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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609966
Report Date: 10/17/2023
Date Signed: 10/17/2023 03:34:06 PM

Document Has Been Signed on 10/17/2023 03:34 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:PARADISO HOMES INCFACILITY NUMBER:
197609966
ADMINISTRATOR:DAVTYAN, NAREKFACILITY TYPE:
735
ADDRESS:16751 CITRONIA STREETTELEPHONE:
(213) 550-7066
CITY:NORTHRIDGESTATE: CAZIP CODE:
91343
CAPACITY: 4CENSUS: 4DATE:
10/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Narek Davtyan AdministratorTIME COMPLETED:
03:40 PM
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Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at approximately 12:55 pm. LPA disclosed to staff the purpose of the visit and the administrator was contacted.

LPA conducted a tour of the physical plant at approximately 11:30 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Common areas were observed for the ability to safely serve the needs residents. These included the living/dining room combination, and kitchen. The common areas were checked for cleanliness and furniture was checked for functionality and observed to be in good condition. Common areas observed to be clean, sanitary and have adequate seating for residents.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The
kitchen food supply was observed and sufficient for the four (4) residents currently residing there. Two (2) days of
perishable food observed. There are two (2) refrigerators :(1) in the kitchen and (1) in Office/staff room. Both stocked with meats, eggs, milk, vegetables and frozen foods. Resident medications are stored in lower kitchen cabinets. Sharps store in kitchen drawer. The toxins are stored under kitchen sink. The medications, sharps, and toxins observed to be locked and inaccessible to residents in care. Two (2) new first aid kits stored in large cabinet in living room. Toxins are stored and locked under kitchen sink and observed to be locked an inaccessible to residents. There is one (1) fire extinguisher in facility attached to kitchen wall. Fire extinguisher observed to be charged.

Laundry room is located in office/staff room. The appliances observed to be clean and in good repair. The locked cabinets in laundry room contain laundry detergents and supplies.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: PARADISO HOMES INC
FACILITY NUMBER: 197609966
VISIT DATE: 10/17/2023
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(Cont. from 809)
The facility has a total of four (4) bedrooms and two (2) bathrooms for residents in care. Office/staff room located in converted garage.

The resident bedrooms were properly furnished with at least one chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, and blankets. Additional linen stored in hall on open cabinet shelves.

Each bathroom has posted “wash your hands” signs and the following items available: hand soap, paper
towels, and trash cans. The hot water temperature was measured for the three (3) bathrooms to ensure it is
within the required range for residents’ comfort and safety. The water temperature range was between 121.1- and 121.6 -degrees Fahrenheit.

Backyard has the following: Covered patio with small patio table two chairs, couch, and large swing chair. Patio furniture observed to be in good repair with adequate seating for residents.

Smoke detector/carbon monoxide detector were tested and operable at time of visit.

Facility grounds were free of hazards.

At approximately 1:45 pm, LPA reviewed three (3) staff files. Staff files had the appropriate trainings to include CPI, First aid and CPR. Resident files included current Individual program plans (IPP), and assessments.

Exit Interview Conducted /Copy of the Report Issued.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC809 (FAS) - (06/04)
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