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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850571
Report Date: 02/04/2025
Date Signed: 02/04/2025 06:17:23 PM

Document Has Been Signed on 02/04/2025 06:17 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:SWEET APPLE ASSISTED LIVINGFACILITY NUMBER:
195850571
ADMINISTRATOR/
DIRECTOR:		AVETISYAN, ARMINEFACILITY TYPE:
740
ADDRESS:6858 AMESTOY AVENUETELEPHONE:
(702) 601-2178
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY: 6CENSUS: 0DATE:
02/04/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:18 PM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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LPA Urena received via email pictures of the corrections for the deficiencies cited on the pre-licensing visit conducted on 01/22/2025.

Pre-Licensing is complete and deficiencies were resolved.

· Chest of drawers was purchased for each bedroom (1,2,3,4).

· The back-door's ramp with handrails to provide access to the residents to get to the backyard/outdoor area was adapted to allow for easy exit to residents.

· The hallway door was adapted with a magnet to keep door open and be activated during a fire.




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. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license.


Exit interview conducted and a copy of the report was issued.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE: DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2025
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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