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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610446
Report Date: 04/25/2025
Date Signed: 04/25/2025 03:22:06 PM

Substantiated


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
11/18/2024 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20241118163523
FACILITY NAME:GLOBUS SENIOR LIVING INCFACILITY NUMBER:
197610446
ADMINISTRATOR:ABRAMIAN, RAFAELFACILITY TYPE:
740
ADDRESS:17339 HORACE STTELEPHONE:
(323) 491-0077
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 3DATE:
04/25/2025
UNANNOUNCEDTIME BEGAN:
08:58 AM
MET WITH:Svetlana MovsisyanTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Licensee admitted Resident with a prohibited health condition
Resident developed multiple pressure injuries in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Cava conducted a subsequent complaint visit to this facility to conclude the investigation regarding the above allegations. It was reported that Resident 1 (R1) was admitted to the hospital on 11/15/2024 with a stage 4 wound. R1 had at least 5 pressure injuries, but the worst was the stage 4 wound that was not present when released from the hospital sometime in August 2024 to a skilled nursing facility. From the skilled nursing facility, R1 was admitted to this facility. The ten day visit was made by LPA Cava on 11/19/24, followed by another subsequent visit made by LPA Cava on 03/25/25. LPA Cava’s investigation consisted of interviews with facility administrator, staff and residents. LPA also obtained and reviewed facility and hospital records.

Interviews with administrator reveal that R1 was admitted to the facility with a wound greater than a stage 2 on 08/31/24. Home Health services was ordered, but had yet to be initiated when R1 was admitted into facility. R1 moved into this facility from a Rehab Center, already with a pressure injury.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2025
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 4
Control Number 31-AS-20241118163523
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: GLOBUS SENIOR LIVING INC
FACILITY NUMBER: 197610446
VISIT DATE: 04/25/2025
NARRATIVE
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Review of both facility records and hospital records reveal the following:
  • R1 was discharged from a health care facility and admitted to this facility on 08/31/24.
  • At discharge from the health care facility, there is record that R1 has a pressure injury greater than stage 2.
  • R1’s physician report indicates a history of skin condition or breakdown with an explanation of a stage 4 pressure injury.
  • On 11/15/24, R1 was transferred to the hospital for weakness.
  • Review of hospital records obtained by LPA on 04/12/25 confirm R1 was admitted into hospital on 11/15/24 for weakness and wounds.
  • Hospital records also reveal that R1 had multiple wounds, notably one Stage 4 and one Stage 3, not identified when resident was admitted to the facility o 08/31/24.
  • Licensee has no home health records on file to document these wounds were being treated while R1 was in care at the facility.
  • Investigations Branch (IB) and LPA Cava attempted to obtain R1’s home health records from the home health agency to no avail.


Based on the information obtained, there is sufficient evidence that the facility admitted and retained R1 with a prohibited health condition. Moreover, it appears that licensee failed to meet R1’s needs as R1 developed multiple pressure injuries while in care at the facility. Therefore, based on the information obtained, the allegations of the Licensee admitting R1 with a prohibited health condition and R1 developing multiple pressure injuries in care are Substantiated. Citations issued on the 9099D.

Licensee advised of possible Civil Penalty and Enhanced Civil Penalties (ECPs) may be assessed.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 31-AS-20241118163523
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: GLOBUS SENIOR LIVING INC
FACILITY NUMBER: 197610446
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/25/2025
Section Cited
CCR
87616(a)(1)
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Prohibited Health Conditions- Persons who require health services for or have a health condition, including but not limited to (1) Stage 3 and 4 pressure Injuries, shall not be admitted or retained in a residential care facility for the elderly. This requirement was not met as evidenced by:
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As Plan of Correction, the licensee will hold training to address this section of the regulation. As proof training was conducted, copy of attendance log, training topic and date training held due to the licensing agency by May 9, 2025.
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Record review reveal that the licensee admitted R1 into facility with a stage 4 pressure injury on 08/31/24. This posed an immediate health and safety risk to the resident in care.
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Type A
04/25/2025
Section Cited
CCR
87465(a)(1)
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Incidental Medical and Dental Care- The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. This requirement was not met as evidenced by: Licensee admitted R1 into the facility without initiating home health to address R1's
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As Plan of Correction, the licensee will hold training to address this section of the regulation. As proof training was conducted, copy of attendance log, training topic and date training held due to the licensing agency by May 9, 2025.
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stage 4 injury. Moreover, while in care, R1 developed multiple wounds, most notably another stage 4 wound and stage 3 wound. This posed an immediate health and safety risk to the resident 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: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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
11/18/2024 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20241118163523

FACILITY NAME:GLOBUS SENIOR LIVING INCFACILITY NUMBER:
197610446
ADMINISTRATOR:ABRAMIAN, RAFAELFACILITY TYPE:
740
ADDRESS:17339 HORACE STTELEPHONE:
(323) 491-0077
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 3DATE:
04/25/2025
UNANNOUNCEDTIME BEGAN:
08:58 AM
MET WITH:Svetlana MovsisyanTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility staff did not meet resident's dietary needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Cava conducted a subsequent complaint visit to this facility to conclude the investigation regarding the above allegation. It was reported that Resident 1 (R1) required a feeding tube and was not fed enough protein while residing at facility. As a result, R1 had lost a lot of weight. LPA's investigation consisted of interviews with the administrator, staff and residents. LPA also obtained R1's records for review.

Interviews with administrator and staff revealed that R1 did not require a feeding tube at admission. Moreover, record review at discharge from the health care facility had no indication that a feeding tube was required at discharge. R1's physician report only indicates no salt added to R1's diet. Interviews with four (4) of four residents reveal no concerns regarding facility's food service. R1's weight went from 162lbs to 155lbs from admission to facility to hospitalizaiton, which did not constitute a significant weight loss. Based on the information obtained, there wasn't enough evidence to prove that staff did not meet R1's dietary needs. Therefore, the allegation is deemed Unsubstantiated at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4