197610625-7-26-2025-31-AS-EMIR-DKGU79-20250812151934

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610625
Report Date: 07/26/2025
Date Signed: 07/26/2025 02:20:15 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
04/03/2025 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20250403084147

FACILITY NAME:	GUARDIAN ANGELS BOARD AND CARE		FACILITY NUMBER:	197610625
ADMINISTRATOR:	GOR KHURSHUDYAN		FACILITY TYPE:	740
ADDRESS:	11786 ENCINO AVE		TELEPHONE:	(818) 217-9444
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 2	DATE:	07/26/2025
		UNANNOUNCED	TIME BEGAN:	08:17 AM
MET WITH:	Gor Khurshudyan		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff did not meet resident's care needs.
Staff did not allow resident to continue hospice services of resident's choice.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a subsequent complaint visit to conclude the investigation regarding the above allegations. LPA met with the administrator, Gor Khurshudyan and advised him of the allegations. LPAs investigation consisted of intervies with the administrator, staff and residents. LPA also conducted a record review and a physical plant inspection to insure facility compliance with regulation.

Regarding the above allegations, it was reported that the licensee would not allow for Resident 1 (R1) to receive hospice services from an agency of R1's preference. R1 would have to receive hospice services from an agency recommended by the licensee. As a result, R1's care needs were not met.

Interviews with the Administrator and Staff 1 (S1) deny both allegations. According to both, R1 was given the right to choose what hospice agency to provide service for at admission. R1 was admitted on or around 03/08/25, but moved out two weeks later because R1 required a higher level of care that the licensee

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2025

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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Control Number 31-AS-20250403084147

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: GUARDIAN ANGELS BOARD AND CARE	FACILITY NUMBER: 197610625
	VISIT DATE: 07/26/2025

NARRATIVE

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could not provide. Administrator stated R1 went to the hospital, and then to a post acute center. Administrator adds that R1 would not be returning to the facility based on their needs.

Interviews with R1's Family (RF) and Family Friend (FF) also deny both allegations. Both RF and FF confirm that R1 only stayed at the facility for about a week, but had no complaints regarding facility services. Both stated, in that time they were happy with the care provided by the licensee and facility staff, and expressed regret that R1 had to be transferred for a higher level of care. When asked if staff was able to meet R1's needs, both RF and FF stated yes, R1's needs were met. The main complaint or concern was with the hospice agency. Both RF and FF stated hospice took to long to process R1's paperwork for R1 to receive physical therapy. Both RF and FF stated the facility administrator tried his best to help as much as he can to assist in getting the paperwork, to no result. Both RF and FF reiterate that the administrator did not force R1 to choose a hospice agency of the licensee's choice, or threaten to not allow R1 to continue with the hospice service of R1's choice. Both RF and FF add that R1 is still capable of making decisions.

Interview with three (3) of three residents deny the allegations of not being able to select a hospice agency of their choice, or staff not meeting their needs. Telephone interview with R1 confirm that this complaint is not meant towards the facility, but for the hospice agency that caused a delay in processing the hospice paperwork. When interviewed, R1 was happy with care and service provided by facility staff, and staff was able to meet R1's needs for the short stay there at the facility.

Based on the information obtained, it could not be proven that "Staff did not meet resident's care needs and
Staff did not allow resident to continue hospice services of resident's choice". Therefore, both allegations are deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2025

LIC9099 (FAS) - (06/04)

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