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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609084
Report Date: 02/05/2021
Date Signed: 02/05/2021 12:51:47 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:PARKVIEW OF GLENDALEFACILITY NUMBER:
197609084
ADMINISTRATOR:APRIL J TAYLORFACILITY TYPE:
740
ADDRESS:426 PIEDMONT AVETELEPHONE:
(925) 377-5197
CITY:GLENDALESTATE: CAZIP CODE:
91206
CAPACITY:135CENSUS: 0DATE:
02/05/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Pablo AguilarTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Kruz Long initiated a Case Management visit. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today's visit was conducted virtually with Pablo Aguilar (Maintenance Director).

During today's visit, LPA toured the facility virtually via Facetime with Pablo Aguilar. LPA observed that there are no Residents residing in the facility. Facility is closed for renovations.

A telephonic exit interview was conducted with Pablo Aguilar and a hard copy was provided via email.
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Kruz LongTELEPHONE: (323) 383-8117
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2021
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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