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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608477
Report Date: 01/29/2025
Date Signed: 01/29/2025 01:01:51 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
05/07/2024 and conducted by Evaluator Antonia Alvizar-Ettima
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20240507143406
FACILITY NAME:IVY PARK AT STUDIO CITYFACILITY NUMBER:
197608477
ADMINISTRATOR:SHAHIN TAGHIZADEHFACILITY TYPE:
740
ADDRESS:4610 COLDWATER CANYON AVETELEPHONE:
(818) 505-8484
CITY:STUDIO CITYSTATE: CAZIP CODE:
91604
CAPACITY:121CENSUS: 67DATE:
01/29/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Executive Director, Dan KashaniTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Facility is not in compliance with Fire Clearanc
INVESTIGATION FINDINGS:
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Licensing Program Manager (LPM) Naira Margaryan and Licensing Program Analyst (LPA) Antonia Alvizar-Ettima made an unannounced subsequent visit to the facility to investigate and deliver finding for the above noted allegation at approximately 9:30a.m., LPM and LPA met with Executive Director and disclosed the purpose of the visit.

Concerns were addressed that the facility is in violation of the Fire Codes. Licensee disregarded the notices of violations received from Los Angeles Fire Department (LAFD) and no corrections were made.

An initial complaint visit conducted on 05/13/2024. At the time of visit at 10:25 a.m., LPA and ED conducted a physical plant tour of the facility. At approximately 2:30p.m. ED provided Fire Logs, Email proofs of the steps they were taking and the pictures of Fire Monitoring Panel. At 3:30p.m LPA interviewed ED Sean Taghizadeh, who indicated that Reg 4 testing was not completed.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-EttimaTELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
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 3
Control Number 31-AS-20240507143406
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: IVY PARK AT STUDIO CITY
FACILITY NUMBER: 197608477
VISIT DATE: 01/29/2025
NARRATIVE
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All issues/violations of the Fire Codes were noted. ED stated that although they were trying to comply with fire regulations, they did not pass an inspection due to broken part that needed to be changed to allow the smoke to come out in case of the fire.

Prior to this visit on 01/08/2025 LPA Antonia Alvizar-Ettima reviewed the information and the documents previously obtained from the facility as well as the information obtained from the Licensing Records. Information received revealed that as of 08/01/2024 the broken part was not changed.

At about 9:45a.m. LPM and LPA interviewed a new Executive Director, who indicated that the issues were corrected, and fire clearance was approved. In addition, at 10:42a.m. LPM Margaryan spoke with the fire inspector who confirmed the information revealed by ED. The fire clearance was approved on 11/01/2024. A copy of approved fire clearance was obtained during this visit.

Based on inspection, observation, interviews and record review there is enough supporting information to verify the allegation. Therefore, the allegation is Substantiated.

The deficiency will be cited under Title 22, Division 8, Chapter 6 and will be recorded on LIC9099D.

At the time of this visit all corrections were made and fire clearance was approved. Therefore, citation will be cleared during this visit.

No other health and safety hazard is noted.

Exit interview was conducted appeal rights discussed and a copy of report was issued to ED.

SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-EttimaTELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20240507143406
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: IVY PARK AT STUDIO CITY
FACILITY NUMBER: 197608477
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/29/2025
Section Cited
CCR
87203
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87203 Fire Safety- 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.
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At the time of this visit all corrections were made and Fire Clearance Granted approved on 11/01/2024 by Los Angeles Fire Department.
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This requirement is not met as evidenced by. The licensee did not ensure that the facility is in conformity with fire regulations for extended period (05/07/24 to 11/01/24). This possessed an immediate health and safety hazard to residents in care.
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During this visit an immediate $500.00 cilvil penalty was assess to the facility.
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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.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-EttimaTELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC9099 (FAS) - (06/04)
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