<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610443
Report Date: 09/19/2024
Date Signed: 09/19/2024 01:06:25 PM


Document Has Been Signed on 09/19/2024 01:06 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:LAKE VIEW RCFEFACILITY NUMBER:
197610443
ADMINISTRATOR:HOVANNESYAN, NAREKFACILITY TYPE:
740
ADDRESS:35940 TIERRA SUBIDA AVETELEPHONE:
(818) 423-8821
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:6CENSUS: 0DATE:
09/19/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:TIME COMPLETED:
02:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Spaeth attempted to conduct an annual visit. However, upon arrival, LPA Spaeth observed no one was at the facility. LPA Spaeth knocked on the door but no one answered. LPA observed there were no cars on the property and there was no indication that residents were living in the facility.

LPA Spaeth received an email from the Licensee, Narek Hovannesyan stating there are no residents living in the facility. The Licensee also stated they are are out of the country but will be returning next month. The Licensee stated they will contact LPA Spaeth once he has returned.
SUPERVISOR'S NAME: Troy AgardTELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Melissa SpaethTELEPHONE: (818) 421-2278
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1