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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610054
Report Date: 07/14/2021
Date Signed: 07/14/2021 01:36:29 PM

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:LEO'S ASSISTED LIVING IIFACILITY NUMBER:
197610054
ADMINISTRATOR:ARAKELIAN, ARMINEFACILITY TYPE:
740
ADDRESS:7567 BOVEY AVENUETELEPHONE:
(310) 292-2992
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:6CENSUS: 0DATE:
07/14/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:43 AM
MET WITH:Leo Sayadyan/ LicenseeTIME COMPLETED:
01:34 PM
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Licensing Program Analyst (LPA) Patrick Shanahan conducted an Annual Required visit and inspection of the facility. This was an infection control visit and mitigation plan review. LPA met with Leo Sayadyan, the licensees husband.

A tour of the physical plant was conducted. All smoke alarms were tested and function properly. The fire extinguisher was green and appeared functional. The carbon monoxide detector was tested and functions properly.
Kitchen: The kitchen appeared clean and the appliances and fixtures functional. LPA found a sufficient amount of non-perishable food at the facility; properly stored. Knives and detergents were stored in locked drawers and cabinets. The medications are stored in a locked cabinet in the office. Bedrooms: There were three bedrooms designated for residents' use. All bedrooms were clean, properly furnished and had sufficient lighting. Bathrooms: There were two bathrooms designated for residents' use. Both bathrooms were clean, properly supplied and had functional fixtures. Hot water temperature was 112.2 degrees Fahrenheit. Cleaning supplies were kept in locked cabinets. Common Areas: These included the living room and dining area. The common areas appeared clean and were properly furnished. Surrounding Grounds: Entry/exits were free of obstruction. The outdoor area was clean and free of hazards.

There were no residents at the time of the visit. No health and safety concerns observed during todays 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: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021
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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