195850176-8-26-2026-29-AS-CYEE-DXC4EJ-20260826190225

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195850176
Report Date: 08/26/2026
Date Signed: 08/26/2026 07:02:49 PM

Document Has Been Signed on 08/26/2026 07:02 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME:	NOHO ASSISTED LIVING, INC		FACILITY NUMBER:	195850176
ADMINISTRATOR/ DIRECTOR:	ARPINE MKRTCHYAN		FACILITY TYPE:	740
ADDRESS:	6331 SIMPSON AVE		TELEPHONE:	(818) 404-0550
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY: 6		CENSUS: 4	DATE:	08/26/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:	Arpine Mkrtchyan, Administrator		TIME VISIT/ INSPECTION COMPLETED:	07:10 PM

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	Licensing Program Analyst(LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool. LPA Yee met with Arpine Mkrtchyan, Administrator. Also present during the visit was Arsen Yanukyan and Anahit Anatomyan, Staff. The reason for today's visit was provided. The facility is a single storey family home consisting of a living room, dining room, a kitchen, 3 resident bedrooms, 2.5 bathrooms, a den, a laundry room and a attached garage. The facility is fire cleared for 6 non-ambulatory residents. On today's visit, all 12 domains of the CARE Inspection Tool, 4 resident and 5 staff files were reviewed. 1 resident is receiving hospice services and 2 residents are receiving home health services. A tour of the physical plant was also conducted inside and outside. The following was observed on today's visit: the living room, dining room and kitchen are furnished and equipped with the appropriate furniture and equipment for its designated use. The fire place located in the living room was observed with a fire screen. all three resident rooms are shared rooms and are furnished with 2 beds, 2 night stands, 2 lamps, 2 chairs, 2 dressers and a built in closet. All the windows were observed with blinds for privacy. the facility has 2.5 bathrooms. A full private bathroom was observed in bedroom #1. The bathroom has a walk in shower, a toilet and a vanity with a single sink. Grab bars, a slip resistant mat and a shower chair were observed. The water temperature was tested and read 115.9 degrees Fahrenheit. Continued on LIC809-C

Kristin Heffernan
Christine Yee
	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: NOHO ASSISTED LIVING, INC	FACILITY NUMBER: 195850176
	VISIT DATE: 08/26/2026

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the common bathroom located in the resident hallway is equipped with a tub with a shower head, a toilet and a vanity with a single sink. Grab bars and a slip resistant mat was observed. The water temperature was tested and read 116.1 degrees Fahrenheit.
the other common bathroom also located in the resident hallway is equipped with a toilet and a vanity with a single sink. The water temperature was tested and read 115.8 degrees Fahrenheit.
extra bed linens and towels were observed in the linen closet located in the hallway.
the laundry closet was observed with a washer and dryer. Laundry detergents are locked in a locked cupboard.
the hardwired smoke detectors located in the resident bedrooms and the combination smoke/carbon monoxide detectors located in resident hallway and in the living room were tested and were operational.
The fire rated door located between the living room and resident hallway was activated when the smoke detectors were triggered and released the door to secure the bedrooms.
the only fire extinguisher is located in the kitchen was purchased on 7/14/26.
sufficient perishable foods for a minimum of 2 days and non-perishable foods for a minimum of 7 days were observed maintained on the premises.
the Administrator's certificate is current.
the first aid kit was reviewed and a first aid manual was observed.
the facility has current liability insurance that meets Title 22 requirements.
medications are stored in a metal filing cabinet located in the kitchen.
disinfectants and cleaning solutions are stored in a locked cabinet under the kitchen sink, sharp knives are stored in a locked kitchen draw and the laundry detergent are stored in a locked cupboard in the laundry closet.
a table with chairs and an umbrella were observed in the backyard.
trash cans stored in the front yard were observed to be tightly sealed.
overall the inside and outside of the facility were observed to be clean.

No deficiencies cited on today's visit.

Exit interview was conducted.

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

LIC809 (FAS) - (06/04)

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