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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610320
Report Date: 02/12/2026
Date Signed: 02/12/2026 04:33:10 PM

Substantiated


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
02/11/2026 and conducted by Evaluator Perchui Khurshudyan
COMPLAINT CONTROL NUMBER: 31-AS-20260211145326
FACILITY NAME:WINNETKA HOME CAREFACILITY NUMBER:
197610320
ADMINISTRATOR:HARUTUNYAN, ALLAFACILITY TYPE:
740
ADDRESS:19733 HEMMINGWAY STTELEPHONE:
(818) 434-9916
CITY:WINNETKASTATE: CAZIP CODE:
91306
CAPACITY:6CENSUS: 4DATE:
02/12/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Andranik Kapikyan - AdministratorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not follow resident’s dietary needs.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 2/12/2026 at approximately 9:00am, Licensing Program Analysts (LPAs) Perchui Milena Khurshudyan and Mariana Agban, Licensing Program Manager Nichelle Gillyard conducted an unannounced visit to investigation into the above allegation. Upon arrival LPAs met with the Staff/Caregiver Isaiah Phiri and explained the reason for the visit. The facility Administrator got contacted over the phone and arrived shortly after.

At approximately 9:15am LPAs conducted a physical plant tour. At approximately 9:25am, LPA requested residents and staff rosters. LPA also requested copies of pertinent information which include, but not limited to Physician’s report, Admission Agreement, Appraisal Needs and Services Plan, and potential documents relevant to the investigation. Between 9:30am – 11:45am, LPA reviewed four (4) residents files. LPA also conducted interviews with the Administrator, one (1) staff/Caregivers, and two (2) out of four (4) residents who were able to answer questions.
Continue on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
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 5
Control Number 31-AS-20260211145326
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: WINNETKA HOME CARE
FACILITY NUMBER: 197610320
VISIT DATE: 02/12/2026
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
Allegation: Staff does not follow resident’s dietary needs.

It was reported that staff are providing fried food. RP stated dietitian, RP cannot have fried food.
To investigate this allegation LPA conducted a review of Residents files, interviewing staff and residents, and observing meal service during the visit. LPA reviewed R1’s Physician Report LIC602A signed by the physician and dated on 1/27/26, which indicated that R1 has a diagnosis of diabetes and requires a restricted diet consistent with diabetic dietary guidelines. During the visit, LPA observed the breakfast served to R1. The meal consisted of scrambled eggs mixed with spicy pork Mexican sausage, yogurt, white bread, and coffee. Although the portion size was adequate, the meal was high in sodium and included items not appropriate for a diabetic or restricted diet, specifically the spicy pork sausage and white bread. LPA interviewed one (1) caregiver, who stated he/she was not fully aware of R1’s dietary requirements and generally prepared meals without customized dietary needs. LPA attempted to interview four (4) residents. Two (2) out of four (4) residents (R1 and R2) who agreed to answer questions, reported no concerns with food portions. However, R1 stated that staff do not ask for meal preferences and typically serve whatever is prepared, without regard to dietary restrictions. LPA also interviewed the administrator, who confirmed that the facility maintains a sufficient supply of food. LPA suggested Administrator to review all residents' files/records and follow dietician orders.
Based on record review, observation, staff and resident interviews, and the administrator’s statements, there is sufficient evidence to support the allegation that staff does not follow residents’ dietary needs. Therefore, the allegation is Substantiated.

A Deficiency is being cited on the LIC9099D.

Exit interview conducted and copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 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
02/11/2026 and conducted by Evaluator Perchui Khurshudyan
COMPLAINT CONTROL NUMBER: 31-AS-20260211145326

FACILITY NAME:WINNETKA HOME CAREFACILITY NUMBER:
197610320
ADMINISTRATOR:HARUTUNYAN, ALLAFACILITY TYPE:
740
ADDRESS:19733 HEMMINGWAY STTELEPHONE:
(818) 434-9916
CITY:WINNETKASTATE: CAZIP CODE:
91306
CAPACITY:6CENSUS: 4DATE:
02/12/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Andranik Kapikyan - AdministratorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not provide nutritious meals for resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 2/12/2026 at approximately 9:00am, Licensing Program Analysts (LPAs) Perchui Milena Khurshudyan and Mariana Agban, Licensing Program Manager Nichelle Gillyard conducted an unannounced visit to investigation into the above allegation. Upon arrival LPAs met with the Staff/Caregiver Isaiah Phiri and explained the reason for the visit. The facility Administrator got contacted over the phone and arrived shortly after.

At approximately 9:15am LPAs conducted a physical plant tour. At approximately 9:25am, LPA requested residents and staff rosters. LPA also requested copies of pertinent information which include, but not limited to Physician’s report, Admission Agreement, Appraisal Needs and Services Plan, and potential documents relevant to the investigation. Between 9:30am – 11:45am, LPA reviewed four (4) residents files. LPA also conducted interviews with the Administrator, one (1) staff/Caregivers, and two (2) out of four (4) residents who were able to answer questions.
Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 31-AS-20260211145326
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: WINNETKA HOME CARE
FACILITY NUMBER: 197610320
VISIT DATE: 02/12/2026
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
Allegation: Staff does not provide nutritious meals for resident.

It was reported that staff does not provide nutritious meals for residents. To investigate the allegation, LPAs conducted interviews with staff, the administrator, and two (2) out of four (4) residents who agreed to be interviewed. LPA also conducted a tour of the facility and observed meal service. During interviews, one (1) of the two (2) residents interviewed (R2) stated that he/she had no complaints or concerns regarding the meals and believed the food provided was nutritious. Resident 1 (R1) reported that meals were not nutritious and stated that no fresh fruits or vegetables were provided. To further investigate the allegation, LPA conducted a tour of the kitchen and food storage areas. LPA observed that the facility had a fully stocked supply of food, including sufficient quantities of perishable and non-perishable items. LPA also observed the breakfast served to R1 during the visit. Although the meal provided was not what R1 requested, it was observed to have an adequate portion size and appeared nutritious. Interview with staff indicated that the facility consistently maintains sufficient food supplies and that meals are prepared daily. Based on interviews and observations, there is insufficient evidence to support the allegation that staff do not provide nutritious meals for residents.

Therefore, the allegation is deemed Unsubstantiated.

Exit interview conducted and copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20260211145326
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: WINNETKA HOME CARE
FACILITY NUMBER: 197610320
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/20/2026
Section Cited
CCR
87555(b)(7)
1
2
3
4
5
6
7
General Food Services...(b)The following food service requirements shall apply:(7)Modified diets prescribed by a resident's physician as a medical necessity shall be provided. This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The administrator has agreed to follow special diet plan for residents require special diet plan and will provide copy of training materials provided to all staff/caregivers regarding food services and special diets.
8
9
10
11
12
13
14
Based on observation and interview, one out of four Residents R1 with diabetes was served the regular meal plan which contains high sodium and sugar. This confirmed that R1 was not on a special diet plan. This poses a potential health and safety risk to resident in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5