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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609895
Report Date: 09/20/2021
Date Signed: 09/20/2021 03:18:31 PM

Document Has Been Signed on 09/20/2021 03:18 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:SUN VALLEY CARE COTTAGE LLCFACILITY NUMBER:
197609895
ADMINISTRATOR:BAGHDASSARIAN, FLORIDAFACILITY TYPE:
740
ADDRESS:8553 GLENCREST DRIVETELEPHONE:
(818) 785-2344
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY: 6CENSUS: 0DATE:
09/20/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Florida Baghdassarian TIME COMPLETED:
03:25 PM
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At 1:45 p.m., Licensing Program Analyst (LPA) Yelena Avetisyan arrived at the facility unannounced to conduct a Required Annual visit. Upon arrival LPA rang the doorbell and knocked on the door. At 1:47 pm LPA called the administrator Florida Baghdassarian. Administrator informed LPA that she did not have any residents in care at this time. LPA requested for the administrator to come to the facility in order to complete the Required Annual visit. Administrator arrived 2:20 pm.

Infection control: LPA reviewed the facility mitigation plan (approved on 06/03/2021) to make sure licensee was following current infection control recommendations. Upon arrival, LPA observed that the home was not operating as a licensed residential care facility.

Licensee/administrator did not follow any of the required screenings, does not have any COVID related postings. The licensee has not gone for N95 Fit testing and has not taken training to be designated as infection control lead.

LPA did not observe a ramp at the front entrance, patio door was blocked by outdoor furnishings, A discussion was held with the licensee/administrator about the requirements to be in compliance with all licensing requirements and infection control practices as long as they are retaining their license. Florida Baghdassarian stated she understood and will make sure to bring the facility into compliance.


Exit interview conducted and copy of report emailed to FBAGHDASSARIAN@AOL.COM
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Yelena Avetisyan
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2021
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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