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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850323
Report Date: 02/13/2023
Date Signed: 02/13/2023 03:43:22 PM

Document Has Been Signed on 02/13/2023 03:43 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:COMFORT ZONE CALFACILITY NUMBER:
195850323
ADMINISTRATOR:TAVITIAN, HRIPSIME RIPAFACILITY TYPE:
740
ADDRESS:13303 REEDLEY STREETTELEPHONE:
(310) 430-0075
CITY:PANORAMA CITYSTATE: CAZIP CODE:
91402
CAPACITY: 6CENSUS: 2DATE:
02/13/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Akhtar Roshanaeian and Hripsime TavitianTIME COMPLETED:
04:00 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 Analysts (LPAs) Emily Peraldi and Ashley Smith conducted a pre-licensing visit to the above noted facility. The initial pre-licensing visit took place on 01/30/2023 and corrections were required. The LPAs met with Akhtar Roshanaeian and Hripsime 'Ripa' Tavitian and explained the reason for the visit.

On 01/30/2023, LPA Emily Peraldi indicated the following corrections were required:
• Hot water needed to measure between 105-120 degrees F.
• Complete first aid kit
• 30 day supply of Personal Protection Equipment (PPE)
• Covered trash cans
• Emergency food and water
• Postings as required by the Department
• Repair required throughout the facility

Upon entry into the facility, the LPAs observed the Department Complaint Poster and Long Term Care Ombudsman (LTCO) poster at the front of the entrance. During today’s visit, the LPAs observed that the facility was in good repair. The licensee had fixed the door leading into Room #2, and fixed the door leading into the bathroom of Room #3. The auditory device for Room #1 is fixed, The ramp in the backyard was also repaired. At 10:35 a.m., water temperature measured at 116.6 degrees F. The LPAs observed that each trash can had an appropriate lid. There was an emergency supply of food and water. The applicants obtained a larger supply of Personal Protection Equipment (PPE). First aid kit was complete. Component 3 was completed during today’s visit.

The physical plant has met regulatory requirements. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. Exit interview conducted. A copy of the report was provided.
SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Ashley Smith
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2023
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