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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610220
Report Date: 10/07/2021
Date Signed: 10/07/2021 01:29:47 PM

Document Has Been Signed on 10/07/2021 01:29 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:BE HAPPY, BE HOMEFACILITY NUMBER:
197610220
ADMINISTRATOR:STEPANYAN, LILITFACILITY TYPE:
740
ADDRESS:11035 MONOGRAM AVETELEPHONE:
(818) 400-1101
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 6CENSUS: 3DATE:
10/07/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Lilit StepanyanTIME COMPLETED:
01:35 PM
NARRATIVE
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Licensing Program Analysts (LPA's) Yelena Avetisyan and Nicholas Reed conducted an unannounced case management visit to this facility. On 08/26/2021 an allegation of unlicensed care was substantiated at this locations at which time A NOTICE OF OPERATION IN VIOLATION OF LAW (NOVL) was issued to the operator Lilit Stepanyan. (Complaint Control # 31-NP-20210817121840)

Upon arrival LPA's met with staff Belinda Sabando . Staff contacted operator Lilit Stepanyan via telephone. Operator arrived shortly after. LPA's conducted a tour of the facility and confirmed that the home continues to provide care and supervision to the 2 residents who were identified as requiring and receiving care at this facility. While conducting the tour LPA's observed the home to be clean and have sufficient food supply. At approximately 12:20 pm to 1:20 pm LPA's conducted interview with the operator regarding 3 individuals who were identified previously residents of this home.

An application for RCFE license for this location; "Be Home, Be Home" was submitted by the operator and is currently pending. LPA's reminded the operator Lilit Stepanyan that no new residents shall be admitted at this time (pending licensure status). LPA's also reminded the operator Lilit Stepanyan that a Notice of Operation in Violation of Law was served to her at the time of complaint investigation and that continued operation pending process of application is a violation of law, subject to civil penalties under Health and Safety Code Section 1547, 1568.0821, 1569.485, or 1596.893 b, and applicable regulations, as well as other actions by the Department.

Exit interview conducted and copy of report emailed to the operator.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Yelena Avetisyan
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2021
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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