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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306002245
Report Date: 03/20/2024
Date Signed: 03/20/2024 12:20:54 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/20/2024 12:20 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:VERONA COURT IIFACILITY NUMBER:
306002245
ADMINISTRATOR:ARDA KARDJIANFACILITY TYPE:
740
ADDRESS:25002 SAUSALITO STREETTELEPHONE:
(949) 215-3142
CITY:LAGUNA HILLSSTATE: CAZIP CODE:
92653
CAPACITY:6CENSUS: 0DATE:
03/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Arda KardjianTIME COMPLETED:
12:50 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) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required visit inspection. LPA arrived at the facility knocked on the door and there was no answer. LPA observed through the living room window and front door that home seemed vacant. LPA called Arda Kardjian, Administrator and was informed facility was vacant. LPA explained that even though the facility was vacant the annual visit had to be conducted. Administrator met LPA at the facility shortly after.

LPA toured the facility and inspected the physical plant of the facility; no residents were observed at facility. Administrator informed LPA that on January 15, 2024, she sent an email to LPA Alejandre and notified him that resident had moved out January 11-12, 2024, to one of the other licensed facilities for the licensee. As of January 13, 2024, facility was vacant for remodeling. Licensee will contact Community Care Licensing to inform of when they are ready to accept new residents or if there are any changes with the license. LPA as a reminder provided annual fee dues information.

At this time there were no deficiencies to report in the facility. As noted above, Licensee will contact the LPA once residents are being admitted.

This report was reviewed with administrator and a copy of the report was provided.
SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth MartinezTELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2024
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