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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610528
Report Date: 10/22/2024
Date Signed: 10/22/2024 03:07:52 PM

Document Has Been Signed on 10/22/2024 03:07 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:MAMIK PAPIK ADULT CENTERFACILITY NUMBER:
197610528
ADMINISTRATOR/
DIRECTOR:
KARAMIAN, ELINFACILITY TYPE:
775
ADDRESS:2220 W. MAGNOLIA BLVD.TELEPHONE:
(818) 817-1070
CITY:BURBANKSTATE: CAZIP CODE:
91506
CAPACITY: 50CENSUS: 0DATE:
10/22/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Elin KaramianTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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At 12:45 p.m. on 10/22/24, Licensing Program Analyst (LPA) Nicholas Reed conducted an announced prelicensing visit. LPA met with the licensee and disclosed the reason for the visit.

The facility is a single story building with an entrance area, activity areas, dining area, office spaces, three (03) bathrooms, storage areas, and a staff area. It has an approved fire clearance for fifty (50) ambulatory residents.

At approximately 1:05 p.m. LPA measured the room temperature to be 71 degrees Fahrenheit. The entrance area contained decorations and postings for personal rights, emergency contacts, and visitation policy. Auditory alarms were on and functioning at the front and rear exits. The dining area contained new furniture in good repair. Walls, floors, windows, screens, and blinds were clean and in good repair. Activity spaces near the dining area were sanitary and were sufficient in space. A locked office area contained a complete first aid kit and a storage area for confidential files. An employee lounge was inaccessible and contained additional storage areas. At 1:15 p.m. dual function smoke and carbon monoxide detector was tested and functional. At 1:20 p.m. LPA observed two (02) fire extinguishers. The fire extinguishers were fully charged and purchased on 05/21/24. Bathrooms were sanitary with paper towels, liquid soap, and trash cans. At 1:30 p.m. the water temperature in the women’s bathroom was measured to be 105.4 degrees Fahrenheit. All emergency exit paths were free from obstructions. Exit doors were unlocked.

At 2:00 p.m. LPA and licensees reviewed the Compliance and Regulatory Enforcement (CARE) Tools and reviewed staff files. All files were complete and available for inspection.

During today's inspection, the facility was in compliance with Title 22 regulations.

Pre-Licensing is complete and this facility has no deficiencies

Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
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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