197610483-8-29-2024-31-AS-EMIR-DDMQUX-20250206112926

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610483
Report Date: 08/29/2024
Date Signed: 08/29/2024 02:13:33 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
08/22/2024 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20240822103213

FACILITY NAME:	LIFELONG SENIOR LIVING		FACILITY NUMBER:	197610483
ADMINISTRATOR:	KAPIKYAN, ANDRANIK		FACILITY TYPE:	740
ADDRESS:	16003 LUDLOW ST		TELEPHONE:	(818) 371-5979
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 6	DATE:	08/29/2024
		UNANNOUNCED	TIME BEGAN:	09:28 AM
MET WITH:	Lewis Ndende		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff does not allow resident access to phone.
Resident was verbally abused while in care.
Staff does not assist resident in a timely manner.
Staff are not meeting resident's dietary needs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPA met with staff, Lewis Ndende, and advised him of the complaint. Administrator, Adranik Kapikyan is currently out, but was reached over the telephone.

Staff does not allow resident access to phone:
In regards to the allegation, it was reported that Staff 1 (S1) does not allow Resident 1 (R1) to use the house phone to make calls. The facility has one telephones available for resident use. Phone is located in the livingroom. Interview with two (2) of two staff deny the allegation. Interviews made with six (6) of six residents does not corroborate with the allegation. During the visit, LPA tested the facility phone, and was able to observe the phone to be functional. Based on the information obtained, there was insufficient evidence to prove the allegation of resident not being allowed access to the the telephone. 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: 08/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

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 3

Control Number 31-AS-20240822103213

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: LIFELONG SENIOR LIVING	FACILITY NUMBER: 197610483
	VISIT DATE: 08/29/2024

NARRATIVE

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Resident was verbally abused while in care:
In regards to the allegation, it was reported that there was a physical incident between R1 and S1 which resulted in S1 contacting law enforcement and the fire department. R1 also reported that S1 was verbally "aggressive" towards them. Details were unknown as there was no time, date or witnesses identified. Interviews made with two of two staff deny the allegation. According to staff and the administrator, R1 has a history of making false accusations. Moreover, interviews with staff and one resident stated that it was R1 being aggressive to staff, which resulted in a call to law enforcement. No reports were left by law enforcement. Review of R1's records indicate that R1 has a diagnosis that can contribute to them making these claims. Interviews made with six (6) of six residents also do not corroborate with the allegation. Resident interviews also reveal that they have never witnessed staff being aggressive towards their peers. Based on the information obtained, there was insufficient evidence to prove R1 was verbally abused while in care. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff does not assist resident in a timely manner:
In regards to the allegation, it was reported that when R1 makes a request for assistance or asks for something, S1 takes a long time to respond, and at times go missing. Interviews with two (2) of two staff deny the allegation, revealing that they haven't gotten any complaints or concerns of them not replying for assistance within a timely manner. Moreover, staff stated most residents are independent and prefer to get things done on their own. Interviews with six (6) of six residents do not corroborate with the allegation, stating they do not have any concerns with staff not being able to meet their needs, or not replying to their calls for assistance in a timely manner. Based on the information obtained, there was insufficient evidence to prove that staff do not assist residents in a timely manner. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff are not meeting resident's dietary needs:
In regards to the allegation, it was reported that R1 is vegan and the facility sometimes runs out of the food they prefer. Review of R1's medical assessment does not indicate that R1 requires a special diet. Moreover, review of R1's admission agreement doesn't indicate any options, or extra pay for this type of meal provided or special service. Interviews with six (6) of six residents reveal no concerns regarding the facility food

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20240822103213

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: LIFELONG SENIOR LIVING	FACILITY NUMBER: 197610483
	VISIT DATE: 08/29/2024

NARRATIVE

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service. According to two (2) of two staff, they do try to accommodate, but there are times that R1 does not like meals that are served. Alternatives are then offered, which R1 would still decline at times. Interview with the administrator reveals that, even though vegan diet wasn't even included in R1's optional service, administrator still accommodates R1's preference in meals. Based on the information obtained, there was insufficient evidence to prove that staff are not meeting the resident's dietary needs. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

LIC9099 (FAS) - (06/04)

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