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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609748
Report Date: 12/29/2025
Date Signed: 12/29/2025 01:26:56 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.RO, 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
09/24/2025 and conducted by Evaluator Gina Saucedo
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20250924160323
FACILITY NAME:GRANADA GOLDEN YEARSFACILITY NUMBER:
197609748
ADMINISTRATOR:ARUTYUNYAN, SEVAKFACILITY TYPE:
740
ADDRESS:17201 LAHEY STTELEPHONE:
(818) 535-9693
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 3DATE:
12/29/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Mariam Balasanyan, AdministratorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff yell at resident in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/29/25, at 9:45am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Caregiver, Bibigul Batyrbekova. LPA explained the purpose of this visit was to gather additional information and deliver findings for this complaint. Mariam Balasanyan, the Administrator was called and arrived shortly after.

On 10/01/25, LPA Saucedo conducted the initial visit. On 10/01/25, LPA Saucedo asked for the census, staff, and resident rosters. On 10/01/25, LPA Saucedo conducted a physical tour and interviewed staff. On 12/29/25, LPA Saucedo conducted another physical tour, interviewed residents and obtained relevant documents.

LIC 9099C-continued
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
09/24/2025 and conducted by Evaluator Gina Saucedo
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20250924160323

FACILITY NAME:GRANADA GOLDEN YEARSFACILITY NUMBER:
197609748
ADMINISTRATOR:ARUTYUNYAN, SEVAKFACILITY TYPE:
740
ADDRESS:17201 LAHEY STTELEPHONE:
(818) 535-9693
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 3DATE:
12/29/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Mariam Balasanyan, AdministratorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not adminster medication(s) to resident in care as prescribed by their physician
Resident developed bed sores due to staff neglect
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/29/25, at 9:45am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Caregiver, Bibigul Batyrbekova. LPA explained the purpose of this visit was to gather additional information and deliver findings for this complaint. Mariam Balasanyan, the Administrator was called and arrived shortly after.

On 10/01/25, LPA Saucedo conducted the initial visit. On 10/01/25, LPA Saucedo asked for the census, staff, and resident rosters. On 10/01/25, LPA Saucedo conducted a physical tour and interviewed staff. On 12/29/25, LPA Saucedo conducted another physical tour, interviewed residents and obtained relevant documents.

LIC 9099C-continued
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 31-AS-20250924160323
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: GRANADA GOLDEN YEARS
FACILITY NUMBER: 197609748
VISIT DATE: 12/29/2025
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
Regarding the allegation: Staff do not administer medication(s) to resident in care as prescribed by their physician. It is being alleged that resident #1 (R1) did not receive their prescribed medications. LPA asked for R1's MAR-Medication Administration Record and or centralized stored medication form and two (2) staff stated, "they do no keep a MAR and/or centralized stored medication form for any of the residents." Although, LPA interviewed (3) three residents that confirmed their medication is being provided to them everyday, the medication they receive is not being documented and there is no list of medication being received. Therefore, based on the LPA's observations, staff and resident interviews, the above allegation(s) above is SUBSTANTIATED at this time.


Regarding the allegation: Resident developed bed sores due to staff neglect. It is being alleged that resident #1 (R1) developed bed sores due to staff being neglectful. During LPA’s interview with staff two (2) staff confirmed that R1 needed a lot of help. One (1) staff member confirmed that R1 just wanted to stay in bed and R1 was also difficult to lift. During LPA’s interview with two (2) witnesses they confirmed that R1 had obtained wounds at the facility. Both witnesses did not know what stage the wounds were. During LPA’s record review it was determined that R1 was not under the care of home health and/or hospice for wound care. In addition, R1's pre-placement appraisal, physician's report and Appraisal/Needs and Services Plan did not indicate that R1 had any bed sores/wounds at the time of admission. Let it be noted, R1's admission was on 08/05/2025. The facility did not update and/or do a resident appraisal indicating that R1 was developing a wound and R1 was not sent to the hospital. LPA requested medical records from Kaiser Permanente, and it was determined that R1 was admitted on 09/23/25 at the hospital and had one (1) wound and a deep tissue injury- the wound was on the coccyx of R1 stageable as two (2) and the deep tissue injury was on the right heel of R1’s foot. Therefore, based on the medical records and interviews conducted the allegation is SUBSTANTIATED at this time.

An exit interview was conducted, citation(s) were issued, a civil penalty issued, appeal rights and a copy of this report was given to the Administrator.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 31-AS-20250924160323
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: GRANADA GOLDEN YEARS
FACILITY NUMBER: 197609748
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/30/2025
Section Cited
CCR
87615(a)(1)
1
2
3
4
5
6
7
(a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: (1)Stage 3 and 4 pressure injuries. This requirement is not met:
1
2
3
4
5
6
7
An immediate civil penalty of $500 assessed. As POC, licensee will obtain training to address this section of the regulation. Proof of the training is due to Community Care Licensing Department no later than 12/30/25.
8
9
10
11
12
13
14
Based on the LPA's record review from Kaiser Permanente the licensee/administrator failed to ensure that the facility admitted and/or retained a resident with a stage 2 wound and with a deep tissue injury without home health/hospice. This posed an immediate health and safety risk to residents in care.
8
9
10
11
12
13
14
Type B
01/12/2026
Section Cited
CCR
87465(H)(6)
1
2
3
4
5
6
7
Incidental Medical and Dental Care(h) The following requirements shall apply to medications which are centrally stored:
(6) The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained for at least one year and includes: This requirement is not met by:
1
2
3
4
5
6
7
 As POC, licensee will obtain training to address this section of the regulation. Proof of the training is due to Community Care Licensing Department no later than 01/12/26.
8
9
10
11
12
13
14
Based on the LPA's record review and interviews the licensee/administrator failed to ensure that the facility retained and/or assured a record of centrally stored medication. This posed a potential health and safety risk to residents in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20250924160323
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: GRANADA GOLDEN YEARS
FACILITY NUMBER: 197609748
VISIT DATE: 12/29/2025
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
Regarding the allegation: Staff yell at resident in care. It is being alleged that the staff have yelled at resident #1 (R1). LPA interviewed three (3) residents that confirmed staff have never yelled at them. During LPA’s interview with two (2) staff confirmed that they have never yelled at any of the residents. LPA also interviewed R1's sister that confirmed the staff at the above facility are super nice. During LPA’s physical tour, LPA did not witness any staff yelling at the residents. Therefore, based on the observations and interviews conducted the allegation is UNSUBSTANTIATED at this time.

An exit interview was conducted, no citation(s) were issued for the above allegation(s), and a copy of this report was given to the Administrator.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5