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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610162
Report Date: 12/21/2023
Date Signed: 12/21/2023 04:52:01 PM


Document Has Been Signed on 12/21/2023 04:52 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: 0DATE:
12/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:David HakobyanTIME COMPLETED:
04:50 PM
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At 4:30 p.m. on 12/21/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced case management visit. LPA called the licensee at 4:35 pm and disclosed the reason for the visit. Licensee informed LPA that no residents and staff were present or residing at the facility, and all residents and staff vacated the premises on or by 12/15/2023.

Today’s case management visit is conducted to confirm the closure of the facility.

At 10:45 a.m. on 12/07/2023 LPA Reed conducted a case management visit to issue a Notice of Operation in Violation of the Law (NOVL) letter due to license forfeiture. The facility was provided fifteen (15) days to cease operations and remove all residents.

During today’s visit, LPA toured the exterior of the facility and observed no residents were admitted or receiving care and supervision. The licensee was unable to sign this report in person.

Exit interview conducted. Copy of report provided.

SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:
DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/21/2023
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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