374604781-2-11-2026-08-AS-APAO-DRMS2D-20260225122923

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604781
Report Date: 02/11/2026
Date Signed: 02/11/2026 05:15:26 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/06/2026 and conducted by Evaluator Dang Nguyen

COMPLAINT CONTROL NUMBER: 08-AS-20260206090140

FACILITY NAME:	LILOS TENDER SENIOR CARE INC I		FACILITY NUMBER:	374604781
ADMINISTRATOR:	BEBEKYAN, NVARD		FACILITY TYPE:	740
ADDRESS:	4149 ROLANDO BLVD		TELEPHONE:	(818) 284-2502
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY:	6	CENSUS: 6	DATE:	02/11/2026
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Caregiver Ashley Vidaurre Cruz and House Manager Stephanie Molina		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

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Licensee's staff filmed a resident without their permission.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to commence a Complaint Investigation regarding the above allegations. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Ashley Vidaurre Cruz. LPA then met with House Manager Stephanie Molina, who arrived shortly after. LPA also spoke via phone with Licensee Anna Petrosyan, via phone.

The Complainant alleged that Licensee’s staff filmed a resident without their permission. CCLD’s investigation involved an unannounced facility tour/welfare check and interviews of all residents in care, multiple pertinent staff, and outside sources. The Department also reviewed relevant care records, work schedule, and staff log notes.

[CONTINUED ON LIC 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026

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 08-AS-20260206090140

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: LILOS TENDER SENIOR CARE INC I	FACILITY NUMBER: 374604781
	VISIT DATE: 02/11/2026

NARRATIVE

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[CONTINUED FROM LIC 9099]

Specifically, the Complainant said on a date in early February 2026, Staff #1 (S1) used their personal smartphone camera to film Resident #1 (R1) while providing incontinence care to R1, while inside R1’s bedroom. [See LIC811 Confidential Names List for a description of person identifiers used in this report.]

Records and interviews aligned to show: R1 was incontinent and routinely required assistance of two (2) caregivers to be cleaned in bed, and to have their Depends changed. During the alleged incident, R1 was assisted by both S1 and Staff #2 (S2) with incontinence care. S1 denied filming R1, either during that incident or on any other day. S2 said they were sure they did not see S1 film R1, either during that incident or any other day.

S1 gave LPA permission to access and review the photographs which were stored on their personal smartphone. LPA reviewed both the currently stored photographs as well as the file containing recently deleted photographs. LPA found no photographs of videos of R1 stored on S1’s smartphone.

LPA interviewed multiple other coworkers; none of these staff had ever seen S1 film R1 or any other residents without their permission. LPA interviewed all five (5) of R1’s housemates/peers; all these residents denied staff ever filming them without their permission.

Based on records and interviews, a preponderance of evidence does not exist to show that Licensee’s staff filmed a resident without their permission. The allegation is therefore Unsubstantiated, and no deficiency was cited for it.

An exit interview was conducted with House Manager Stephanie Molina. A copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Licensee during today’s visit.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026

LIC9099 (FAS) - (06/04)

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