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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608844
Report Date: 12/16/2025
Date Signed: 12/16/2025 11:55:40 AM

Document Has Been Signed on 12/16/2025 11:55 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:TRIUMPHANT ELDERLY CARE LLCFACILITY NUMBER:
197608844
ADMINISTRATOR/
DIRECTOR:		RHODA K. GOCHINFACILITY TYPE:
740
ADDRESS:8106 LOMA VERDE AVENUETELEPHONE:
(818) 718-0978
CITY:CANOGA PARKSTATE: CAZIP CODE:
91304
CAPACITY: 6CENSUS: DATE:
12/16/2025
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Rhoda Gochin-Licensee/AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 12/16/2025 Regional Manager (RM) Angela J. Whittaker and Licensing Program Analyst (LPA) Perchui Melina Khurshudyan met with Administrator Rhoda Gochin for an informal office visit.

The purpose of the office visit is to discuss the current operation of this facility and to clarify Title 22 requirements.

On 12/4/2025, Woodland Hills South received information that an incident occurred on 12/2/2025, involving the Administrator reportedly refusing entry to a Department of Mental Health (DMH) Case Manager who was attempting to relocate a client from the facility. It was reported that the Administrator propped a chair against the facility door and refused to allow the DMH case manager to enter the facility. The Administrator had communicated concerns about wanting a 30-day notice, and that this may have contributed to refusal of entry. After communication with the case manager and assurance of payment throughout the remainder of the month, the Administrator allowed access to the facility and R1 was able to work with the case manager to move out.

During today's meeting, Administrator informed RM that although, they informed and requested a proper 30 day notice in order to release the client to another facility, the case manager never submitted the 30 day notice or any formal letter to proceed with the transition. The Administrator also informed that because of his/her health condition it is hard to stand up for a long period of time, therefore a chair was placed next to the door for him/her to seat while waiting for the case manager to contact the DMH supervisor.

Continue on LI809-C

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Perchui Khurshudyan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: TRIUMPHANT ELDERLY CARE LLC
FACILITY NUMBER: 197608844
VISIT DATE: 12/16/2025
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During the Informal Meeting, Regional Manager (RM) Angela J. Whittaker reminded current Licensee/Administrator Mrs. Gochin that Residents’ Rights must be maintained at all times, including dignity, freedom from intimidation, and the ability to receive visits services from authorized representatives/ Case Managers when applicable. Blocking and/or refusal entry may raise serious compliance concerns, including potential impact to resident care and safety.

RM also mentioned that for the safety of clients, it is essential that RCFE staff proceed with these proper actions and steps before releasing residents to another placement by requesting 30 day notice. Adhering to these procedures ensures compliance with licensing regulations, minimizes risks, and promotes a smooth transition that prioritizes the resident’s well-being.

Administrator was instructed to ensure future interactions with authorized representatives are handled professionally and in compliance with requirements.

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Perchui Khurshudyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC809 (FAS) - (06/04)
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