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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608986
Report Date: 01/28/2026
Date Signed: 01/28/2026 10:10:08 AM

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
06/02/2025 and conducted by Evaluator Brian Balisi
COMPLAINT CONTROL NUMBER: 29-AS-20250602132841
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:0CENSUS: 0DATE:
01/28/2026
UNANNOUNCEDTIME BEGAN:
08:08 AM
MET WITH:TIME COMPLETED:
09:00 AM
ALLEGATION(S):
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Staff do not ensure that the facility remains free of odors
Staff do not ensure resident's room is clean and sanitary
Staff did not ensure resident was assisted with dressing
Staff do not ensure resident's hygiene needs are being met
Staff do not ensure resident's showering needs are being met
Staff did not ensure resident received adequate first aid for injuries
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent unannounced complaint visit to deliver findings. Due to facility license revocation, facility was closed effective 01/16/2026. LPA attempted to contact former Licensee Sarkis Dovlatyan, but stated they were unavailble. Sarkis texted LPA confirming they will review report via email / and mail.
On 06/06/2025, from 09:30 a.m. to 10:30 a.m., LPA Balisi conducted an initial 10-day complaint visit to investigate the allegations listed above. At approximately 09:30 a.m., the LPA conducted a physical plant tour, interviewed staff, and reviewed and obtained copies of pertinent documentation relevant to the investigation. On 07/10/2025, from 09:45 a.m. to 03:00 p.m. LPA conducted interviews with residents and staff while onsite for a separate investigation. On 09/04/2025, from 09:30 a.m. to 12:30 p.m., LPA conducted a tour of the physical plant. LPA also interviewed staff and residents while onsite for a separate investigation. On 10/16/2025, from 09:30 a.m. to 03:30 p.m. LPA conducted a tour of the physical plant and also conducted interviews with residents and staff while onsite for a separate investigation.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
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 7
Control Number 29-AS-20250602132841
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: 01/28/2026
NARRATIVE
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Continued from 9099

On 10/31/2025, from 09:40 a.m. to 01:30 p.m. LPA conducted a physical plant tour, interviewed staff and residents while on site for a separate investigation. On 11/17/2025, LPA received and reviewed hospital records for Resident #1 (R1).

It was reported that “staff do not ensure that the facility remains free of odors” and “staff do not ensure resident’s room is clean and sanitary” as it was alleged that R1’s room was observed to smell of urine like a “dog shelter” and that clothes were all over the floor. On 06/06/2025, at approximately 9:45 a.m., during a physical plant inspection, the LPA observed a urine odor coming from Resident #1’s (R1) room and observed unfolded clothing scattered on the bed. At approximately 9:50 a.m., the LPA observed Staff #1 (S1) mopping the hallways and common areas. During an interview, S1 stated that the floors were being mopped due to an odor originating from R1’s room. S1 further stated that R1 had thrown their clothing on the floor and that S1 had placed the clothing on the bed. Interviews and observations conducted during the course of the investigation revealed that flies were observed on multiple occasions in common areas and resident bedrooms due to trash cans not being emptied and food debris on counter tops. Based on information gathered during the investigation, the department has sufficient evidence to confirm these allegations occurred. Therefore, the allegations that “Staff do not ensure that the facility remains free of odors” and “Staff do not ensure resident’s room is clean and sanitary” have been deemed Substantiated at this time.

It was reported that “Staff do not ensure resident was assisted with dressing”, “Staff do not ensure resident’s hygiene needs are being met” and “Staff do not ensure resident’s showering needs are being met” as it was alleged that R1 was observed laying naked on top of bed and staff did not dress them in a timely manner, R1’s toenails were observed to be long and R1 was observed to appear to not have been showered for an extended period of time. On 06/06/2025, at approximately 9:45 a.m., during a physical plant inspection, the LPA observed a resident in bed without clothing, with a sheet covering the torso and waist area. During an interview, S1 reported that attempts were made on two occasions that morning to assist the R1 with dressing; however, the R1 removed the clothing each time. Staff further stated that the R1 was left alone with the intent to attempt dressing again later, but the R1 subsequently fell asleep.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 29-AS-20250602132841
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: 01/28/2026
NARRATIVE
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Continued from 9099-C
S1 also stated they did not make any attempts to contact the Administrator for assistance. LPA also observed that R1’s toenails appeared to be approximately 1 inch in length and unkept. LPA’s interview S1 revealed that the facility was awaiting a visit from a podiatrist to trim R1’s toenails. S1 further stated that R1 had not been assisted with showering since admission to the facility, as S1 had been informed that staff were not required to provide shower assistance because a home health nurse would be responsible for assisting R1. S1 stated they were unable to recall whether any home health agency had provided showering or grooming services to R1 at the time of the interview. At the time of the visit, no documentation was available on site to confirm that home health services had been arranged or provided. Interviews and observations conducted during the course of the investigation revealed that Resident # 2 (R2) also had not received a shower for an extended period while residing at the facility. Additionally, four (4) residents interviewed during the investigation reported concerns regarding the availability of personal hygiene supplies, including soap, shampoo, and laundry detergent. Based on information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegations that “Staff do not ensure resident was assisted with dressing”, “Staff do not ensure resident’s hygiene needs are being met” and “Staff do not ensure resident’s showering needs are being met” have been Substantiated at this time.

It was reported that “Staff did not ensure resident received adequate first aid for injuries” as it was alleged that R1 was observed with two (2) big wounds on hands. During LPAs visit on 06/06/2025, no wounds or visible markings on R1’s hands were observed. However, hospital records indicated that the R1 was admitted to a local hospital on 06/27/2025 for changes in mental status. Upon admission to the hospital, R1 was assessed for two (2) wounds; one located on a lower extremity and one located on the posterior thigh. A review of hospital records for R1 revealed there is documented history of wounds in the same anatomical areas. Interviews with S1 and Assistant Administrator revealed they did not recall observing any wounds or bruising on R1 prior to the hospital admission. No records on site to indicate R1 was on hospice or home health. Additionally, during the course of the investigation it was revealed that Resident #3 (R3) sustained a fall in the facility and was not provided with first aid or care in a timely manner. Based on information gathered during the investigation, the department has sufficient evidence to confirm these allegations occurred. Therefore, the allegation that “Staff did not ensure resident received adequate first aid for injuries” have been Substantiated at this time.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 7
Control Number 29-AS-20250602132841
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: 01/28/2026
NARRATIVE
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Continued from 9099-C

Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 9099-D.)

Due to the facility closure on 01/16/2026, a copy of this report and the appeals rights (LIC 9058 1/16) will be sent via email to Sarkis Dovlatyan and another certified copy vis USPS Sarkis Dovlatyan at their last known address. Former licensee / delegate should review, sign the report with a wet signature, and email the report back to CCLASCOWoodlandHillRO@dss.ca.gov or mail the report directly back to the LPA listed on the report at 21731 Ventura Blvd, Suite 250, Woodland Hills CA 91364
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 29-AS-20250602132841
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: 01/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/28/2026
Section Cited
CCR
87465(g)
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87465(g)The licensee shall immediately telephone 9-1-1 if an injury or other circumstance... apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c)(4). This requirement is not met as evidenced by:
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No POC can be provided as this facility closed on 01/16/2026.
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Based on interviews and records review, the licensee did not comply with the section cited, as R1 was admitted into a local hospital with wounds on body. Staff had no knowledge of any wounds R1, which posed an immediate health and safety risk to residents in care.
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Type A
01/28/2026
Section Cited
CCR
87615(a)(1)
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Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly:(1) Stage 3 and 4 pressure injuries. This requirement was not met as evidence by:
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No POC can be provided as this facility closed on 01/16/2026.
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Based on interviews and records review, the licensee did not comply as, R1 was admitted into a hospital with a prohibited health condition. Staff had no knowledge of any prohibited health conditions, which posed an immediate health/safety 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: 01/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 29-AS-20250602132841
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: 01/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/28/2026
Section Cited
CCR
87625(b)(3)
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Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. This requirement was not met as evidenced by:
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No POC can be provided as this facility closed on 01/16/2026.
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Based on interviews and observations, the Licensee did not comply in the section cited as the facility was observed to smell like urine throughout the facility , which posed a potential health, safety personal rights risk to residents in care.
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Type B
01/28/2026
Section Cited
CCR
87303(a)
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The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by:
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No POC can be provided as this facility closed on 01/16/2026.
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Based on interviews and observations, the Licensee did not comply in the section cited as the facility was observed to smell like urine 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: 01/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 29-AS-20250602132841
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: 01/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/28/2026
Section Cited
CCR
87464(f)(4)
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Personal assistance and care as needed by the resident... bathing and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports. This requirement was not met as evidence by:
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No POC can be provided as this facility closed on 01/16/2026.
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Based on interviews and observations, the licensee did not comply as R1 was observed multiple times without clothing in the facility and toenails unkept. R1, R2 were not showered in a timely manner, which posed a potential health, safety or 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: 01/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC9099 (FAS) - (06/04)
Page: 7 of 7