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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609135
Report Date: 11/02/2016
Date Signed: 03/09/2022 01:33:33 PM

Document Has Been Signed on 03/09/2022 01:33 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
CCLD Regional Office, 744 P STREET, MS 8-3-91
SACRAMENTO, CA 95814
FACILITY NAME:BURBANK HILLS COMFORT LIVINGFACILITY NUMBER:
197609135
ADMINISTRATOR:NARINE HANNESYANFACILITY TYPE:
740
ADDRESS:2745 N. MYERS STREETTELEPHONE:
(818) 389-3612
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY: 6CENSUS: DATE:
11/02/2016
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Narine HannesyanTIME COMPLETED:
10:55 AM
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On November 02, 2016, Component II was held. The following individual participated: Narine Hannesyan, CEO of Burbank Hills Comfort Care INC and Administrator of Burbank Hills Comfort Living.

When Narine Hannesyan was asked if she has read and understands Title 22, she responded in the affirmative.

Component II was successfully completed.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Bethany Hunter
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2016
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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