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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603179
Report Date: 04/09/2024
Date Signed: 04/09/2024 04:33:46 PM


Document Has Been Signed on 04/09/2024 04:33 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:DRYDEN GARDENSFACILITY NUMBER:
198603179
ADMINISTRATOR:MINSHULL, ARMENFACILITY TYPE:
740
ADDRESS:610 W DRYDEN STREETTELEPHONE:
(818) 919-4139
CITY:GLENDALESTATE: CAZIP CODE:
91202
CAPACITY:6CENSUS: 4DATE:
04/09/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:31 AM
MET WITH:Armen Minshull, AdministraterTIME COMPLETED:
04:32 PM
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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an annual required visit. LPA met with Administrator Armen Minshull. The reason for the visit was explained. The facility is licensed for six (6) residents over the age of 60, with a hospice waiver for six (6) residents. There are currently two residents on hospice.

There is only one entrance being utilized at the facility.

LPA inspected the interior and the exterior of the facility with Administrator including but not limited to living room, dining room, kitchen, three (3) resident bedrooms, two (2) bathrooms, laundry which is located in the back of the kitchen and backyard. LPAs observed that the facility does not have a swimming pool or other bodies of water. All indoor and outdoor passageways are free of obstruction.

Bathrooms and bedrooms were clean and in good repair. All residents bedrooms were toured. Each bedroom were furnished with required furniture. Both bathrooms were toured. Bathrooms have the required grabs bars and non-skid mats. The hot water was measured at LPA observed the fire extinguisher near the kitchen which was fully charged. Carbon monoxide detectors were observed throughout the facility. First-aid Kit is complete and located in the kitchen. There is a locked cabinet for medications in the office area located in the dinning room.

The kitchen was toured. All appliances were operating properly. There was a sufficient amount of perishable and non-perishable food. Kitchen knives and sharps are stored in a locked drawer in the kitchen. The common areas including the living room and dining room are clean and have the required furniture. The backyard has a shaded area and sitting area. The facility has cameras in the common areas only.

Based on California Code of Regulations, Title 22, there were no deficiencies observed during the visit.

Exit interview conducted and a copy of the report was issued.

SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024
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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