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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609828
Report Date: 01/03/2025
Date Signed: 01/03/2025 12:49:24 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
12/26/2024 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20241226160146
FACILITY NAME:NO PLACE LIKE HOME FOR GOLDEN AGES 3, LLCFACILITY NUMBER:
197609828
ADMINISTRATOR:MELIK, DIANEFACILITY TYPE:
740
ADDRESS:3754 MONTROSE AVE.TELEPHONE:
(747) 255-7188
CITY:GLENDALESTATE: CAZIP CODE:
91214
CAPACITY:6CENSUS: 5DATE:
01/03/2025
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Oscar Montes de OcaTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Facility is unsanitary
Facility is in disrepair
INVESTIGATION FINDINGS:
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At approximately 10:30 a.m. on 01/03/25 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with staff and disclosed the reason for the visit.

To investigate the allegations above, LPA and toured the facility inside and out at 10:35 a.m. today and interviewed staff and residents between 10:45 a.m. and 12:00 p.m.

Regarding the allegation "Facility is unsanitary" it was alleged a dirty diaper was left on a bathroom sink. A photograph of a diaper on a sink was provided to the Department, but it was indeterminable whether the diaper was dirty or not. During today’s facility tour, LPA observed clean, unused diapers and incontinence items on a bathroom sink. No dirty diapers or other refuse were observed in the home. Interview with Staff #1 (S1) at 11:20 a.m. today revealed staff immediately take diapers to an outside trash can after assisting residents with incontinence care. Three (03) out of three (03) residents interviewed had no issues with facility cleanliness or incontinence care.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
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-20241226160146
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: NO PLACE LIKE HOME FOR GOLDEN AGES 3, LLC
FACILITY NUMBER: 197609828
VISIT DATE: 01/03/2025
NARRATIVE
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 Interview with Resident #1 (R1) at 11:45 a.m. revealed staff “mop as frequent as possible”. Based on observations and interviews, the facility is sanitary. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Facility is in disrepair" it was alleged paint on the walls was chipping and some windows had broken coverings. LPA observed walls were in good repair. At approximately 10:45 a.m., LPA observed one (01) minor paint chip on the living room ceiling which did not pose an immediate or potential risk to the health, safety, or personal rights of residents in care. Interviews with three (03) out of three (03) residents interviewed revealed they had no issue with the state of the facility. LPA did not observe any broken window coverings. Based on observations and interviews, the facility is in good repair. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health or safety risks were observed during today’s visit.

Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2