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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609787
Report Date: 02/25/2024
Date Signed: 02/25/2024 01:21:21 PM

Document Has Been Signed on 02/25/2024 01:21 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:SANTA CLARITA VALLEY SENIOR CENTERFACILITY NUMBER:
197609787
ADMINISTRATOR:MACDONALD, KEVINFACILITY TYPE:
775
ADDRESS:27180 GOLDEN VALLEY ROADTELEPHONE:
(661) 259-9444
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY: 35CENSUS: DATE:
02/25/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:TIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Abeye Duguma attempted to complete a required one (01) year inspection. As LPA was walking towards the facility's front entrance, LPA was met by two (02) cleaning/maintenance personnel in the parking lot and informed that the facility is closed and there are no staff in the building. LPA attempted to open the front entrance but it was locked. There were no signs of activity in the building. LPA attempted to contact the facility at (661) 259-9444 but to no avail.

No further action at this time.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2024
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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