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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608967
Report Date: 02/25/2025
Date Signed: 02/25/2025 11:00:23 PM

Document Has Been Signed on 02/25/2025 11:00 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:SHANKS BOARD & CAREFACILITY NUMBER:
197608967
ADMINISTRATOR/
DIRECTOR:		AUSTIN SHANKS SR.FACILITY TYPE:
735
ADDRESS:13055 WEIDNER STREETTELEPHONE:
(818) 896-9304
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY: 6CENSUS: DATE:
02/25/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Leizl de la Cerra arrived to the facility at 10:15AM. for an annual inspection. LPA rang the door bell and there was no answer. LPA knocked on the metal door multiple times but no one answered. LPA made several attempts to reach the licensee by phone (818)896-9304 and there was no answer, an answering service was not available either to leave a voicemail message. LPA left business card by the door on a black table.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leizl De La Cerra
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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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