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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609606
Report Date: 03/12/2025
Date Signed: 03/12/2025 02:53:28 PM

Document Has Been Signed on 03/12/2025 02:53 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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:AURORA HOME FOR SENIORSFACILITY NUMBER:
197609606
ADMINISTRATOR/
DIRECTOR:
MKRTCHYAN, ANI HASMIKFACILITY TYPE:
740
ADDRESS:16346 SHAMHART DRIVETELEPHONE:
(818) 257-1457
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 6CENSUS: 3DATE:
03/12/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:37 AM
MET WITH:Salkin ToktogozjoevaTIME VISIT/
INSPECTION COMPLETED:
03:00 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 Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with staff, Salkin Toktogozjoeva, and advised her of the visit. The administrator, Ani Mkrtchyan, was notified over the telephone.

With the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms and carbon monoxide detectors are dual and interconnected. The fire extinguisher is located by the kitchen. It was purchased on 04/11/24.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen.

Bedrooms: There were four (4) bedrooms designated for residents' use. Two (2) bedrooms are private and two (2) bedrooms are shared. LPA observed all four rooms properly furnished with appropriate beddings and linens with sufficient lighting. LPA observed extra supplies of linens and towels stored in the hallway.

Bathrooms: There are two (2) bathrooms of which one (1) is designated for residents' use. The other bathroom is designated for staff. The bathroom designated for residents were properly supplied and had functional fixtures. Hot water temperature was measured at 111 degrees Fahrenheit. LPA did not observe any cleaning supplies accessible to the residents during the day's inspection.

Common Areas: These included the living room and dining area. The living room has a large couch, chair, coffee table, entertainment center and television. The fireplace in non-functional. It has a chained screen. The dining room table is large enough to seat up to six residents. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. The floors were clean and furniture were in good repair. Entrance/exits were clear of obstruction.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: AURORA HOME FOR SENIORS
FACILITY NUMBER: 197609606
VISIT DATE: 03/12/2025
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
26
27
28
29
30
31
32
Surrounding Grounds: Passageways at the front, back and side of the home were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. There is a swimming pool, which was fenced all around. The fence is approximately five foot high with a locked gate making it inaccessible for residents to enter.

Staff Work Station/Break Room: Staff Work Station/Break Room is located near the front entrance.

Garage: The garage is attached to the home and was observed to be locked during visit. The garage is used as a laundry area and storage for emergency water and supplies.

Laundry: Laundry area is located in the garage.

Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms.

Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms.

Medications: The medication closet is located near the front entrance. Medication and Medication Records were reviewed for proper storage and documentation.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a copy of the Report Issued.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
LIC809 (FAS) - (06/04)
Page: 2 of 2