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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609785
Report Date: 11/04/2020
Date Signed: 11/04/2020 05:31:34 PM

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:EATON CANYON VILLAS IFACILITY NUMBER:
197609785
ADMINISTRATOR:GARIBYAN, ARMONDFACILITY TYPE:
740
ADDRESS:2518 GANESHA AVETELEPHONE:
(818) 429-0070
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY:6CENSUS: 5DATE:
11/04/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Armond GaribyanTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Manya Lefian conducted an unannounced visit to the facility for the purpose of following up on a confirmation of removal notification. Due to the situation surrounding the Corona virus Disease 2019 (COVID-19) and to implement mitigation measures, todays visit was conducted telephonically with Licensee Armond Garibyan and a virtual tour was conducted with Facility Manager Veronica Ledezma.

A notification letter was generated on 10/07/2020 to notify the licensee that Staff #1(S1) should be removed from the facility immediately. During today's visit, LPA spoke with Mr. Garibyan and gathered facility documents pertaining to S1. S1 has not been employed at the facility since October 9,, 2020, and was immediately removed from the facility due to this notification. Based on evidence obtained during today's visit, the LPA has verified that this individual is not present, employed or residing at the facility. Administrator has disassociated the individual from their roster and submit an updated LIC500. Verification of removal is complete.

A telephonic exit interview was conducted with Mr. Garibyan and a hard copy was provided via email for signature.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Manya LefianTELEPHONE: (747) 230-3364
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2020
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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