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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850216
Report Date: 04/11/2025
Date Signed: 04/11/2025 04:08:49 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/19/2025 and conducted by Evaluator Trevor Byrne
COMPLAINT CONTROL NUMBER: 29-AS-20250319084954
FACILITY NAME:ELDERCARE HOMES, INC.FACILITY NUMBER:
195850216
ADMINISTRATOR:HEKIMYAN, LUIZAFACILITY TYPE:
740
ADDRESS:7754 COLDWATER CANYON AVENUETELEPHONE:
(818) 764-8545
CITY:N. HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY:6CENSUS: 5DATE:
04/11/2025
UNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Luiza HekimyanTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Resident was prescribed medication without notifying the authorized representative
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Trevor Byrne conducted a follow-up complaint visit for the above allegation. LPA arrived to the facility at 09:29 AM. LPA met with facility staff who contacted the facility Administrator, Luiza Hekimyan, and the facility Assistant Administrator, Tina Arutyunyan, via telephone call. The Administrator and the Assistant Administrator arrived at approximately 10:00 AM. Entrance interviews were conducted and the reason for the visit was explained.

During the initial complaint visit on 03/21/2025 the LPA conducted a physical plant tour, collected copies of pertinent documents, and conducted interviews with the Administrator, the Assistant Administrator, and one (1) staff member between 10:35 AM. and 12:30 PM. During today’s visit, the LPA conducted a physical plant tour to ensure there are no health and safety hazards, conducted a medication review for four (4) residents, and conducted interviews with the Administrator, the Assistant Administrator, five (5) residents, and three (3) witnesses between 09:30 AM. and 01:15 PM.
Unsubstantiated
Estimated Days of Completion: 30
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 29-AS-20250319084954
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ELDERCARE HOMES, INC.
FACILITY NUMBER: 195850216
VISIT DATE: 04/11/2025
NARRATIVE
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The allegation of “Resident was prescribed medication without notifying the authorized representative” alleges that facility staff #1 (S1) requested the resident’s Hospice agency to prescribe R1 with psychotherapeutic drugs without notifying Durable Power of Attorney (DPOA) of the medication request. LPA reviewed R1’s hospice paperwork and the resident’s centrally stored medication and destruction record sheet (CSMDR). The paperwork indicated that all medications that the hospice company ordered were prescribed by a physician. LPA confirmed that the medications on the hospice paperwork matched those listed on R1’s CSMDR. LPA interviewed S1, the Assistant Administrator and the Administrator all of whom confirmed that the facility followed the administration instructions of the resident’s prescribed medications. All staff denied requesting the hospice company to prescribe R1 with psychotherapeutic medications. Additionally, LPA received a copy of a text conversation between DPOA and the Assistant Administrator. In this conversation DPOA informed staff of medications that R1 used to take to assist in managing their agitation. DPOA suggested to staff to speak with R1’s nurse and get the medication prescribed. Although the allegation may have happened or is valid there is insufficient evidence to support the allegation of, “Resident was prescribed medication without notifying the authorized representative.” Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. Report was reviewed and a copy was provided.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3