195850239-7-30-2025-29-AS-KLOZ-DK55XE-20250731202038

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850239
Report Date: 07/30/2025
Date Signed: 07/30/2025 03:02:50 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/11/2025 and conducted by Evaluator Trevor Byrne

COMPLAINT CONTROL NUMBER: 29-AS-20250611114359

FACILITY NAME:	SILVER LIGHT CARE		FACILITY NUMBER:	195850239
ADMINISTRATOR:	KHACHATRYAN, ELBA		FACILITY TYPE:	740
ADDRESS:	8201 VANTAGE AVENUE		TELEPHONE:	(747) 228-4111
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91605
CAPACITY:	6	CENSUS: 6	DATE:	07/30/2025
		UNANNOUNCED	TIME BEGAN:	01:27 PM
MET WITH:	Edgar Khachatryan		TIME COMPLETED:	03:05 PM

ALLEGATION(S):

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Staff left resident in soiled diapers/clothes for an extended period of time.
Staff put residents to bed early.
Staff are not assisting residents at night.
Resident was not provided with adequate food service.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Trevor Byrne conducted an unannounced follow-up complaint visit for the above allegations. LPA arrived to the facility at 01:27 PM and met with facility staff #2 (S2). LPA contacted the facility Administrator Elba Khachatryan via telephone call. The facility Administrator did not arrive to the facility during today’s visit and has designated S2 to sign this report on their behalf. Entrance interview conducted and the reason for the visit was explained.

During today’s visit between 01:30 PM and 02:30 PM LPA conducted a physical plant tour, obtained copsies of documents, interviewed six (6) residents, one (1) staff, and delivered findings for the above allegation.

Continued on LIC 9099C.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025

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

LIC9099 (FAS) - (06/04)

Page: 1 of 4

Control Number 29-AS-20250611114359

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: SILVER LIGHT CARE	FACILITY NUMBER: 195850239
	VISIT DATE: 07/30/2025

NARRATIVE

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The allegation of “Staff left resident in soiled diapers/clothes for an extended period of time.” alleges that resident #1 (R1) was left in soiled diapers overnight between the approximate hours of 07:00 PM and 07:00 AM. LPA interviewed R1 who stated that for five (5) nights during their stay at the facility they were not changed in the evening by staff. R1 confirmed that they never asked Staff #1 (S1) for assistance with changing at night due to being instructed by the Administrator not to bother staff after 7:00 PM. LPA interviewed S1 who confirmed that R1 never asked for assistance with being changed in the evening during their stay at the facility. LPA interviewed the Administrator who denied telling R1 that they were not allowed to ask for assistance from the caregiver at night. The Administrator provided LPA with proof of a bedside commode that was delivered to the facility on 06/04/2025 for R1’s use. The Administrator stated that one (1) commode was placed in R1’s room near their bedside and one (1) was placed in the facility bathroom but R1 refused to utilize either commode. Interviews with the Administrator and S1 revealed that they are aware that staff are required to assist residents at night. The interview with Resident #3 (R3) revealed that in the past they have asked S1 for assistance with changing at night and S1 has assisted them. No current residents interviewed had concerns about being left in soiled garments for extended periods of time. Based on the information obtained during interviews and physical plant tour although the allegation may have happened or is valid there is insufficient evidence to support the allegation of “Staff left resident in soiled diapers/clothes for an extended period of time” Therefore, the allegation is deemed Unsubstantiated at this time.

The allegation of “Staff put residents to bed early.” alleges that facility staff require residents to remain in bed after approximately 7:00 PM each day. Interviews with the Administrator, S1, R2, R3, and R4 revealed that there is no specific time residents are required to be in bed, but residents are expected to keep noise at a minimum in the evening to be respectful to the other residents of the facility. The Administrator informed LPA that R1 would utilize their personal laptop and speaker to conduct personal conversations until approximately 11:00 PM which caused disturbances to the other residents. LPA reviewed the facility house rules and observed the following “TV, radio, and all noise must be turned down after 10:00 PM.” LPA did not observe house rules relating to a curfew or enforced bedtime for residents. Based on the information obtained during interviews and physical plant tour although the allegation may have happened or is valid there is insufficient evidence to support the allegation of “Staff put residents to bed early.” Therefore, the allegation is deemed Unsubstantiated at this time.
Continued on LIC 9099C.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 29-AS-20250611114359

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: SILVER LIGHT CARE	FACILITY NUMBER: 195850239
	VISIT DATE: 07/30/2025

NARRATIVE

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The allegation of “Staff are not assisting residents at night.” alleges that facility staff did not assist R1 with their care needs between the approximate hours of 07:00 PM and 07:00 AM. Interviews with the facility Administrator and S1 revealed that S1 is the primary caregiver and is present at the facility twenty four (24) hours a day for six (6) days of the week with S2 covering for the seventh (7) day of the week. Interviews with S1 and the Administrator confirmed that S1 knows that they are required to provide care to the residents during the evening hours. S1 stated that if requested at night they assist residents in caring for their needs. Interviews with resident #2 (R2), resident #3 (R3), and resident #4 (R4) did not reveal concerns with asking staff for assistance with their needs during the night. LPA observed S1’s bed to be located adjacent to the kitchen in a central area of the facility. LPA interviewed R1 who stated that they never asked S1 for assistance at night due to being instructed not to by the facility Administrator. In an interview with S1 they confirmed that R1 never requested assistance from them at night. The facility Administrator denied telling R1 that they were not allowed to ask for assistance from the caregiver at night. Based on the information obtained during interviews although the allegation may have happened or is valid there is insufficient evidence to support the allegation of “Staff are not assisting residents at night.” Therefore, the allegation is deemed Unsubstantiated at this time.

The allegation of “Resident was not provided with adequate food service.” alleges that R1 was not fed for three days while they resided at the facility. LPA conducted a physical plant tour of the facility on 06/16/2025, 07/15/2025, and 07/30/2025 and observed the location to have sufficient amounts of perishable and non-perishable foods. LPA interviewed S1 who stated that in addition to providing care to the residents they cook three (3) meals a day for the residents of the facility. S1 denied R1 refusing food but stated that R1 would consume snacks that they had brought from outside of the facility rather than eating the meals that were provided. Interviews with R2 corroborated that R1 would prefer to consume the outside snacks over the food the facility provided. Additionally, R2 stated that R1 was served meals at the same time as the other residents in the facility. Interviews with R2, R3, and R4 did not reveal concerns about the quality, frequency, or quantity of meal service at the facility. The Administrator confirmed that the facility provides residents with three (3) meals a day and snacks are available between meals. Additionally, the Administrator provided LPA with photos of meals that are served to residents, the food served appeared to be of good quality and served in sufficient amounts. Based on the information obtained during interviews and physical plant tour although the allegation may have happened or is valid there is insufficient evidence to support the allegation of “Resident was not provided with adequate food service.” Therefore, the allegation is deemed Unsubstantiated at this time. Continued on LIC 9099C.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 29-AS-20250611114359

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: SILVER LIGHT CARE	FACILITY NUMBER: 195850239
	VISIT DATE: 07/30/2025

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 26 27 28 29 30 31 32	This report was read to the Administrator via telephone call. Exit interview conducted and a copy of this report was provided.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 4