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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610145
Report Date: 04/05/2022
Date Signed: 04/05/2022 01:13:40 PM


Document Has Been Signed on 04/05/2022 01:13 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:AARON'S CARE VILLAFACILITY NUMBER:
197610145
ADMINISTRATOR:SALUNGA, ALBERTFACILITY TYPE:
740
ADDRESS:11328 WOODLEY AVETELEPHONE:
(747) 237-0417
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 6DATE:
04/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Albert Salunga/ AdministratorTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA), Patrick Shanahan, arrived at the home and was greeted by the facility staff and the administrator. LPA was asked the COVID 19 questions and had his temperature taken before signing into the facility.

A brief tour of the physical plant was conducted and no health and safety concerns were observed. The smoke alarms and carbon monoxide detectors were tested and functioned properly.

No deficiencies were noted and the facility is following their mitigation plan.

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: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2022
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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