306005792-5-17-2026-22-AS-AORZ-DUNT6Z-20260602142759

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005792
Report Date: 05/16/2026
Date Signed: 05/17/2026 10:30:02 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/18/2024 and conducted by Evaluator Samer Haddadin

COMPLAINT CONTROL NUMBER: 22-AS-20240118162702

FACILITY NAME:	BLUE SKY MANOR INC		FACILITY NUMBER:	306005792
ADMINISTRATOR:	SONA HAKOBYAN		FACILITY TYPE:	740
ADDRESS:	280 N WILSHIRE AVE		TELEPHONE:	(714) 844-2667
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	50	CENSUS: 41	DATE:	05/16/2026
		UNANNOUNCED	TIME BEGAN:	08:17 AM
MET WITH:	Gabriel Airapetian		TIME COMPLETED:	04:19 PM

ALLEGATION(S):

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1-Staff accessed residents banking information without authorization.
2-Staff is contacting the resident online and harassing the resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced site visit to the facility to investigate and deliver findings regarding the above-mentioned allegations Upon arrival, Administrator (AD) Gabriel Airapetian greeted LPA Haddadin, granted entry into the facility, and was informed of the purpose of the visit.
During the course of the investigation, LPA Haddadin conducted a health and safety walk-through of the facility, observed the physical plant, reviewed relevant facility records, and conducted interviews with four staff members and four residents. The investigation also included a review of records related to Resident (R1’s) admission and discharge history.
Regarding the allegation that “Staff accessed resident’s banking information without authorization,” Records reviewed revealed that R1 was admitted to the facility on 03/25/2020 and discharged on 09/24/2020 under the CalOptima recuperative program. {***CONTINUE 9099C***}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2026

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 22-AS-20240118162702

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BLUE SKY MANOR INC	FACILITY NUMBER: 306005792
	VISIT DATE: 05/16/2026

NARRATIVE

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Records reviewed did not show documentation indicating that the facility was authorized to access, manage, or control R1’s banking information. Additionally, records reviewed did not indicate that the facility maintained banking records, financial account information, or other financial documents belonging to R1. four out of four staff interviewed denied that facility staff accessed R1’s banking information without authorization. Staff stated that the facility does not obtain, keep, maintain, or manage residents’ banking information. Four out of four residents interviewed did not provide information to support the allegation. The residents interviewed denied having knowledge of facility staff accessing residents’ banking information without authorization and did not report concerns involving staff misuse of resident financial information.
Regarding the allegation that “Staff is contacting the resident online and harassing the resident,” four out of four staff interviewed denied that facility staff contacted R1 online or harassed R1. Staff denied having knowledge of any staff member contacting R1 through social media, electronic messaging, or any other online platform in a harassing, threatening, retaliatory, or inappropriate manner. Four out of four residents interviewed did not provide information to support the allegation. The residents interviewed denied having knowledge of staff contacting residents in a harassing manner and did not report concerns involving staff harassment, intimidation, retaliation, or inappropriate communication.
Based on observations, interviews conducted, and records reviewed, the Department was unable to determine whether the above allegations occurred as reported. Although the allegations may have happened or may be valid, there was not a preponderance of evidence to prove or disprove that the alleged violations occurred. Therefore, the allegations are deemed unsubstantiated. An exit interview was conducted with Administrator (AD) Gabriel Airapetian. A copy of this report was discussed with and provided to AD Gabriel Airapetian at the conclusion of the visit.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2026

LIC9099 (FAS) - (06/04)

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