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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610427
Report Date: 08/22/2023
Date Signed: 08/22/2023 02:20:57 PM


Document Has Been Signed on 08/22/2023 02:20 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.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364



FACILITY NAME:NEW HOPE SENIOR CAREFACILITY NUMBER:
197610427
ADMINISTRATOR:TADEVOSYAN, LUSINEFACILITY TYPE:
740
ADDRESS:8403 HILLVIEW AVETELEPHONE:
(818) 436-2250
CITY:CANOGA PARKSTATE: CAZIP CODE:
91304
CAPACITY:6CENSUS: 5DATE:
08/22/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Lusine Tadevosyan, AdministratorTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an announced Pre-Licensing visit to this facility and met with applicant Lusine Tadevosyan, Administrator. Currently there are five residents in care. Visit was conducted on 8/22/25. Component three was also conducted on 8/22/23.
The visit consisted of a tour of the physical plant. LPA inspected the facility for fire safety, personal accommodations and services, medication procedures, and food service. Facility has four bedrooms. Three bedrooms are shared. There are two bathrooms. Fire clearance is approved for five non-ambulatory residents and one bedridden. LPA observed bedrooms and bathrooms to be clean. Bedrooms had appropriate linens on the beds, appropriate window coverings with screens, and appropriate furniture. Hot water was observed by LPA and administrator at 115 degrees F. The facility smoke alarm system and carbon monoxide is operable. Medications will be locked in a closet. Chemicals and cleaning solutions will be locked and stored under the kitchen sink. All knives and sharp objects will be locked in a kitchen drawer. There are no bodies of water on the premises.
LPA toured all common areas. LPA observed home to be clean and furniture to be in good condition. LPA did not observe any obstructions throughout the facility.
A telephonic exit interview was conducted, and a hard copy of the report was provided via email for signature. LPA will notify Centralized Application Unit regarding the completion of the pre-licensing visit and the completion of component III,
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2023
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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