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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850658
Report Date: 07/29/2026
Date Signed: 07/29/2026 05:04:39 PM

Document Has Been Signed on 07/29/2026 05:04 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:HOME FOR ALL BOARDING CARE 1 INCFACILITY NUMBER:
195850658
ADMINISTRATOR/
DIRECTOR:		PANIKYAN,MARIAMFACILITY TYPE:
740
ADDRESS:6229 ATOLL AVENUETELEPHONE:
(818) 577-6005
CITY:VAN NUYSSTATE: CAZIP CODE:
91401
CAPACITY: 6CENSUS: 2DATE:
07/29/2026
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:33 AM
MET WITH:Mariam Panikyan - Licensee/AdministratorTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Quoc Huynh conducted a Post-Licensing visit to the above noted facility. The LPA arrived at 11:33AM and met with Staff who stated that the new Owner and Administrator were assisting a resident run an errand. The new Owner and Administrator arrived shortly thereafter and was informed that a Change of Ownership (CHOW) application does not clear them to operate the current facility. At 12:44PM the LPA contacted the facility’s Licensee who then arrived at approximately 1:37PM. Entrance interview conducted.

Beginning at 11:38AM, the LPA and Staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations. The following was observed:

KITCHEN: Knives were stored in a locked kitchen drawer. The supply of dishes, utensils, pots, pans and drinkware is adequate. The supply of nonperishable food, perishable food, and emergency food supply was in compliance. Appliances in the kitchen were clean, and all appeared functional. Food in the refrigerator and freezer were observed to be of good quality. First aid kit was observed to be complete, including a thermometer and a current version of a first aid manual.

COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. Required postings were located on a wall near the kitchen. The facility maintained a comfortable temperature throughout the visit. Night lights were observed throughout the facility. A garage was observed to be secured and contained laundry machines in good condition, general supplies, and emergency water.

Report Continued on LIC 809-C
Kristin Heffernan
Quoc Huynh
DATE: 07/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 9
Document Has Been Signed on 07/29/2026 05:04 PM - It Cannot Be Edited


Created By: Quoc Huynh On 07/29/2026 at 04:26 PM
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: HOME FOR ALL BOARDING CARE 1 INC
FACILITY NUMBER: 195850658

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87411(a)
Personnel Requirements - General
(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in the facility did not take measures to ensure R2 was not being administered duplicate medications prescribed by different parties which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/30/2026
Plan of Correction
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The Licensee will contact the physician and psychiatrist to ensure the correct medications/orders are prescribed/updated for R2 and will provide proof from both parties verifying the updated orders to CCLD by the POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kristin Heffernan
NAME OF LICENSING PROGRAM MANAGER:
Quoc Huynh
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/29/2026 05:04 PM - It Cannot Be Edited


Created By: Quoc Huynh On 07/29/2026 at 04:26 PM
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: HOME FOR ALL BOARDING CARE 1 INC
FACILITY NUMBER: 195850658

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87211(g)
Reporting Requirements
(g) The licensee shall notify the Department, in writing, within thirty (30) days of the hiring of a new administrator. The notification shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in the Department did not receive notification of an Administrator change which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2026
Plan of Correction
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The Licensee will provide CCLD the Administrator's records to process the change by POC due date.
Type B
Section Cited
CCR
87307(a)(2)(B)
Personal Accommodations and Services
(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply: (2) Resident bedrooms shall be provided which meet, at a minimum, the following requirements: (B) No room commonly used for other purposes shall be used as a sleeping room for any resident. This includes any hall, stairway, unfinished attic, garage, storage area, shed or similar detached building.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in staff utilized residents' private restroom which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2026
Plan of Correction
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The Licensee will have the staff shower in an alternate location. The Licensee will review regulations and provide a statement of understanding by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kristin Heffernan
NAME OF LICENSING PROGRAM MANAGER:
Quoc Huynh
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2026


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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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Document Has Been Signed on 07/29/2026 05:04 PM - It Cannot Be Edited


Created By: Quoc Huynh On 07/29/2026 at 04:26 PM
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: HOME FOR ALL BOARDING CARE 1 INC
FACILITY NUMBER: 195850658

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87506(a)
Resident Records
(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in residents' records were not complete with signatures which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2026
Plan of Correction
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The Licensee will obtain signatures on all documents and provide them to CCLD by POC due date.
Type B
Section Cited
CCR
87109(b)
(b) The Licensee shall notify the licensing agency… at least thirty (30) days prior to the transfer of the property or business, or at the time that a bona fide offer is made…

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above by not notifying the Department of the change of ownership which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2026
Plan of Correction
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The Licensee will review regulations and submit a statement of understanding to CCLD by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kristin Heffernan
NAME OF LICENSING PROGRAM MANAGER:
Quoc Huynh
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2026


LIC809 (FAS) - (06/04)
Page: 6 of 9
Document Has Been Signed on 07/29/2026 05:04 PM - It Cannot Be Edited


Created By: Quoc Huynh On 07/29/2026 at 04:26 PM
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: HOME FOR ALL BOARDING CARE 1 INC
FACILITY NUMBER: 195850658

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87355(e)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in the new Administrator was not associated which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/30/2026
Plan of Correction
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The Licensee will associate the Administrator and provide CCLD proof by POC due date.
Type A
Section Cited
CCR
87203
All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in the fire exttinguisher was not serviced or re-purchased annually which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/29/2026
Plan of Correction
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The Licensee purchased a new fire extinguisher during the visit. POC cleared.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kristin Heffernan
NAME OF LICENSING PROGRAM MANAGER:
Quoc Huynh
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2026


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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: HOME FOR ALL BOARDING CARE 1 INC
FACILITY NUMBER: 195850658
VISIT DATE: 07/29/2026
NARRATIVE
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INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and reviewed annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 04/21/2026. Smoke and carbon monoxide detectors were tested at 2:08PM and were operational. One (1) fire extinguisher was observed and was last purchased on 06/16/2025. The facility was advised that fire extinguishers must be serviced or re-purchased annually and in not doing so is a violation of fire safety. The facility obtained a new fire extinguisher during the visit.

MEDICATIONS: Medication review began at 1:43PM. Medications were centrally stored and kept inaccessible in the kitchen. Medications were observed for R2. Medications were labeled and checked for expiration dates and were properly documented on the centrally stored medications and destruction record. It was observed that R2 was prescribed three (3) medications from a secondary pharmacy and physician. The new owner and Administrator stated that R2 contacted their physician and ordered the medications on their own, despite being prescribed the same medication through their primary care physician. The LPA requested physician’s orders where it was confirmed by a Department of Mental Health Social Worker that the three (3) additional medications were prescribed through a psychiatrist and they were unaware that R2 was already being provided the medications through their physician.

On 04/01/2026, the Department received a CHOW application from the new Owner Gevorg Ghukasyan with the Administrator listed as Marine Ghukasyan. The Department was not previously notified of a CHOW. During today’s visit it was observed that the new Owner and Administrator were operating the facility without prior approval of licensure. The facility’s Licensee stated that Gevorg was hired as a caregiver and that Marine was the facility’s new Administrator; however, the Department was not notified of the Administrator change. The Licensee reported that with the CHOW application submitted, they presumed they did not need to take further steps. Document review of the new Owner/caregiver and the Administrator revealed documents submitted under the CHOW facility that was whited out, and the current facility name written over. It was also revealed that the new Owner/caregiver was associated and the facility did not begin to accept residents until after the CHOW was established. Additionally, the Administrator was not associated to the facility.

Pursuant to Title 22 CA Code of Regulations and/or the Health and Safety Code, the following deficiencies were cited (Refer to LIC 809-D).

Exit interview conducted. A copy of the appeal rights and report was reviewed and provided.
NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Quoc Huynh
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2026
LIC809 (FAS) - (06/04)
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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: HOME FOR ALL BOARDING CARE 1 INC
FACILITY NUMBER: 195850658
VISIT DATE: 07/29/2026
NARRATIVE
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BEDROOMS/BATHROOMS: The facility had four (4) bedrooms: three (3) shared resident rooms and one (1) live-in staff room. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Extra linens were stored in each residents’ bedroom. There were three (3) bathrooms: one (1) private, one (1) jack and jill, and one (1) half bath in the hallway. Restrooms were clean, sanitary, and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand-washing signs. The hot water temperature was tested and measured within the required range of 105*F to 120*F.

Per the Pre-Licensing visit conducted on 11/18/2025, it was determined that Bedroom #2 did not have access to a full bathroom with a shower without using another resident bedroom as a passageway. The Licensee agreed and provided an updated floor plan to utilize the room as an office. During today’s visit, it was observed that Bedroom #2 was utilized for live-in staff and that they were utilizing a vacant resident room’s private restroom to shower.

OUTDOOR AREA: The exterior passageways were clean and clear of any obstructions. There was furniture in the rear with tables and chairs where residents can sit. The outdoor space is properly gated. There are no bodies of water on the premises at the present time. One (1) side gate with a self-latching mechanism was observed and led to the front yard. The LPA also observed an Additional Dwelling Unit (ADU) that was separated and unrelated to the facility.

RECORDS: Record review began at 12:59PM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. Resident #1’s (R1) Appraisal/Needs and Services Plan was not signed by the resident or their representative. Resident #2’s (R2) required records did not have the resident’s or their representative’s signature including the admission agreement. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training.

Report Continued on LIC 809-C
NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Quoc Huynh
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2026
LIC809 (FAS) - (06/04)
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