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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609823
Report Date: 09/28/2021
Date Signed: 09/28/2021 11:56:23 AM

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:ALALIK CARE HOMEFACILITY NUMBER:
197609823
ADMINISTRATOR:ARZUMANYAN, HARUTYUNFACILITY TYPE:
740
ADDRESS:11152 WOODLEY AVETELEPHONE:
(818) 818-1808
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 6DATE:
09/28/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:TIME COMPLETED:
12:16 PM
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Licensing Program Analyst (LPA) Patrick Shanahan, met with administrator Harutyun Arzumanyan for Required One (1) Year visit for this facility. This was an infection control visit.

A tour of the physical plant was conducted with Mr. Arzumanyan. The facility has six (6) bedrooms and four (4) bathrooms. There is also an office room located near the kitchen.

Upon entry, Facility staff took the LPA's temperature and had the LPA wash hands and sign in.

Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings, and doors were checked.

Living and dining room furniture were also checked. The living room is neat and clean along with the dining room. The facility maintains a comfortable temperature at 75°F. The smoke detectors are hardwired and interconnected and observed to be operational. There is a carbon monoxide detector installed. All doors are equipped with auditory alarm.

The backyard of the facility has outdoor furniture, with a covered shaded area for clients. There is no body of water at the facility.

Exit interview conducted and report issued.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Patrick ShanahanTELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021
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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