197610754-2-18-2026-31-AS-MGFS-DRQ2K5-20260227162718

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610754
Report Date: 02/18/2026
Date Signed: 02/18/2026 12:23:44 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.RO, 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
02/09/2026 and conducted by Evaluator Evelin Rios

COMPLAINT CONTROL NUMBER: 31-AS-20260209085900

FACILITY NAME:	DIGNITY ASSISTED LIVING LLC		FACILITY NUMBER:	197610754
ADMINISTRATOR:	MAHMOODZADEH,NIRVANA		FACILITY TYPE:	740
ADDRESS:	11000 NOBLE AVE		TELEPHONE:	(818) 913-7799
CITY:	MISSION HILLS	STATE: CA	ZIP CODE:	91345
CAPACITY:	6	CENSUS: 6	DATE:	02/18/2026
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Nirvana Ghaemi Mahmoodzadeh - Administrator		TIME COMPLETED:	11:30 PM

ALLEGATION(S):

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Staff did not clean the facility.
Staff did not keep facility from being malodorous.

INVESTIGATION FINDINGS:

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On 02/18/2026 at 9:15 a.m., Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced complaint visit to this facility to investigate the above allegations. Upon arrival, LPA met with Staff #1 (S1) and requested that S1 contact the Administrator. LPA met with the Administrator, Nirvana Mahmoodzadeh shortly after and explained the reason for the visit. In the facility there were six (6) residents and two (2) staff. LPA requested a copy of the Register of Facility Residents (LIC9020) and Personnel Report (LIC500).

LPA Rios initiated a physical plant inspection at approximately 9:29 a.m. LPA did not observe any immediate health or safety concerns with the physical plant. From 9:29 a.m. to 10:30 a.m., LPA interviewed five (5) out of six (6) residents. An interview was attempted with one resident; however, the resident did not provide responses related to the allegation. LPA also conducted interviews with S1 and the Administrator. During the physical plant inspection LPA focused on the facility kitchen, three (3) shared bedrooms and two (2) bathrooms. LPA also requested and reviewed staff records for S1 and Staff #2(S2).
(Continue to LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026

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-20260209085900

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: DIGNITY ASSISTED LIVING LLC	FACILITY NUMBER: 197610754
	VISIT DATE: 02/18/2026

NARRATIVE

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Allegation: Staff did not clean the facility.
In regards to the allegation it was reported that the kitchen floors were grimy and dirty, and that multiple towels on the floor appeared used and old. During the physical plant tour, LPA Rios did not observe the kitchen floors to be dirty or sticky, nor were any towels observed on the floor. LPA observed hampers for residents to place their dirty laundry. According to S1 cleaning rags are kept separate and laundered on their own. LPA's interviews with residents did not corroborate the allegation. LPA's interviews with the caregiver and the Administrator also denied the allegation. The caregiver reported that the kitchen floors are mopped after meals and at least every morning and evening. Based on the LPA’s observations and interviews, the allegation, staff did not clean the facility is deemed Unsubstantiated at this time.

Allegation: Staff did not keep facility from being malodorous.
In regards to the allegation, it was reported that the facility had a strong odor of urine and bleach. During the physical plant tour, LPA Rios did not detect any foul odors or strong scents of cleaning products. The Administrator stated that the facility uses Fabuloso to mop the floors and Lysol products to clean the bathrooms. LPA also observed Clorox stored in the laundry area. LPA's interviews with residents did not corroborate the allegation. One (1) resident reported that the facility has not had bad odors and that while the home may occasionally smell of cleaning products, it does not bother them. Staff interviews further indicated that they have not received complaints from residents regarding cleaning product odors or unpleasant smells. Based on the LPA’s observations and interviews, the allegation, staff did not keep facility from being malodorous is deemed Unsubstantiated at this time.

Exit interview was conducted and a copy of the report was issued.

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026

LIC9099 (FAS) - (06/04)

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