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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610109
Report Date: 03/05/2024
Date Signed: 03/05/2024 11:32:47 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/05/2024 11:32 AM - 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:INFINITY CARE WITH LOVE, INC.FACILITY NUMBER:
197610109
ADMINISTRATOR:NASHIKYAN, SUSANNAFACILITY TYPE:
740
ADDRESS:16709 SUNBURST ST.TELEPHONE:
(818) 738-5045
CITY:NORTHRIDGESTATE: CAZIP CODE:
91343
CAPACITY:6CENSUS: 0DATE:
03/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:34 AM
MET WITH:Ani ManvelyanTIME COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA) Tihesha Smith conducted an unannounced Annual visit to this facility. LPA Smith was greeted by Licensee daughter Ani Manvelyan and she revealed facility is still not operating and Licensee/Administrator is not present in the facility.

Ani contacted the Licensee Susanna Nashikyan administrator at approximately 11:05 am. The Licensee revealed no clients are residing in home only her family. The Licensee also revealed she would like to keep her license and will be paying any renewal fees. The licensee revealed will contact LPA or Licensing department if decision to remain open changes.

LPA conducted a tour at 11:20 am of the physical plant to ensure there are no health and safety hazards and no clients are currently residing in the home. The only individuals in home are Licensee's family.

Exit interview conducted/Copy of report given.

SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha SmithTELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
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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