197608349-9-27-2025-31-AS-TAGD-DMFVD6-20251014162013

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608349
Report Date: 07/08/2025
Date Signed: 09/27/2025 09:19:52 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 VILLA		FACILITY NUMBER:	197608349
ADMINISTRATOR:	MARINE KARAPETIAN		FACILITY TYPE:	740
ADDRESS:	14132 HUBBARD STREET		TELEPHONE:	(818) 837-0077
CITY:	SYLMAR	STATE: CA	ZIP CODE:	91342
CAPACITY:	78	CENSUS: 65	DATE:	07/08/2025
		UNANNOUNCED	TIME BEGAN:	09:21 AM
MET WITH:	Marine Karapetian - Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not ensure that the resident has means to communicate

Staff do not properly assist a resident with medical testing and appointments

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

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 Administrator Marine Karapetyan and explained the reason for the visit.
LPA conducted a physical plant tour at 9:35 AM, requested copies of facility documents relevant to the investigation at 10:00 AM, reviewed records between 10:00 AM to 11:00 AM and interviewed staff and residents between 11:00 AM to 1:00 PM. Regarding the allegation that Staff do not ensure that the resident have means to communicate, it was alleged that Resident #1 (R1) is deaf and has no phone to use. LPA's observation on the prior visit on 04/09/25 revealed that R1 had a phone provided by R1's Adult Day Health Center ADHC) but was not set up properly so it wasn't working. LPA called the administrator and admitted that the Administrator was not aware that R1 has this landline phone. The administrator called the ADHC and the technician of the phone only to find out that the landline phone needed a subscription before it could work but R1 is unwilling to pay the subscription fee. (continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2025

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 2

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: 07/08/2025

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)

LPA's observation during today's visit revealed that R1 had three (3) cellular phone units in R1's possession but none seems to be working due to unpaid subscription to provider. LPA’s records review also revealed that R1 had a cochlear implant which was lost prior to admission but the administrator successfully obtained a replacement in April 2023 and had it implanted to R1, but R1 removed it despite the instruction that it had to be connected to R1's brain for a minimum of 24 hours to successfully adapt and work properly but R1 did not abide by instruction and eventually broke and lost the implant again. The administrator worked again to obtain another set of implant for R1 and it was shipped from the provider company on 04/01/25 and was received directly by R1, with the condition however that R1 return the old broken implant to the provider company, record review revealed that R1 refused to return the old broken implant and now was billed for $7,995.00 for the new implant.

Regarding the allegation that Staff do not properly assist a resident with medical testing and appointments, it was alleged that the staff do not assist R1 and that they have ordered testing for R1 that was not done. LPA's record review today revealed that R1 had numerous doctor's appointments in different disciplines from dental to Neurology to Psychiatric appointment, including an Audiology appointment for testing on 03/28/25. Further facility records review, specifically medical appointment log, also revealed that the staff arranged R1's transportation during these appointments including hearing testing of R1.

Based on the information gathered during this and prior visits, 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: 07/08/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2