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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850239
Report Date: 11/07/2025
Date Signed: 11/07/2025 11:05:33 AM

Substantiated


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
08/05/2025 and conducted by Evaluator Trevor Byrne
COMPLAINT CONTROL NUMBER: 29-AS-20250805085307
FACILITY NAME:SILVER LIGHT CAREFACILITY NUMBER:
195850239
ADMINISTRATOR:KHACHATRYAN, ELBAFACILITY TYPE:
740
ADDRESS:8201 VANTAGE AVENUETELEPHONE:
(747) 228-4111
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY:0CENSUS: 0DATE:
11/07/2025
UNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:NoneTIME COMPLETED:
10:47 AM
ALLEGATION(S):
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Due to neglect, resident sustained pressure injuries while in care.
Due to neglect, resident had to have a partial foot amputation
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Trevor Byrne created this report to deliver findings for the above listed allegations. The facility Silver Light Care 195850239 was closed effective August 1, 2025 due to a Temporary Suspension Order (TSO) issued on August 1, 2025. LPA attempted to contact the former licensee via telephone call on 11/07/2025 at 10:40 AM and 10:47 AM to deliver findings. Both telephone numbers available were disconnected/no longer belonged to the licensee. A copy of this report will be emailed to the former licensee and mailed to the former licensee’s mailing address for signature.

On 08/05/2025 the Woodland Hills North Adult and Senior Care Regional Office (RO) received a complaint alleging that due to neglect, resident #1 (R1) sustained pressure injuries while in care and due to neglect, R1 had to have a partial foot amputation. The case was referred to the Community Care Licensing Division (CCLD) Investigations Branch (IB) and was assigned to Investigator Edward Hector. During the initial complaint visit on 08/06/2025 LPAs Byrne and Urena conducted a physical plant tour and interviewed the temporary manager (TM) of Silver Light Care 195850665 and interviewed four (4) residents.
Continued on LIC 9099C.
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
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 5
Control Number 29-AS-20250805085307
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: 11/07/2025
NARRATIVE
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On 08/15/2025, at 12:59 PM IB Investigator Hector interviewed Witness #1 (W1). On 08/21/2025, at 01:23 PM Investigator Hector interviewed R1. On 08/27/2025, at 12:59 PM Investigator subpoenaed documents from the hospital that treated R1. On 08/28/2025, obtained the Los Angeles Police Department (LAPD)’s Investigations reports. On 09/03/2025, at 08:26 AM IB received medical records from the hospital that treated R1. Between 09/09/2025 and 09/23/2025, the Investigator corresponded with LAPD Detective. On 09/23/2025, at 12:16 PM the Investigator contacted Wise & Healthy Aging, Long-Term Care Ombudsman Program (LTCO). On 09/25/2025, at 11:00 AM the Investigator attempted to interview Staff #1 (S1) at their home but was unavailable, although contact was made with Individual #1 (I1). On 09/25/2025, at 12:22 PM the Investigator attempted to contact Staff #2 (S2) at their home but was unavailable. On 09/25/2025, at 12:44 PM, the Investigator received a message from I1 but later advised S1 was no longer available for interview. On 10/08/2025, IB mailed certified U.S. Postal Service letters to S1 and S2 requesting an opportunity to get their statements. On 10/15/2025, the Investigator received a phone call from an attorney representing S1 and S2 stating both S1 and S2 declined to provide a statement.

The allegation of “Due to neglect, resident sustained pressure injuries while in care.” alleges that due to neglect by facility staff R1 sustained pressure injuries to the foot and heel area. The additional allegation of “Due to neglect, resident had to have a partial foot amputation” alleges that due to neglect by facility staff R1 sustained a condition that resulted in a partial amputation of R1’s foot. The interview with W1 revealed that after the TSO for Silver Light Care 195850239 was issued the temporary management company assumed operations of the facility under Silver Light Care 195850665. After assuming operations of the facility staff employed by TM conducted assessments of the residents that remained at the facility. W1 reported observing R1 with Stage 3 and Stage 4 wounds. W1 advised that R1 was only at the facility for one (1) day while the Temporary Management company was assigned to the facility before being transferred to the hospital for treatment on 08/02/2025.

Continued on LIC 9099C.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 29-AS-20250805085307
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: 11/07/2025
NARRATIVE
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Medical record review revealed R1 had a non-healing ulcer on his right foot that included sepsis, osteomyelitis, and right foot cellulitis. Further review of the medical records revealed that R1 had a left heel pressure injury, left foot deep tissue injury, and a right foot non-healing ulcer to his 4th and 5th metacarpal with X-rays of the right foot revealing that R1 had bone erosion to the lateral 5th metatarsal head.
Records review further revealed that on 08/03/2025, R1 participated in a surgical procedure “right foot partial 5th ray resection due to osteomyelitis” the fifth toe and at least a portion of its associated metatarsal bone (the fifth ray) were removed because of an infection in the bone called osteomyelitis. Record review revealed no evidence to support that R1 had received any prior wound care from an appropriate skilled professional while under the care of the licensee. During the interview with R1 they stated that they first observed the wound on their foot seven (7) months ago and described the wound as a “hole inside their foot”. R1 stated that S1 observed the wound and “tried to wrap it up”. R1 reported that S2 came to the facility after a while and observed the injury. R1 reported that S2 stated that they were planning on calling the hospital but R1 denied ever going to the hospital for treatment of the wound. R1 denied a doctor, nurse, home health professional, or hospice representative coming to the facility to look at their injury. R1 confirmed that the only care the facility staff provided was to wrap their foot with bandage tape. R1 stated that the appearance of the injury got worse over time. R1 denied having any pain due to their lack of sensation in the lower extremities due to paraplegia.

The investigator attempted to interview S1 and S2 but was advised by their attorney that they did not wish to provide a statement regarding these allegations. Based on the information obtained during interviews and record review there is sufficient evidence to support the allegations of “Due to neglect, resident sustained pressure injuries while in care” and “Due to neglect, resident had to have a partial foot amputation.” Therefore, the allegations are deemed Substantiated at this time.

The following deficiencies were cited (refer to LIC 9099D). A copy of this report and appeal rights will be emailed and mailed to the former licensee SILVER LIGHT CARE, INC., for signature. A $500 immediate civil penalty is also being assessed today. Additional civil penalties might be assessed based on Health and Safety Code 1569.49(e) and 1569.49(f).
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 29-AS-20250805085307
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
11/07/2025
Section Cited
CCR
87464(f)(1)
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87464 Basic Services
(f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).
This requirement is not met as evidenced by:
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The facility Silver Light Care 195850239 was closed effective August 1, 2025 due to a Temporary Suspension Order (TSO) issued on August 1, 2025. There is no POC for this citation.
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Based on record review and interview, the licensee failed to provide care and supervision resulting in R1 sustaining pressure injuries and a partial foot amputation which is an immediate health and safety risk to R1 in care.
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Request Denied
Type A
11/07/2025
Section Cited
CCR
87405(d)(7)(1)
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87405 Administrator - Qualifications...
(d) The administrator shall have the qualifications specified....
(1) Knowledge of the requirements for providing care and supervision appropriate to the residents.
This requirement is not met as evidenced by:
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The facility Silver Light Care 195850239 was closed effective August 1, 2025 due to a Temporary Suspension Order (TSO) issued on August 1, 2025. There is no POC for this citation.
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Based on record review and interview, the Administrator failed to ensure R1 received proper care which resulted in R1 sustaining pressure injuries and a partial amputation which is an immediate health and safety risk to R1.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20250805085307
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
11/07/2025
Section Cited
CCR
87211(a)(1)(D)
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87211 Reporting Requirements
(a) Each licensee shall furnish...:
(1) A written report shall be submitted to... licensing...within seven days of...
(D) Any incident which threatens the welfare, safety or health of any resident...
This requirement is not met as evidenced by:
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The facility Silver Light Care 195850239 was closed effective August 1, 2025 due to a Temporary Suspension Order (TSO) issued on August 1, 2025. There is no POC for this citation.
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Based on record review, the licensee failed to submit an incident report to CCL regarding R1 sustaining pressure injuries in a timely manner which is an immediate health and safety risk to R1 in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5