<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608349
Report Date: 01/28/2025
Date Signed: 01/29/2025 10:47:47 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/08/2024 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20241108102704
FACILITY NAME:ABBEY ROAD VILLAFACILITY NUMBER:
197608349
ADMINISTRATOR:MARINE KARAPETIANFACILITY TYPE:
740
ADDRESS:14132 HUBBARD STREETTELEPHONE:
(818) 837-0077
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY:78CENSUS: 67DATE:
01/28/2025
UNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Anush Khudatyan - Medication TechnicianTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is financially abusing resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit at this facility to further investigate the above allegation. LPA met with staff Anush Khudatyan and explained the reason for the visit.

LPA conducted physical plant tour at 10:02 AM, requested copies of facility documents relevant to the investigation at 10:36 AM, reviewed facility documents between 10:45 AM to 11:45 AM and interviewed staff between 12:00 PM to 1:15 PM. Regarding the allegation that the Staff is financially abusing Resident #1 (R1), it was alleged that the facility is still receiving R1's Social Security money since R1 left in February 2024 up to November 2024. LPA's interview with the administrator on 11/12/24 at around 12:30 PM, revealed that R1 was receiving two (2) Social Security Check through direct deposit, one (1) for regular Social Security Pension (SSP) and another for Supplemental Income (SSI). Immediately after R1 was confirmed of not coming back to the facility as a family member (FM) took R1's belongings from the facility, the administrator requested the SSA to stop the direct deposit of R1's check to the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025
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 31-AS-20241108102704
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ABBEY ROAD VILLA
FACILITY NUMBER: 197608349
VISIT DATE: 01/28/2025
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
26
27
28
29
30
31
32
(continued from LIC 9099)

The administrator confirmed that the Social Security Administration (SSA) did stop the direct deposit but only the SSA continued to direct deposit to the facility's account R1's SSI payment. LPA's record review today between 10:45 AM to 11:45 AM, revealed that the facility faxed request to SSA to stop payment to no avail, the facility then received the invoice from SSA and returned to SSA all the payment made to the facility on behalf of R1, the last being on 11/06/24 with the receipt from SSA.

Based on the information gathered during this and prior visit, the allegation is deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3