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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610139
Report Date: 12/06/2023
Date Signed: 12/06/2023 10:18:00 AM


Document Has Been Signed on 12/06/2023 10:18 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:ELEOS HOMES INCFACILITY NUMBER:
197610139
ADMINISTRATOR:BAGRAMYAN,MARGARITAFACILITY TYPE:
740
ADDRESS:17144 COURBET STTELEPHONE:
(818) 488-1525
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 0DATE:
12/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Arthur BagramianTIME COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with staff, Arthur Bagramian and explained the reason for the visit. LPA spoke with the licensee representative, Vanessa Richiazzi over the telephone to advise her of the overdue annual.

With the assistance of staff, LPA took a tour of the physical plant. Currently the facility is vacant and not operating, but the licensee wishes to continue to retain their license. The home is a one story building. Annual fees are current. The smoke alarms and carbon monoxide detectors are hardwired and interconnected. The fire extinguisher is located in the kitchen. It is fully charged.

Kitchen: The kitchen appliances and fixtures were maintained and kept clean. Because there are no residents, perishable food not required at this time, but the facility has a sufficient amount of non-perishable food stored in the garage. Knives will be kept in the locked medication closet, located at the hallway entrance.

Bedrooms: There are four (4) resident bedrooms, two (2) private and two (2) shared room. One (1) additional bedroom is designated for staff use. Resident bedrooms were observed to be appropriately furnished with appropriate beddings and linens with sufficient lighting.

Bathrooms: There are three (3) bathrooms in the facility. One (1) bathroom is designated for staff use only and the common bathroom has non-skid mat and appropriate grab bars installed. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 114 degrees Fahrenheit.

Common Areas: These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit.
SUPERVISOR'S NAME: Eva MillerTELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael CavaTELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2023
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: ELEOS HOMES INC
FACILITY NUMBER: 197610139
VISIT DATE: 12/06/2023
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Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor
use. The outdoor area was free of hazards. The laundry area and detergents are located by the kitchen.

Staff Workstation/Room: There is a staff room and a separate bathroom located by the front entrance. Cleaning supplies will be kept locked and inaccessible in the staff room. There is also a staff workstation located near the living and dining room area.

Resident Files: No files reviewed as facility is currently not operating.

Staff Files: No files reviewed as facility is currently not operating.

Medications: Medications will be maintained centrally stored and locked in the medication closet located by the front entrance.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.
SUPERVISOR'S NAME: Eva MillerTELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael CavaTELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2023
LIC809 (FAS) - (06/04)
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