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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610676
Report Date: 02/27/2025
Date Signed: 02/27/2025 04:14:26 PM

Document Has Been Signed on 02/27/2025 04:14 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
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:AFFORDABLE BOARDING CAREFACILITY NUMBER:
197610676
ADMINISTRATOR/
DIRECTOR:
GALSTYAN, SONAFACILITY TYPE:
740
ADDRESS:733 CELTIC DRTELEPHONE:
(626) 310-3333
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY: 6CENSUS: 2DATE:
02/27/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Sona GalstyanTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the caregiver. The caregiver confirmed there are two residents. The Administrator Sona Galstyan arrived at 2:25 pm. LPA Spaeth stated the purpose of the visit was to tour the facility and review residents' files.

LPA reviewed the residents' files at 2:30 pm until 2:50 pm. LPA Spaeth and the Administrator toured the facility at 3:30 pm until 3:35 pm. LPA observed the facility was neat and clean.

There are no deficiencies to report at this time. Exit interview conducted and a copy of the report was given.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Melissa Spaeth
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2025
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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