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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609823
Report Date: 07/25/2022
Date Signed: 07/25/2022 12:22:11 PM


Document Has Been Signed on 07/25/2022 12:22 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: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:
07/25/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:ARZUMANYAN, HARUTYUNTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA), Patrick Shanahan, arrived at the facility in response to an SOC 341 that was submitted to the Woodland Hills Regional Office South. The LPA was able to speak with staff and residents regarding the issue. All residents interviewed confirmed that they have never experienced or been witness to any forms of abuse at the home. All residents agreed that the facility treats them well and all of their needs are met. Facility staff was also interviewed and they too confirmed that they have never heard any complaints of abuse or witnessed any forms of abuse at this facility

The LPA was also able to tour the home and observed that the facility is complying with their infection control plan. No deficiencies were observed during today's visit.

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: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2022
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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