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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610393
Report Date: 01/31/2024
Date Signed: 01/31/2024 02:41:11 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
10/25/2023 and conducted by Evaluator Christopher Alemoh
COMPLAINT CONTROL NUMBER: 31-AS-20231025083533
FACILITY NAME:NEASISFACILITY NUMBER:
197610393
ADMINISTRATOR:GHAZARYAN, ANIFACILITY TYPE:
740
ADDRESS:8523 TERHUNE AVETELEPHONE:
(747) 250-9701
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY:6CENSUS: 4DATE:
01/31/2024
UNANNOUNCEDTIME BEGAN:
10:09 AM
MET WITH:Levon KhalulyanTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff left resident on the floor
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christopher Alemoh conducted a subsequent complaint visit to the facility to investigate the above allegation. LPA met with the Administrator Levon Khalulyan and advised them of the complaint.

It was alleged that staff left resident on the floor. To investigate the allegation, on 1/31/2024, at 1030 LPA conducted a physical plant tour. At 11:15 AM LPA requested facility files at 12:00 PM, LPA interviewed (6) staff at 1:30 PM and three (3) residents at 2:30 PM. Physical plant tour revealed all residents have call buttons. File review noted all staff is up- to date on Staff trainings. Administrator stated all residents are checked on every twenty to thirty minutes. taff Three (3) out of (4) four resident interviews stated they have never fallen at the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Christopher Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
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-20231025083533
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: NEASIS
FACILITY NUMBER: 197610393
VISIT DATE: 01/31/2024
NARRATIVE
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Staff provides a good and safe level of care. R1 stated prior to this incident she has never fallen, and staff has never left her unattended. R1 stated both staff and her fell and staff rendered aid.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards noted during the visit.

Exit interview conducted and a copy of the report was issued.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Christopher Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2