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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609826
Report Date: 07/07/2022
Date Signed: 07/07/2022 01:02:03 PM


Document Has Been Signed on 07/07/2022 01:02 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:GARDEN OF PALMSFACILITY NUMBER:
197609826
ADMINISTRATOR:PEARL DINKELSFACILITY TYPE:
740
ADDRESS:1025 N FAIRFAX AVETELEPHONE:
(323) 656-7900
CITY:LOS ANGELESSTATE: CAZIP CODE:
90046
CAPACITY:130CENSUS: 53DATE:
07/07/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:52 AM
MET WITH:Menachem GinsburgTIME COMPLETED:
01:06 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) LaQueena Lacy arrived at the facility on 07/07/2022 at 11:05am to conduct an unannounced Case Management Incident visit in conjunction with a complaint (CONTROL NUMBER:31-AS-20220627141822) visit conducted on 07/07/2022. During today's visit that is not related to the complaint, upon arrival LPA met with Administrator Menachem Ginsburg and explained the purpose of the visit.

LPA conducted a physical plant tour at 11:12am. LPA interviewed with the administrator and staff #1 (S1) on 07/05/2022 at 9:10am and requested and obtained documents relevant to the investigation.

Based on documents obtained and interviews conducted, LPA has determined that further investigation is required at this time.

Exit interview conducted. Copy of this report issued




.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: LaQueena LacyTELEPHONE: (818) 661-0002
LICENSING EVALUATOR SIGNATURE:
DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/07/2022
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