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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609312
Report Date: 09/12/2023
Date Signed: 09/12/2023 03:38:07 PM


Document Has Been Signed on 09/12/2023 03:38 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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364



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: 4DATE:
09/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:53 AM
MET WITH:Arsen Der-AprahamianTIME COMPLETED:
03:37 PM
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Licensing Program Analysts (LPAs), Tihesha Smith and Gina Saucedo conducted an unannounced Required 1-year inspection at this facility at approximately 10:55 am. LPAs were greeted by the administrator and disclosed the purpose of the visit.

LPAs conducted a tour of the physical plant at approximately 11:10 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Common areas were observed for the ability to safely serve the needs residents. These included the kitchen, dining room area and living room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished appropriately.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The
kitchen food supply was observed and sufficient for the four (4) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Sharps are stored in lower locked kitchen drawer near the stove. The resident medications are locked in hall cabinets near kitchen. The medications were observed to be inaccessible to residents. There are two (2) fire extinguishes located in the kitchen. Fire extinguishers observed to be charged.

Laundry room is near detached garage. The appliances observed to be functional.

Due to time constraints this required annual will be completed at a later time.

Exit interview conducted/Copy of report given
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha SmithTELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:
DATE: 09/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/12/2023
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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