197610176-3-19-2025-31-AS-EMIR-DH5TRL-20250529145741

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610176
Report Date: 03/19/2025
Date Signed: 03/19/2025 01:58:32 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/20/2025 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20250220154740

FACILITY NAME:	ESSENTIAL CARE ASSISTED LIVING		FACILITY NUMBER:	197610176
ADMINISTRATOR:	KHACHATRYAN, VERZHINE		FACILITY TYPE:	740
ADDRESS:	3132 WAVERLY DR.		TELEPHONE:	(818) 284-7607
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90027
CAPACITY:	6	CENSUS: 0	DATE:	03/19/2025
		UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Verzhine Khachtryan		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility did not provide scheduled activities for residents.
Facility did not provide adequate food service for residents.
Facility was not kept free from insects/pests
Facility staff withheld fluids to control resident's incontinence.
Resident using couch in common area as a sleeping room.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Michael Cava conducted a subsequent visit to the facility to conclude the investigation regarding above allegations. LPA met with administrators Verzhine Khachtryan, and advised her of the complaint. Today's investigation consisted of interviews with the administrator and a physical plaint inspection.

Facility did no provide scheduled activities for residents:
In regards to the allegation, it was reported that the licensee did not provide activities for the residents in care. Interview with the administrator deny the allegation stating her activities include board games, puzzles and chess. Moreover, when the weather permits, outdoor exercises are conducted as frontyard is large enough to hold activities. Administrator adds birthday/pool parties are also held. LPA conducted a plant inspection and observed sufficient yard space where outdoor activities can be held. LPA also also observed

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

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 3

Control Number 31-AS-20250220154740

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ESSENTIAL CARE ASSISTED LIVING	FACILITY NUMBER: 197610176
	VISIT DATE: 03/19/2025

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

magazines, board games chess and puzzles available. LPA was unable to interview any residents at the time of investigation as facility census is currently zero. According to the administrator, she did not receive any complaints from her past residents or their families regarding activities. Based on the information obtained, there was insufficient evidence to prove that the facility did not provide scheduled activities for residents. Therefore, the allegation is deemed Unsubstantiated at this time.

Facility did not provide adequate food service for residents:
In regards to the allegation, it was reported that food was awful, the same jar of oatmeal was fed to the residents for three days. Sandwiches were given for lunch and dinner no variety of foods. Interview with the administrator deny the allegation, stating facility offers a variety of food with snacks in between. Food service range from American food to cultural. Residents can choose what they would want to eat. LPA made an inspection of the kitchen, and despite the census being zero, licensee maintains a sufficient amount of perishable and non-perishable food. LPA was unable to interview any residents at the time of investigation as facility census is currently zero. According to the administrator, she did not receive any complaints from her past residents or their families in regards to food service. Based on the information obtained, there was insufficient evidence to prove that the facility did not provide adequate food service for the residents. Therefore, the allegation is deemed Unsubstantiated at this time.

Facility was not kept free from insects/pests:
In regards to the allegation, it was reported that a resident found a brown maggot in the bathroom. No other information was provided in regards to insects or pests in the facility. According to the administrator, she's never received any complaints of insects or pests at the facility when she had residents. LPA conducted a physical plant inspection of the physical plant. The facility is a one story building with four bedrooms and two bath. No insects/pests were observed during the plant inspection. LPA was unable to interview any residents at the time of investigation as facility census is currently zero. According to the administrator, she did not receive any complaints from her past residents or their families in regards to insects for pests. Based on the information obtained, there was insufficient evidence to prove the facility is not kept free from insects and pests. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20250220154740

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ESSENTIAL CARE ASSISTED LIVING	FACILITY NUMBER: 197610176
	VISIT DATE: 03/19/2025

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

Facility staff withheld fluids to control resident's incontinence:
In regards to the allegation it was reported that Resident 2 (R2) was not served or given water in the evening because R2 is incontinent and staff wanted to avoid any incontinent accidents at night. Interview with staff deny the allegation. She acknowledge that R2 was incontinent, but had a diaper, which was checked on throughout the night to insure that no change was needed. Administrator stated that goes the same for her other two residents that required incontinent care. LPA was unable to interview any residents at the time of investigation as facility census is currently zero. According to the administrator, she did not receive any complaints from residents or their families in regards to withholding fluids to control a resident's incontinent care. Based on the information obtained, there was insufficient evidence to prove that staff withheld fluids to control a resident's incontinence. Therefore, the allegation is deemed Unsubstantiated at this time.

Resident using couch in common area as a sleeping room:
In regards to the allegation, it was reported that there was another person, a non-resident, who would visit the facility, and sleep on the facility couch. The complaint report did not identify who this person is. Interviews with the administrator deny the allegation. The only persons that she identifies that comes and works at her facility is her assistant administrator and her husband. They would never sleep while on duty, or while there are residents in care. LPA was unable to interview any residents at the time of investigation as facility census is currently zero. According to the administrator, she did not receive any complaints from residents or their families in regarding individuals/non residents using the couch in common areas as a sleeping room. Based on the information obtained, there was insufficient evidence to prove that there was an individual/non resident using the couch in common areas as a sleeping room. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 3