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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600370
Report Date: 04/08/2024
Date Signed: 04/29/2024 07:46:34 PM

Document Has Been Signed on 04/29/2024 07:46 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 N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:ADLA INC. #2FACILITY NUMBER:
198600370
ADMINISTRATOR/
DIRECTOR:		AIDINOVA, SALBIFACILITY TYPE:
735
ADDRESS:6731 LENNOX AVENUETELEPHONE:
(818) 997-6216
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY: 4CENSUS: DATE:
04/08/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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At 9:10 am Licensing Program Analyst (LPA) Valeria Conway attempted to conduct a requiered visit to the facility. LPA knocked on the door and there was no answer. LPA was unable to gain access to the property. LPA called the Licensee at 9:25 am to phone # 818-997-6216, also, LPA tried calling 818-521-6532 at 9:43 am but no one answered.

LPA will attempt to make a second visit on another day.



Exit interview, report emailed to licensee for signature.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Valeria Conway
LICENSING EVALUATOR SIGNATURE: DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/08/2024
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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