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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609604
Report Date: 08/05/2022
Date Signed: 08/05/2022 01:20:16 PM

Document Has Been Signed on 08/05/2022 01:20 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. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:HM SWEET HOMEFACILITY NUMBER:
197609604
ADMINISTRATOR:NADRIAN, ASMIKFACILITY TYPE:
740
ADDRESS:6215 BLUEBELL AVENUETELEPHONE:
(818) 903-6302
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY: 6CENSUS: 6DATE:
08/05/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Anahit HovhannisyanTIME COMPLETED:
01:30 PM
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) Salia Walker initiated a Case Management-Incident visit to the facility above. The purpose of this visit is to follow up on a suspected unlawful eviction of Resident #1 (R1). The LPA met with Administrator Asmik Nadrian at 10:12 a.m., and explained the reason for the visit.

On 07/28/22 at 7:37 p.m., LPA Walker received a text message from administrator Asmik Nadrian. The message stated, “I am having an issue with relocating one of my residents. Whoever brought the resident to our facility told us that [R1] was able to walk on [R1’s] own but [R1] cannot. The resident does not receive any income monthly (which they told us [R1’s] family members will pay us) and now we are in a bit of a problem to relocate this resident. Please advice as how I can proceed thank you in advance.” On 07/29/22 at 8:00 a.m., LPA Walker received an email from Administrator Asmik Nadrian with the subject section noting “I’d like to inform you that [a resident] has been transferred to another facility..thank you.” The email contained a ‘Criminal Background Clearance Transfer Request’ (LIC9182) filled out with R1’s information. This is the third time LPA Walker has received LIC9182’s from the Administrator filled out for resident’s that have been relocated to other facilities. LPA Walker has explained on several occasions to the Administrator via email, in-person, and via telephone that the LIC9182 form is utilized for Staff that are being transferred/associated to another Licensed facility for employee purposes only.

During today’s visit at 11:30 a.m., the LPA observed that R1 is currently still residing at the facility; and was not illegally Evicted. From 10:12 a.m. until 11:30 a.m., the LPA conducted interviews with the Administrator and Designee. From 11:30 a.m. until 11:40 a.m., the LPA conducted an interview with R1. Based on LPAs observation, and Interviews conducted, R1 was not illegally evicted. Therefore, no citation is warranted at this time. No deficiencies cited. Exit interview conducted, and a copy of the report was issued.
SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Salia Walker
LICENSING EVALUATOR SIGNATURE: DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2022
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