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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610483
Report Date: 01/29/2025
Date Signed: 01/29/2025 03:04:46 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 LIVINGFACILITY NUMBER:
197610483
ADMINISTRATOR:KAPIKYAN, ANDRANIKFACILITY TYPE:
740
ADDRESS:16003 LUDLOW STTELEPHONE:
(818) 371-5979
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 6DATE:
01/29/2025
UNANNOUNCEDTIME BEGAN:
10:32 AM
MET WITH:Lewis Ndende, Nsikeloelo MasuloaTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
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:
1
2
3
4
5
6
7
8
9
10
11
12
13
In conjunction to a Required Annual Inspection and complaint control #31-AS-20241218081847, Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to follow up on the above allegation. On 10/17/24 and 11/07/24, two calls were made from a co-complainants addressing the allegation of staff not allowing residents access to the telephone. Initial investigation to this allegation was made on 08/29/24, along with three other allegations. At that time, based on the information received, complaint pertaining to all four allegations were Unsubstantiated. Today's investigation consisted of interviews with staff and residents. A physical inspection was also made to insure the facility has a working telephone. Interviews with two (2) of two staff deny the allegation of staff not allowing residents access to the telephone. Interviews with six (6) of six residents do not corroborate with the allegation. Inspection of the physical plant confirm there is a working telephone on the facility grounds. Based on the information obtained, the allegation of residents not having access remain Unsubstantiated. Moreover, the other three (3) allegations will also remain Unsubstantiated at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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