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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850637
Report Date: 08/11/2026
Date Signed: 08/11/2026 12:18:17 PM

Document Has Been Signed on 08/11/2026 12:18 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:TROOST SENIOR CAREFACILITY NUMBER:
195850637
ADMINISTRATOR/
DIRECTOR:		GEVORGYAN, ERNAFACILITY TYPE:
740
ADDRESS:8051 TROOST AVETELEPHONE:
(747) 223-2672
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY: 6CENSUS: DATE:
08/11/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:58 AM
MET WITH:Erna GevorgyanTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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Licensing Program Analysts (LPA) Trevor Byrne arrived at the facility unannounced to conduct a case management - deficiencies visit at 10:58 AM. LPA met with facility staff who contacted the Administrator Erna Gevorgyan. Administrator arrived to the facility at 11:10 AM. Entrance interview was conducted and the reason for the visit was explained.

During today's visit LPA conducted a physical plant tour between approximately 11:11 AM and 11:45 AM.

During a complaint investigation at the facility, it was revealed that an individual who was not a resident of the licensed facility had resided in the garage. LPA conducted a file review and observed the facility’s fire clearance to contain a comment which states, “Garage to be maintained as a garage only.” During the pre-licensing inspection which occurred on 11/03/2025 LPA conducted a physical plant tour and observed that the lot that the facility is on is split in half, North to South, by a fence with a gate. LPA observed the garage to be located on the back half of the property separated by the fence from the facility which is placed on the front half of the property. Although the facility sketch submitted with the application included the garage. LPA toured the garage and observed items including a bed and refrigerator which appeared to suggest that the garage was being utilized as a living area at the time of inspection. During the 11/03/2025 pre-licensing inspection LPA had a conversation with the Administrator and Applicant informing them of the facility’s fire clearance which stated that the garage was to be maintained as a garage. The Administrator and Applicant expressed understanding at the time and agreed to comply with the requirement. LPA interviewed the property owner for the address where the facility is located who is hereby referred to as Witness #1 (W1).

CONTINUED ON LIC 809C.

Kasandra Lopez
Trevor Byrne
DATE: 08/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2026
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: TROOST SENIOR CARE
FACILITY NUMBER: 195850637
VISIT DATE: 08/11/2026
NARRATIVE
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W1 stated that they used to operate the home where the facility is located as an Independent Living home prior to the Licensee leasing the home and opening a licensed facility. W1 confirmed that an individual resided in the garage while the licensed facility was in operation but denied the licensed facility having any involvement with the individual or the back half of the property. W1 stated that the garage was never part of the lease that the facility signed for the home and that anything going on with the garage or the individual who was residing in the garage “was my (W1’s) business.”

LPA reviewed the lease agreement signed by the facility Licensee and W1 and observed that the lease indicated that the tenant leased the premises at 8051 Troost Ave. North Hollywood, CA 91605. LPA did not observe any indication that the tenant did not have access to the back half of the property or the garage indicated in the lease agreement. The Administrator informed LPA that on 01/30/2026 W1 applied for a permit to split the property along the North to South fence line and to construct an ADU on the back half of the property. LPA informed the Administrator that since individual had resided in the garage between approximately May 2025-June 2026 the individual resided in the unapproved garage which was under the facility’s lease between the date the facility was licensed (11/12/2025) until the property owner split the property (01/30/2026). LPA informed the Administrator that even though the individual was not a resident of the facility the garage was not being maintained as a garage which constituted a violation of the facility’s fire clearance. LPA informed the Administrator that this is a zero-tolerance violation and a civil penalty in the amount of $500 is being assessed on today’s date (08/11/2026). LPA informed the Administrator that the facility will need submit a new facility sketch and to request a new fire inspection/clearance to indicate that the garage is no longer part of the facility.

Pursuant to Title 22 of the CA Code of Regulations the following deficiency was cited and civil penalty assessed (refer to LIC 809-D): Exit interview conducted and copy of the report was issued and appeal rights provided.

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Trevor Byrne
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/11/2026 12:18 PM - It Cannot Be Edited


Created By: Trevor Byrne On 08/11/2026 at 11:13 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: TROOST SENIOR CARE
FACILITY NUMBER: 195850637

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/26/2026
Section Cited
CCR
87202(a)

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87202 Fire Clearance
(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal.
This requirement is not met as evidenced by:
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Administrator agreed to obtain a new fire clearance which does not include the garage as it is no longer part of the facility. Additionally, Administrator agreed to submit a new facility sketch which reflects that the garage is not part of the facility. Administrator agreed to submit the sketch and to...
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Based on interviews and record review the Licensee did not comply with the section cited above as I1 was housed in the facility garage while it was under the control of the facility and not approved for habitation which posed an immediate health and safety risk to clients in care.
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either complete the fire inspection or to submit proof that the inspection has been scheduled to CCLD no later than POC due date.

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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.
Kasandra Lopez
NAME OF LICENSING PROGRAM MANAGER:
Trevor Byrne
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2026


LIC809 (FAS) - (06/04)
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