197610841-11-10-2025-31-AS-MAGN-DNAR8F-20251110114751

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197610841
Report Date: 11/10/2025
Date Signed: 11/10/2025 11:50:50 AM

Document Has Been Signed on 11/10/2025 11:50 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:	HAPPY LIFE AND LOVE		FACILITY NUMBER:	197610841
ADMINISTRATOR/ DIRECTOR:	GASPARYAN, SUSANNA		FACILITY TYPE:	740
ADDRESS:	8545 WILBUR AVE		TELEPHONE:	(818) 425-3540
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY: 6		CENSUS: 0	DATE:	11/10/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:43 AM
MET WITH:	SUSANNA GASPARYAN- Administrator		TIME VISIT/ INSPECTION COMPLETED:	12:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Mariana Agban conducted a Pre-Licensing Inspection with facility Administrator/ Licensee Susanna Gasparyan and Staff Armen Sahredyan. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on May 27, 2025. A fire clearance was approved on July 29, 2025, for a maximum capacity of five (5) non-ambulatory residents, one(1) Bedridden resident. Hospice waiver has been requested for six (6) residents, which is pending approval of the Manager. A tour of the physical plant was initiated at 9:55 am, and the following was observed: KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, stove, and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6) residents. COMMON AREAS: These included the living room and dining room, which were equipped with furniture, a television, and sofas. There is a fireplace with a screen and a glass slide. It is non-operational. No fireplace tools or fixtures present. The dining area has a dining table to accommodate six (6). There were no visible immediate hazards. LPA observed one fire extinguisher located in the dining /kitchen with a date of purchase of 07/15/25. The common areas were properly furnished. LPA tested the smoke alarms and carbon monoxide detectors, and they were functioning properly. BEDROOMS: There are five (5) bedrooms designated for residents' use. Four bedrooms are designated for private use , and 1 shared room. All bedrooms are furnished with beds, dressers, and required bedding and linen. The bedrooms have sufficient closet space. Bedrooms#2 and #6 are approved for one bedridden resident. The auditory alarms on all exit doors were on and functional at the time of the visit. LPA observed the office room where the Administrator is going to keep residents' medications locked and resident/staff files stored. (Continue 809C)

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Mariana Agban
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: HAPPY LIFE AND LOVE	FACILITY NUMBER: 197610841
	VISIT DATE: 11/10/2025

NARRATIVE

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BATHROOMS: The facility has two (2) main bathrooms in the main hallway. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 109.1 and 112.3 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection.

Laundry Area: The washer/dryer appears to be in good condition, and they were located in the main hallway between the residents' rooms. Laundry toxins were locked, and thus laundry detergents are inaccessible to residents.

SURROUNDING GROUNDS: The driveway, passageways, and entrance to the home were clear of obstruction. There is a carport large enough to park two cars. The backyard of the facility has a patio and backyard furniture to accommodate the six (6) residents. The facility's backyard has sufficient yard space. There is no swimming pool or bodies of water. The side gates were checked to ensure it was clear of obstruction.

Staff and resident files: Staff and resident files will be kept and maintained in a locked cabinet in the office.

In addition to the Pre-Licensing inspection, a Component III PowerPoint presentation was also held.
Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised, and a copy of this report provided.

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Mariana Agban
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025

LIC809 (FAS) - (06/04)

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