608884
Report Date: 12/16/2021
Date Signed: 01/13/2022 03:34:59 PM

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:EVENING GRACE ASSISTED LIVINGFACILITY NUMBER:
197608884
ADMINISTRATOR:PAUL KENEZFACILITY TYPE:
740
ADDRESS:17355 BURBANK BLVD.TELEPHONE:
(818) 990-0593
CITY:ENCINOSTATE: CAZIP CODE:
91316
CAPACITY:6CENSUS: 0DATE:
12/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Not applicableTIME COMPLETED:
02:20 PM
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On 12/16/2021 at 2:00pm, LPA attempted to conduct an unannounced annual visit. The facility door had an electronic pad lock, no curtains and appeared to be completely empty. LPA contacted the Administrator Paul Kenez and he stated that the he no longer owns the facility and that he sold the property. When asked about the residents, he stated that they were all transferred to other facilities that are currently owned by himself and his mother.

Unable to get Administrator's signature, because he was not at the facility. A copy of this report emailed.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye DugumaTELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021
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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