<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609312
Report Date: 07/27/2022
Date Signed: 07/27/2022 09:39:17 AM


Document Has Been Signed on 07/27/2022 09:39 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA



FACILITY NAME:A PARADISE IN THE VALLEYFACILITY NUMBER:
197609312
ADMINISTRATOR:DER-APRAHAMIAN, ARSENFACILITY TYPE:
740
ADDRESS:7754 TEXHOMA AVETELEPHONE:
(323) 821-1419
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:6CENSUS: DATE:
07/27/2022
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Narine PetikyanTIME COMPLETED:
09:40 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Elsie Campos conducted an unannounced Collateral inspection at the facility today at 8:45 a.m. The LPA met with Staff and spoke to Administrator Arsen Der-Aprahamian over the phone and explained the reason for this visit.

Today's inspection is in regard to the investigation of complaint control #29-NP-20220222171126, which is unrelated to this facility. The LPA conducted an interview with the resident relevant to the complaint investigation.

No health and safety concerns were observed during this visit. Exit interview conducted. A copy of the report was provided.
SUPERVISOR'S NAME: Jeralyn Ann PfannenstielTELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Elsie CamposTELEPHONE: (747) 230-3909
LICENSING EVALUATOR SIGNATURE:
DATE: 07/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/27/2022
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 1