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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608986
Report Date: 09/04/2025
Date Signed: 09/04/2025 12:40:48 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/11/2025 and conducted by Evaluator Brian Balisi
COMPLAINT CONTROL NUMBER: 29-AS-20250811102049
FACILITY NAME:AGE WELL ASSISTED LIVING FACILITYFACILITY NUMBER:
197608986
ADMINISTRATOR:LALA SOGHOMONYANFACILITY TYPE:
740
ADDRESS:15149 SYLVAN STREETTELEPHONE:
(818) 666-1665
CITY:VAN NUYSSTATE: CAZIP CODE:
91411
CAPACITY:6CENSUS: 4DATE:
09/04/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lala SoghomonyanTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure facility is free from pests
Staff do not ensure window screen are in good repair
Staff did not ensure cleaning supplies were inaccessible to residents
Administrator is not at the facility for the required amount of time
Administrator did not designate a qualified staff while administrator out of the country
Administrator does not return ombudsman calls
Staff do not ensure facility has the required amount of food to meet residents needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
**This is the amended report to update information. The intial report was delivered 08/19/2025***
Licensing Program Analysts (LPAs) Brian Balisi, Martha Arroyo along with Licensing Program Manager (LPM) Desaree Perera conducted an unannounced complaint visit to investigate allegations listed above. Upon arrival LPAs and LPM met with with Staff and explained the reason for the visit. Administrator Lala Soghomonyan arrived shortly after.

At approx 10:00am, LPA conducted physical plant, interviewed staff, residents and reviewed and obtained copies of pertinent documentation relevant to the investigation.

It was reported that "Staff did not ensure facility is free from pests" as it was alleged that flies were observed in the kitchen, common area, residents bedrooms and hallways. Interviews conducted revealed three (3) out of Three (3) residents have observed flies throughout the facility.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
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 9
Control Number 29-AS-20250811102049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: AGE WELL ASSISTED LIVING FACILITY
FACILITY NUMBER: 197608986
VISIT DATE: 09/04/2025
NARRATIVE
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Continued from 9099
During physical plant LPA observed flies hovering over food debris on the dining table and the kitchen countertop. Based on information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegation that "Staff did not ensure facility is free from pests" has been deemed Substantiated at this time.

It was reported that "Staff do not ensure window screen(s) are in good repair" as it was alleged that a window screen was observed not secure and torn. During physical plant, LPA observed screen in bedroom #1 to be in disrepair. The room was not occupied at this time. Based on information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegation that " Staff do not ensure window screen(s) are in good repair " has been deemed Substantiated at this time.

It was reported that "Staff did not ensure cleaning supplies were inaccessible to residents" as it was alleged that cleaning supplies were observed in the bath area making it difficult for residents to shower. During the visit, LPA observed multiple cleaning supplies stored underneath the kitchen sink not locked and accessible to residents in care. Interviews conducted with three (3) out of (3) residents in care revealed that (2) of the residents who use the facility shower have not observed any cleaning supplies stored in the bathroom at this time. One (1) of the residents interviewed stated that a nurse visits at least twice a week to provide bed baths so they do not make use of the facility shower at this time. Based on information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegation that "Staff did not ensure cleaning supplies were inaccessible to residents" has been deemed Substantiated at this time.

It was reported that "Administrator is not at the facility for the required amount of time, Administrator does not return ombudsman calls and Administrator did not designate a qualified staff while administrator was out of the country" Interview conducted with (3) three out of (3) residents in care revealed they all have observed the Administrator visit the facility at least once a week and at most twice during the week. They do not recall a time when the Administrator did not visit the facility for a prolonged period of time.Before today's visit, LPA conducted visits to this facility on the following dates: 06/06/2025, 06/16/2025, 06/23/2025 and 07/10/2025 and was not able to meet with the Administrator. LPA spoke with Licensee Sarkis Dovaltyan who stated that they were not aware of any third party agencies attempting to contact the Administrator, but for any pressing concerns staff would typically inform Sovaltyan if immediate assistance was required.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 9
Control Number 29-AS-20250811102049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: AGE WELL ASSISTED LIVING FACILITY
FACILITY NUMBER: 197608986
VISIT DATE: 09/04/2025
NARRATIVE
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Continued from 9099-C
During today's visit, at approx. 10:00 a.m. LPA spoke with Administrator Lala Soghomonyan who stated they would meet the LPA on site. LPA attempted to follow up with Lala at approximately 11:30 a.m. but they stated they were unable to make the visit due to a family emergency. Based on information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegation that "Administrator is not at the facility for the required amount of time, Administrator does not return ombudsman calls and Administrator did not designate a qualified staff while administrator was out of the country" has been deemed Substantiated at this time.

It was reported that "Staff do not ensure facility has the required amount of food to meet residents needs" as it was alleged that there was not a variety of food, there was not a sufficient supply of food and the food that was observed was not stored properly. Interviews conducted with three (3) out of (3) residents in care revealed all (3) did not express any concerns with the taste, the amount or the type of foods and snacks that were observed however, all (3) expressed that they would prefer more fruits and vegetables offered. During the visit LPA observed a sufficient amount of perishable and non-perishable food properly stored. Based on information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegation that "Staff do not ensure facility has the required amount of food to meet residents needs" has been deemed Substantiated at this time.

The following deficiencies were observed (See LIC 9099-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. A copy of the report and appeal rights were provided

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 9
Control Number 29-AS-20250811102049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: AGE WELL ASSISTED LIVING FACILITY
FACILITY NUMBER: 197608986
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/04/2025
Section Cited
CCR
87309(a)
1
2
3
4
5
6
7
Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions... in locked storage and are not left unattended if outside the locked storage. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee agreed to purchase new lock and install on cabinet underneath the sink provide proof to LPA via email by COB 08/20/2025
8
9
10
11
12
13
14
Based on LPA's observation, the licensee did not comply with the section cited above as cleaning supplies were observed accessible to residents in care which posed an immediate health, safety and personal rights risk to residents in care.
8
9
10
11
12
13
14
Type A
09/04/2025
Section Cited
CCR
87405(a)
1
2
3
4
5
6
7
All facilities shall have a qualified and currently certified administrator...in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee agreed to review reg cited and submit a statement of understanding, along with a written plan to ensure that an Administrator is present at the facility for a sufficient number of hours. The Licensee also agrees to submit the requested documents,
8
9
10
11
12
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14
Based on LPA’s interviews and observations, the licensee did not comply with the section cited above as Adm was not availible in the facility for a sufficient amount of time which posed an immediate health, safety and personal rights risk to residents in care.
8
9
10
11
12
13
14
 including an updated LIC 500, to LPA via email by COB 08/20/2025
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: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 9
Control Number 29-AS-20250811102049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: AGE WELL ASSISTED LIVING FACILITY
FACILITY NUMBER: 197608986
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/04/2025
Section Cited
CCR
87303(c)
1
2
3
4
5
6
7
Maintenance and operation - All window screens shall be clean and maintained in good repair. This requirement is not met as evidenced by:
1
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3
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5
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7
Licensee agreed to replace or repair window screen and provide proof to LPA via email by COB 08/29/2025
8
9
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14
Based on LPA observation, the Licensee did not comply in the section cited above as window screens were observed in disrepair which posed a potential health, safety and personal rights risk to residents in care.
8
9
10
11
12
13
14
Type B
09/04/2025
Section Cited
CCR
87555(a)
1
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7
The total daily diet shall be of the quality and in the quantity necessary to meet the needs... All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement was not met as evidenced by:
1
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 Licensee agreed to purchase more produce when grocery shopping. Licensee also agreed to review section cited and provide written plan on how they will ensure future complaince.and provide document to LPA via email by COB 08/29/2025
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Based on interviews the licensee did not comply with section above as residents express concerns for lack of fresh produce offered which posed a potential health, safety and personal rights risk to residents in care.
8
9
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13
14
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: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 9
Control Number 29-AS-20250811102049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: AGE WELL ASSISTED LIVING FACILITY
FACILITY NUMBER: 197608986
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/04/2025
Section Cited
CCR
87555(b)(27)
1
2
3
4
5
6
7
All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects.
This requirement is not met as evidenced by:
1
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3
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7
Licensee agreed to ensure that all surfaces used for food preparation are kept clean, free of debris, and equipped with devices or items designed to prevent pest infestation. The Administrator will also provide photographs of these devices to the LPA via email by COB 08/29/2025
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Based on LPA observation, the Licensee did not comply in the section cited as insects were observed throughout the facility which posed a potential health, safety personal rights risk 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: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/11/2025 and conducted by Evaluator Brian Balisi
COMPLAINT CONTROL NUMBER: 29-AS-20250811102049

FACILITY NAME:AGE WELL ASSISTED LIVING FACILITYFACILITY NUMBER:
197608986
ADMINISTRATOR:LALA SOGHOMONYANFACILITY TYPE:
740
ADDRESS:15149 SYLVAN STREETTELEPHONE:
(818) 666-1665
CITY:VAN NUYSSTATE: CAZIP CODE:
91411
CAPACITY:6CENSUS: 4DATE:
09/04/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lala SoghomonyanTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not ensure a telephone is available to residents
Staff do not ensure facility is clean
Staff store durable medical equipment in the bathroom/tub resulting in residents not being able to shower easily
Staff did not ensure facility was kept at a comfortable temperature for residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
**This is the amended report to update information on the 9099. The intial report was delivered 08/19/2025***
Licensing Program Analysts (LPAs) Brian Balisi, Martha Arroyo along with Licensing Program Manager (LPM) Desaree Perera conducted an unannounced complaint visit to investigate allegations listed above. Upon arrival LPAs and LPM met with with Staff and explained the reason for the visit. Administrator Lala Soghomonyan arrived shortly after.
At approx 10:00am, LPA conducted physical plant, interviewed staff, residents and reviewed and obtained copies of pertinent documentation relevant to the investigation.

It was reported that "Staff do not ensure a telephone is available to residents" as it was alleged that residents do not have the ability to make / receive phone calls. Interviews conducted with (3) three out of (3) residents in care revealed that they have not requested to use the facility phone since they have their own phone. During the visit, LPA dialed LPA’s cell phone and confirmed the facility phone is operational. LPA also dialed facility phone number, and the facility phone rang.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 7 of 9
Control Number 29-AS-20250811102049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: AGE WELL ASSISTED LIVING FACILITY
FACILITY NUMBER: 197608986
VISIT DATE: 09/04/2025
NARRATIVE
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Continued from 9099
Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the above allegation “Staff do not ensure a telephone is available to residents” is deemed Unsubstantiated at this time.

It was reported that "Staff do not ensure facility is clean" as it was alleged that floors are not cleaned and plates, cups and silverware are dirty. Interviews conducted with three (3) out of (3) residents in care revealed they observed staff throughout their shift. All (3) stated they do not recall seeing any dirty utensils when eating and all (3) did not express any concerns for staff not ensuring facility is kept cleaned. During the visit, LPA observed staff mopping floors and cleaning the bathroom. LPA observed all utensils and dishware store in the cabinets to clean at this time. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the above allegation “Staff do not ensure facility is clean” is deemed Unsubstantiated at this time.

It was reported that "Staff store durable medical equipment in the bathroom / tub resulting in residents not being able to shower easily" as it was alleged that toilet frames were kept in the shower area making it difficult for residents to shower. Interviews conducted with three (3) residents in care revealed two (2) out of (3) residents have observed the equipment stored in the area, however both stated that staff moved it out of the way when they shower and both did not express any concerns for their accessibility to shower at this time. One (1) resident stated that nurse visits them twice a week to bathe them in bed. This resident has never used the hallway bathroom to shower. LPA’s interview with staff revealed that when residents request to shower they move the equipment out of the way. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the above allegation “Staff store durable medical equipment in the bathroom / tub resulting in residents not being able to shower easily” is deemed Unsubstantiated at this time

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 8 of 9
Control Number 29-AS-20250811102049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: AGE WELL ASSISTED LIVING FACILITY
FACILITY NUMBER: 197608986
VISIT DATE: 09/04/2025
NARRATIVE
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Continued from 9099-C

It was reported that "Staff did not ensure facility was kept at a comfortable temperature for residents" as it was alleged that it was observed that the outside temperature was over 90 degrees and the inside of the facility felt warm. Interviews conducted with three (3) out of (3) residents in care revealed that all (3) did not express any concerns for the temperature of the home since they have resided here. Furthermore, all (3) stated they do not recall when the facility felt too hot. During the visit, LPA observed the outside temperature to be 88 degrees with the thermostat set to 74 degrees. LPA did not observe it to be uncomfortable inside the facility. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the above allegation “Staff did not ensure facility was kept at a comfortable temperature” is deemed Unsubstantiated at this time

Exit interview conducted and copy of report issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 9 of 9