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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609862
Report Date: 01/09/2024
Date Signed: 01/09/2024 02:24:38 PM


Document Has Been Signed on 01/09/2024 02:24 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:EMERALD ESTATE SENIOR CARE, INCFACILITY NUMBER:
197609862
ADMINISTRATOR:HOVHANNES PAPAZYANFACILITY TYPE:
740
ADDRESS:10401 ENCINO AVETELEPHONE:
(747) 300-2232
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 6DATE:
01/09/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Hayk MargaryanTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Michael Cava attempted to conduct an Required Annual at this address, but was informed by administrator, Hayk Margaryan, that this facility has since been closed on 10/26/22. Current facility license number is 197610318. FAS review reveal that this number the current license, and an Required Annual was made for this facility license number on 11/02/23. During that inspection, facility was compliant, pursuant to title 22, division 6 of the California Code of Regulation. Currently, the new facility license number has a census of six. LPA conducted an inspection of the physical plaint, and facility remains compliant.

Facility license number 197609862 will be closed effective 10/26/22.
SUPERVISOR'S NAME: Eva MillerTELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael CavaTELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:
DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2024
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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