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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850298
Report Date: 04/03/2025
Date Signed: 04/03/2025 03:51:18 PM

Substantiated


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
01/17/2025 and conducted by Evaluator Trevor Byrne
COMPLAINT CONTROL NUMBER: 29-AS-20250117154733
FACILITY NAME:LAURELGROVE BOARD AND CAREFACILITY NUMBER:
195850298
ADMINISTRATOR:TADEVOSYAN, LUSINEFACILITY TYPE:
740
ADDRESS:8221 LAURELGROVE AVETELEPHONE:
(818) 355-2632
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY:6CENSUS: 5DATE:
04/03/2025
UNANNOUNCEDTIME BEGAN:
03:03 PM
MET WITH:Dianna KarapetyanTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff financially abused a resident in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Trevor Byrne conducted an unannounced follow-up complaint investigation visit at the facility at 03:03 PM. LPA met with facility staff who contacted the Administrator Dianna Karapetyan. The Administrator arrived to the facility at approximately 03:20 PM the reason for the visit was explained and entrance interview was conducted.

During the initial complaint visit on 01/22/2025, LPA conducted a physical plant tour to ensure there are no health and safety hazards, collected copies of pertinent documents, and conducted interviews with the Administrator, one (1) staff member, and three (3) residents between 09:30 AM. and 11:20 AM. During the follow-up visit on 02/07/2025, LPA conducted a brief physical plant tour, Interviewed one (1) staff member, two (2) witnesses, and one (1) resident. During today’s visit LPA interviewed the Administrator and delivered findings for two (2) allegations.

Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2025
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 5
Control Number 29-AS-20250117154733
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: LAURELGROVE BOARD AND CARE
FACILITY NUMBER: 195850298
VISIT DATE: 04/03/2025
NARRATIVE
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The allegation of “Staff financially abused a resident in care” alleges that facility staff did not safeguard R1’s monetary resources while their "Golden State Advantage" Food stamps card was in staff’s possession. During an interview with R1 they revealed that they had a food stamps card that they would give to staff to purchase additional food items. R1 stated that they gave the card to facility staff in November of 2024 but did not receive the card back until late December 2024. R1 stated that they made no requests for food purchases during the timeframe that the card was not in their possession. LPA was provided with a receipt from Food 4 Less which showed the remaining balance on the card to be $206.16. R1 confirmed that when they received the card back there was $0 left on the card. Conformation was received via telephone call that the balance left on the card was $0. LPA interviewed facility staff who confirmed that R1 did not order any extra food items between November and December. Facility staff denied spending any of the money on R1’s card. Facility staff believed that R1’s card was subject to a scam. Facility staff confirmed that they were in possession of R1’s card during the timeframe of November to December. Facility staff confirmed that the money went missing off of R1’s card during the timeframe that they were in possession of the card. Based on the information obtained during interviews there is sufficient evidence to support the allegation of “Staff financially abused a resident in care“ Therefore, the allegation is deemed Substantiated at this time.

The following deficiency was cited (refer to LIC 9099D). A copy of the report was printed, appeal rights were provided, and exit interview was conducted.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
01/17/2025 and conducted by Evaluator Trevor Byrne
COMPLAINT CONTROL NUMBER: 29-AS-20250117154733

FACILITY NAME:LAURELGROVE BOARD AND CAREFACILITY NUMBER:
195850298
ADMINISTRATOR:TADEVOSYAN, LUSINEFACILITY TYPE:
740
ADDRESS:8221 LAURELGROVE AVETELEPHONE:
(818) 355-2632
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY:6CENSUS: 5DATE:
04/03/2025
UNANNOUNCEDTIME BEGAN:
03:03 PM
MET WITH:Dianna KarapetyanTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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2
3
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9
Staff physically abused a resident in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Trevor Byrne conducted an unannounced follow-up complaint investigation visit at the facility at 03:03 PM. LPA met with facility staff who contacted the Administrator Dianna Karapetyan. The Administrator arrived to the facility at approximately 03:20 PM the reason for the visit was explained and entrance interview was conducted.

During the initial complaint visit on 01/22/2025 LPA conducted a physical plant tour to ensure there are no health and safety hazards, collected copies of pertinent documents, and conducted interviews with the Administrator, one (1) staff member, and three (3) residents between 09:30 AM. and 11:20 AM. During the follow-up visit on 02/07/2025 LPA conducted a brief physical plant tour, Interviewed one (1) staff member, two (2) witnesses, and one (1) resident. During today’s visit LPA delivered findings for two (2) allegations.

Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 29-AS-20250117154733
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: LAURELGROVE BOARD AND CARE
FACILITY NUMBER: 195850298
VISIT DATE: 04/03/2025
NARRATIVE
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The allegation of “Staff physically abused a resident in care” alleges that facility staff #1 (S1) hit Resident #1 (R1) on the shoulder three (3) times during an altercation. During the initial interview with R1 they stated that during the altercation with S1 they were struck in the shoulder three (3) times. R1 also stated that these strikes caused them to suffer a scratch on their nose. LPA did not observe any injuries or scaring to R1’s nose at the time of the interview. R1 stated that they never sought medical attention for the injuries they sustained and never reported the incident to other facility staff. During a follow-up interview with R1 they stated that the injuries they sustained were actually scratches on their hand and not their nose. LPA interviewed S1 who denied ever striking or scratching R1. S1 provided LPA with a photograph of injuries they sustained to their hand. S1 stated that while they were holding on to R1’s bag, R1 scratched their hands breaking the skin. S1 along with other facility staff members confirmed that the photo provided to LPA was a picture of S1’s hand not R1’s. Interviews with Resident #2 (R2) and Resident #3 (R3) did not reveal any concerns with staff members. Both residents denied ever witnessing confrontations between staff and residents. Based on the information obtained, there is insufficient evidence to support the allegation. Although the allegation may have happened or is valid there is insufficient evidence to support the allegation of, “Staff physically abused a resident in care.” Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview was conducted. This report was reviewed with the Administrator and a copy was provided.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20250117154733
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: LAURELGROVE BOARD AND CARE
FACILITY NUMBER: 195850298
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/17/2025
Section Cited
CCR
87217(b)
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87217 Safeguards for Resident Cash, Personal Property, and Valuables
(b) Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables...
This requirement is not met as evidenced by:
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Licensee will submit their plan on how they will resolve R1's missing money to CCLD no later than POC due date.
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Based on interviews and record review the licensee did not comply with the section cited above as $206.16 went missing from R1's EBT card while the card was in posession of the facility which poses a potential personal rights risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5