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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610498
Report Date: 07/10/2025
Date Signed: 07/10/2025 01:56:54 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.ASC, 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
05/14/2025 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20250514171142
FACILITY NAME:LOS ANGELES ASSISTED LIVINGFACILITY NUMBER:
197610498
ADMINISTRATOR:ARZUMANYAN, ANUSHFACILITY TYPE:
740
ADDRESS:15216 CHATSWORTH STREETTELEPHONE:
(424) 666-5666
CITY:MISSION HILLSSTATE: CAZIP CODE:
91345
CAPACITY:6CENSUS: 6DATE:
07/10/2025
UNANNOUNCEDTIME BEGAN:
08:58 AM
MET WITH: Anush Arzumanyan - AdministratorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not safeguard resident's funds
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jose Tan conducted an unannounced initial complaint visit at this facility to investigate the above allegation. LPA met with Administrator Anush Arzumanyan and explained the reason for the visit.

LPA conducted physical plant tour at 9:09 AM, requested copies of facility documents relevant to the investigation at 9:45 AM, reviewed records between 10:00 AM to 11:00 AM and interviewed residents and staff between 11:00 AM to 12:30 PM. Regarding the allegation that Staff did not safeguard resident's funds, it was alleged that Resident #1 (R1)'s bank statement had unrecognized transaction by R1 amounting to $1599.96 from 02/03/25 to 04/16/25. LPA's record review of R1's physician's report (LIC 602) today between 10:00 AM to 11:00 AM revealed that R1 is able to manage own cash resources. LPA's physical plant on prior visit on 05/22/25 revealed that R1's bank card was kept locked together with R1's medication, it was locked during LPA's visit. LPA's interview with R1 today revealed that R1 went to the bank and now has a new bank card and has R1's money regularly coming into R1's bank account. (continued on LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025
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 2
Control Number 31-AS-20250514171142
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: LOS ANGELES ASSISTED LIVING
FACILITY NUMBER: 197610498
VISIT DATE: 07/10/2025
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
(continued from LIC 9099)

Further interview with R1 revealed that R1 preferred to keep own bank card the way it is instead of being locked in the safe inside the office so R1 can access it anytime R1 needs money. Moreover, R1 stated that R1's case worker filed fraud on R1's bank due to this transactions.

LPA's interview with the Administrator and co-Administrator revealed that they had no online access to R1's bank account nor were they aware of the transactions listed on R1's bank statements. LPA's record review of R1's bank statements revealed that most of the transactions were online order for food and some in store purchases near the facility. LPA's interview with two (2) staff on 05/22/25 revealed that none of them had used R1's bank card but stated that they sometime go with R1 to purchase own stuff such as cigarettes and some food. LPA observed during today's visit revealed that R1's bank card and some cash money are still kept in R1's wallet together with R1's medication and locked in the medication cabinet in the kitchen.

Based on the information gathered during this and prior visit, the allegation is deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2