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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610162
Report Date: 12/08/2023
Date Signed: 12/08/2023 05:04:18 PM


Document Has Been Signed on 12/08/2023 05:04 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
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364



FACILITY NAME:LOVE & CARE SENIOR LIVING, INC.FACILITY NUMBER:
197610162
ADMINISTRATOR:PASCO, DINAH RFACILITY TYPE:
740
ADDRESS:17710 MARTHA STREETTELEPHONE:
(818) 585-0063
CITY:ENCINOSTATE: CAZIP CODE:
91316
CAPACITY:6CENSUS: 5DATE:
12/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Nat and Ramon BarronTIME COMPLETED:
05:10 PM
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At approximately 4:00 p.m. on 12/08/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced case management inspection. LPA met with Staff #1 (S1) and Staff #2 (S2) and disclosed the reason for the visit.

Today’s case management visit was conducted to ensure the health and safety of residents in care.

LPA toured the facility inside and out at 4:10 p.m., reviewed records at 4:15 p.m., and interviewed staff at 4:30 p.m. No immediate health and safety risks were observed.

LPA called Davit Hakobyan at 4:45 p.m. today to explain the civil penalties. LPA was unable to leave a message.

LPA reiterated that due to the continued operations of the facility without a current and valid license, pursuant to Health and Safety Code Sections 1569.10, 1569.44, 1569.19, 1569.485, and/or 1569.49, the licensee is subject to civil penalties in the amount of $100 per resident per day of continued operation.

Exit interview conducted. Appeal rights discussed. Copy of report provided.

SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2023
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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