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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610220
Report Date: 01/24/2025
Date Signed: 01/24/2025 02:08:43 PM

Document Has Been Signed on 01/24/2025 02:08 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/
DIRECTOR:		STEPANYAN, LILITFACILITY TYPE:
740
ADDRESS:11035 MONOGRAM AVETELEPHONE:
(818) 400-1101
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 6CENSUS: 6DATE:
01/24/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:32 AM
MET WITH:Lilit StepanyanTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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In conjunction with a complaint investigation (control #31-AS-20250117152824), Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Lilit Stepanyan, and explained the reason for the visit.

At approximately 9:45am, with the assistance of the administrator, LPA took a tour of the physical plant. The facility is a one story building with a fire clearance approved for five (5) non-ambulatory, and one (1) bedridden, for a total capacity of six (6). Facility also has a hospice waiver approved for six (6). Required postings were observed in the entry area. The smoke alarms and carbon monoxide detectors are dual and connected. The fire extinguisher is located in the kitchen. It was serviced December 16, 2024

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. The facility also maintains a supply of non-perishable items in an outside storage area. Knives are stored in a locked drawer. Properly labeled medications were locked in one of the kitchen cabinets.

Bedrooms: There are three (3) bedrooms designated for residents' use. Bedrooms are shared, and were observed to be properly furnished with appropriate beddings and linens with sufficient lighting.

Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 111 degrees Fahrenheit. No cleaning supplies were observed accessible in the bathrooms.

Common Areas: These included the living room and dining area. The living room is furnished with a couch, chair, side tables and television. The dining room table is large enough to seat up to six individuals.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2025
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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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: BE HAPPY, BE HOME
FACILITY NUMBER: 197610220
VISIT DATE: 01/24/2025
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The auditory alarms on all exit doors were on and functional at the time of the visit.

Staff Office/Workstation: No designated staff office.

Laundry Area: The laundry area is located in the hallway by resident rooms. Staff supervision present, as laundry was being done during the visit. Detergents and cleaning supplies were not present, nor accessible.

Garage: Facility does not have a garage.

Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor
use. There is sufficient outdoor space to hold activities if the weather permits.

Resident Files: Resident files maintained in the locked medication cabinet, located in the kitchen. LPA conducted a file review of resident records to insure compliance of licensing forms.

Staff Files: Staff files are also kept in the medication cabinet, along with resident files. LPA conducted a file review of staff records to insure compliance.

Medications: Medications are kept in a locked cabinet in the kitchen. Medication and Medication Records were reviewed for proper storage and documentation. Complete first kit and manual also maintained in the medication cabinet.

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: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
LIC809 (FAS) - (06/04)
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