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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608349
Report Date: 04/09/2025
Date Signed: 09/27/2025 09:19:00 PM

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
02/18/2025 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20250218003240
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: 66DATE:
04/09/2025
UNANNOUNCEDTIME BEGAN:
09:03 AM
MET WITH:Marine Karapetian - AdministratorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff are providing allergic foods to a resident

Staff do not ensure a resident is properly fed while in care
INVESTIGATION FINDINGS:
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This is an amendment of report dated 04/09/25 to rectify typographical errors, No change in findings.
Licensing Program Analyst (LPA) Jose Tan conducted an unannounced subsequent complaint visit to this facility to further investigate the above allegations. LPA met with Marine Karapetian and explained the reason for the visit.
LPA conducted a physical plant tour at 9:18 AM, requested copies of facility documents relevant to the investigation at 10:02 AM, reviewed records from 10:03 to 11:15 AM and interviewed staff and residents between 11:30 to 1:00 PM. Regarding the allegation that Staff are providing food to a resident that the resident is allergic to, it was alleged that Resident #1 (R1) was given food that R1 is allergic to. LPA’s record review today confirmed that R1 has food allergies. During LPA's physical plant tour however, LPA observed that R1's food allergy is prominently posted in the kitchen preparation area. LPA's interview with kitchen staff today at 12:34 PM revealed that they always prepare separate food for R1 and ensure that R1's food has none of the food that R1 has an allergy with. LPA observed during lunch that R1 was served with different food from the menu without the food R1 is allergic to. (continued on LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
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-20250218003240
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: 04/09/2025
NARRATIVE
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(continued from LIC 9099)

Regarding the allegation that Staff do not ensure a resident is properly fed while in care, it was alleged that R1 goes without eating for days and does not have alternative food to eat. LPA's observation during physical plant tour revealed that the facility has alternate food (sandwiches) in the refrigerator and LPA's interview with the kitchen staff confirmed that they always have alternate food all the time in case any resident wants one or to give during snacks. LPA's interview with R1 today at 12:23 PM revealed that R1 goes to Adult Day Health Care (ADHC) program almost every day from 6:35 AM to 1:30 PM and stated that R1 eats breakfast and lunch at the ADHC. Further, R1 also buys own food all the time. Three (3) staff interviewed on 02/20/25 confirmed that R1 buys their food all the time.

Based on the information gathered during this visit, these allegations are 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: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3