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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 05/20/2026
Date Signed: 05/20/2026 03:16:02 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/18/2026 and conducted by Evaluator Antonia Alvizar-Ettima
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20260518100855
FACILITY NAME:CEDARS ASSISTED LIVING, THEFACILITY NUMBER:
197608267
ADMINISTRATOR:STEPAN SARMAZIANFACILITY TYPE:
740
ADDRESS:17300 ROSCOE BLVD.TELEPHONE:
(818) 344-2042
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:175CENSUS: 126DATE:
05/20/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Administrator, Stepan Sarmazian AKA SteveTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Licensee is operating beyond the conditions and limitations specided on the license
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conduced unannounced complaint visit the facility. LPA met with the Administrator and explained the purpose of the visit.

It was alleged that the facility resident #1 ,(R1) was receiving in-house dialysis, which required a higher level of care. During this investigation at 12:45p.m., LPA inspected the facility including residents’ rooms.
At 1:15p.m., LPA requested and reviewed R1s facility file, including but not limited to R1’s Physician Report, Needs and Services Plan, Identification Information, Resident Appraisal and other medical documents.

At 1:25p.m., LPA spoke with three(3) facility staff including Administrator. Upon inspection of room #237, LPA observed the medical equipment for dialyses. Resident #1 residing in the room was not present due to being at the hospital. Therefore, LPA was unable to interview R1.Staff verified that R1 is receiving dialysis at the facility three (3) times a week.
Cont. on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
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 3
Control Number 31-AS-20260518100855
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: CEDARS ASSISTED LIVING, THE
FACILITY NUMBER: 197608267
VISIT DATE: 05/20/2026
NARRATIVE
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Cont. from LIC 9099

The services were ordered by R1’s family and provided by the Spectrum Dialysis Center. R1 was not receiving Home Health or Hospice services and was able to attend to dialysis center before. There were no changes in R1’s condition to allow them to receive the services in nonmedical settings.

A review of R1’s facility file did not provide any information to verify the need to receive a Skilled Nursing Services, that should have been provided in the medical settings.

No exception request was requested by the facility, prior to allowing R1 to receive dialysis in the facility.
Overall investigation concluded that facility allowed R1 to receive medical services that shall be provided in medical setting. Therefore, based on inspection, observation and interviews, the allegation is SUBSTANTIATED at this time.

Under Title 22, Division 6. Chapter 8 following citation was issued and recorded on LIC9099D.

An immediate $500.00 civil penalty was issued to the facility due to allowing resident to receive Skilled Nursing Services, instate of arranging off– site outpatient medical services.

Exit interview conducted, copy of the report and appeal rights were provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 31-AS-20260518100855
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: CEDARS ASSISTED LIVING, THE
FACILITY NUMBER: 197608267
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/21/2026
Section Cited
CCR
87611(a)
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87611 General Requirements for Allowable Health Conditions (a) Prior to accepting or retaining a resident with an allowable health condition licensees … shall obtain Department approval:
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Administrator contacted Spectrum Dialysis, CEO and cancelled Dialysis services for R1 at the facility. Spectrum was asked to pick up all Dialysis equipment from R1's room.
POC was cleared during today's visit.
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This requirement is not met as evidenced by. The Licensee allow R1, who was not receive home health or hospice services to receive dialysis in the facility, without seeking prior approval from the Licensing Agency. This poses an imminent health and safety hazard to residents 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: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3