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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610617
Report Date: 09/12/2024
Date Signed: 11/18/2024 11:05:29 AM

Document Has Been Signed on 11/18/2024 11:05 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:A PARADISE ASSISTED HOMEFACILITY NUMBER:
197610617
ADMINISTRATOR/
DIRECTOR:		HAKOBYAN,ANNAFACILITY TYPE:
740
ADDRESS:9927 COLLETT AVETELEPHONE:
(747) 236-4064
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 6CENSUS: 0DATE:
09/12/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Anna Hakobyan- LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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At 9:30am, Licensing Program Analyst (LPA), Leslie Ngo-Castaneda conducted an announced pre-licensing visit to the above facility and met with administrator Anna Hakobyan. LPA conducted an entrance interview with the Licensee. With the assistance of the Licensee LPA conducted a physical plant tour at 9:36AM, during the your LPA observed that licensee family still resides in the in the address.

LPA advised licensee that this is not allowed since they can get a resident anytime when LPA approve of licensing. Licensee and LPA agreed to re-schedule pre-licensing.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
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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