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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608349
Report Date: 09/16/2025
Date Signed: 09/16/2025 02:29:33 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
06/09/2025 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20250609155856
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: 65DATE:
09/16/2025
UNANNOUNCEDTIME BEGAN:
09:27 AM
MET WITH:Marine Karapetian - AdministratorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not provide resident with an itemized bill

Staff did not provide resident with a copy of Admission Agreement

Staff did ensure resident from using methamphetamine on premises of facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jose Tan conducted an unannounced subsequent complaint visit at this facility to investigate the above allegations, LPA met with Administrator Marine Karapetian and explained the reason for the visit.

LPA conducted a physical plant tour at 9:40 AM, requested copies of facility documents relevant to the investigation at 10:05 AM, reviewed records between 10:05 AM to 11:05 AM and interviewed residents and staff between 11:15 AM to 1:00 PM. Regarding the allegation that Staff did not provide resident with an itemized bill, it was alleged that Resident #1 (R1) was requesting Itemized bill from the administrator but had not been given one. LPA's record review today between 10:05 AM to 11:05 AM revealed that R1 is a Social Security Supplemental Income (SSI) recipient and pays SSI rate to the facility and there is no itemized bill because the services provided to R1 and all other SSI recipients are enumerated on their Admission Agreement. LPA's interview with the administrator today at 11:19 AM, revealed that R1 is under the Assisted Living Waiver (ALW) program Level 4 (continued to LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025
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-20250609155856
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: 09/16/2025
NARRATIVE
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(continued from LIC 9099)

Regarding the allegation that Staff did not provide resident with a copy of Admission Agreement, it was alleged that R1 has been requesting his admission agreement but was not provided one. LPA's record review today revealed that R1 was admitted on 04/24/25 and signed the admission agreement on the same day. LPA's interview with R1 also revealed that R1 had received a copy of R1's admission agreement. Further interview with R1 also revealed that R1 is self-responsible and can manage own cash resources.

Regarding the allegation that Staff did ensure resident from using methamphetamine on premises of facility, it was alleged that the reporting party (RP) saw a man smoking meth in a grassy area just outside the facility, the RP remarked that the area had a strong smell of meth. LPA made a reasonable effort to contact the RP to no avail. LPA's interview with seven (7) residents or more than 10% of the current census today between 11:15 AM to 1:00 PM, revealed that seven (7) out of seven (7) residents interviewed did not know any resident who is using illegal drugs nor witnessed anyone using drug while inside the facility.

Based on the information gathered during this and prior 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: 09/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025
LIC9099 (FAS) - (06/04)
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