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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609980
Report Date: 04/09/2026
Date Signed: 04/09/2026 04:25:12 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/28/2025 and conducted by Evaluator Trevor Byrne
COMPLAINT CONTROL NUMBER: 29-AS-20250528153637
FACILITY NAME:AMY'S PARADISE HOME OF ANGELS INC.FACILITY NUMBER:
197609980
ADMINISTRATOR:EMMA AVETISYANFACILITY TYPE:
740
ADDRESS:11950 ROSCOE BLVDTELEPHONE:
(310) 913-6161
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY:6CENSUS: 6DATE:
04/09/2026
UNANNOUNCEDTIME BEGAN:
01:28 PM
MET WITH:Meri TarposhyanTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff engaged in an inappropriate relationship with resident.
Staff did not seek timely medical attention for resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Trevor Byrne conducted a follow-up complaint visit for the above allegations. LPA arrived to the facility at 01:28 PM. LPA met with facility staff who contacted the facility Administrator Emma Avetisyan. The Administrator informed LPA that they were unable to come to the facility at the time of the visit. Facility representative Meri Tarposhyan (S2) arrived to the facility at 01:45 PM. Entrance interview was conducted and the reason for the visit was explained. During today’s visit, the LPA conducted a physical plant tour and delivered findings between 01:30 PM and 04:00 PM.

The allegation of “Staff engaged in an inappropriate relationship with resident” alleges that facility staff #1 (S1) engaged in an inappropriate relationship with Resident #1 (R1) while R1 resided at the facility. On 05/30/2025, LPA interviewed S1, and during the interview S1, they confirmed that they and R1 were married at the facility. S1 provided LPA with a copy of the marriage certificate between them and R1 with an effective date of 11/01/2024. CONTINUED ON LIC 9099C.
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
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 3
Control Number 29-AS-20250528153637
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: AMY'S PARADISE HOME OF ANGELS INC.
FACILITY NUMBER: 197609980
VISIT DATE: 04/09/2026
NARRATIVE
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Interviews with Witness #1 (W1) and Witness #2 (W2) revealed concerns that R1 was manipulated by the facility into marrying S1 for immigration or green card purposes. Interviews with R1 revealed that R1 did not feel pressured into marrying S1, and R1 denied any coercion from S1 or facility staff. Interviews with S1 and R1 revealed that they intended to go to the immigration office to obtain documents for S1, but no such visit took place due to issues in obtaining the required perquisite documentation. LPA reviewed R1’s medical documentation and facility file. R1 was determined by their physician to not have cognitive deficit, was able to make their own decisions, and was able to manage their own finances. Additionally, LPA observed R1 to be self-responsible and did not have a Power of Attorney (POA). On 03/18/2026, LPA interviewed S1 and R1. LPA was informed that as of 02/17/2026, S1 and R1 were legally separated. Based on interviews and record review there is sufficient evidence to support the allegation of “Staff engaged in an inappropriate relationship with resident.” Therefore, the allegation is deemed Substantiated at this time.

The allegation of “Staff did not seek timely medical attention for resident” alleges that the facility did not seek timely medical attention for R1 following a medical emergency which occurred at the facility. Interviews with S1 revealed that on 05/14/2025, R1 suffered a medical emergency at the facility and required hospitalization. S1 stated that symptoms, including diarrhea, were first noticed the day prior (05/13/2025) and were monitored by S1. S1 stated that on 05/14/2025, they observed blood in R1’s stool. S1 reported observing the blood for approximately two (2) to three (3) hours before calling the Administrator and later emergency services to transport R1 to the hospital. LPA interviewed the Administrator who stated that R1 appeared fine on the morning of 05/14/2025, but around 12:00 PM R1’s blood pressure was observed by S1 to be rapidly dropping. Administrator stated that they received a follow-up call from S1 at approximately 05:00 PM informing them that R1 was not doing well. Administrator stated that an ambulance was called for R1 at approximately 06:00 PM and R1 was transported to the hospital for treatment. LPA reviewed the hospital paperwork from R1’s 05/14/2025 hospitalization. LPA observed that R1 was admitted to the hospital in critical condition with severe hyperkalemia (high potassium levels in blood) and later suffered cardiac arrest. Based on interviews, LPA observed a delay in seeking timely medical attention for R1 of more than twenty-four (24) hours from the initial onset of symptoms and six (6) hours of the presentation of severe symptoms. Based on interviews and record review there is sufficient evidence to support the allegation of “Staff did not seek timely medical attention for resident.” Therefore, the allegation is deemed Substantiated at this time.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D): Exit interview conducted and copy of the report was issued and appeal rights provided.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20250528153637
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: AMY'S PARADISE HOME OF ANGELS INC.
FACILITY NUMBER: 197609980
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/10/2026
Section Cited
CCR
87465(a)(1)
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87465 Incidental Medical and Dental Care
(a) ...by compliance with the following:
(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents.
This requirement is not met as evidenced by:
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Administrator agreed to conduct training with all staff members of the facility covering the importance of noticing signs and symptoms of a medical emergency and seeking medical attention in a timely manner. Administrator agreed to submit proof of completed training to CCLD no later than POC due date.
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Based on interview and record review the licensee did not comply with the section cited above as the facility did not seek timely medical attention for R1 following the presentation of symptoms of a medical emergency which posed an immediate health risk to clients in care.
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Type B
04/23/2026
Section Cited
CCR
87468.1(a)(1)
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87468.1 Personal Rights of Residents...
(a) Residents... shall have all of the following personal rights:
(1) To be accorded dignity in their personal relationships with staff, residents, and other persons.
This requirement is not met as evidenced by:
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Administrator agreed to conduct a meeting with staff members of the facility covering what constitutes appropriate staff/resident relationship and what behaviors are acceptable for facility staff. Administrator agreed to submit proof of the meeting to CCLD no later than POC due date.
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Based on interviews and record review the licensee did not comply with the section cited above as S1 entered into an inappropriate relationship with R1 through their marriage and subsequent divorce which posed a potential personal rights risk to clients in care.
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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: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3