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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 10:03:00 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
07/01/2025 and conducted by Evaluator Brian Balisi
COMPLAINT CONTROL NUMBER: 29-AS-20250701165718
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:
09:00 AM
MET WITH:TIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Resident developed a pressure injury while in care
Staff hit resident in care
Staff do not ensure residents grooming needs are being provided
Staff keep residents isolated in rooms without any interaction
Staff do not ensure residents medications are dispensed as prescribed
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 05:15 p.m. LPA conducted a physical plant tour, 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 physical plant tour, interviewed 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-20250701165718
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 “Resident developed a pressure injury while in care” as it was alleged that Resident #1 (R1), sustained a pressure injury on their buttocks. Interviews conducted and records revealed 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. Hospital records did not indicate any pressure injuries were observed on the buttocks area. A review of hospital records for R1 revealed there is documented history of pressure injuries in the same anatomical areas. Interviews with Staff #1(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. On 09/04/2025, during a subsequent complaint visit on a separate investigation, LPAs observed Resident #2 (R2) at the facility with a prohibited health condition. LPAs interview with administrator reflected that R2 did not have any Home Health (HH) services at that time of the visit. Based on information gathered during the investigation, the department has sufficient evidence to confirm these allegations occurred. Therefore, the allegations that “Resident developed a pressure injury while in care” has been Substantiated at this time.

It was reported that “Staff hit resident in care” and “Staff keep residents isolated in rooms without any interaction” as it was alleged that Staff #2 (S2) had hit R1 and on multiple occasions visitors observed the door to R1’s room to be closed and believed it to be closed for extended periods of time. No further details were provided to the reporting party. Interviews conducted over the course of the investigation reflected that S2 did in fact treat residents in an aggressive manner. S2 would yell, and did not allow residents to speak with each other, leave their bedrooms or eat outside. Interviews further reflected that S2 was also seen hitting a resident, however, no injuries were noted. Additionally Interviews further revealed four (4) residents in care revealed concerns regarding being confined to their rooms.
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-20250701165718
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
Three (3) of the four (4) residents reported that the hallway door separating the bedroom areas from the common area was observed to be closed and locked on multiple occasions. One (1) resident, who requires assistance transferring in and out of bed, reported not receiving the necessary support from staff. Another resident, who requires assistance with ambulating stated that staff did not provide assistance with safely ambulating throughout the facility. Based on information gathered during the investigation, the department has sufficient evidence to confirm these allegations occurred. Therefore, the allegations that “Staff hit resident in care” and “Staff keep residents isolated in rooms without any interaction” have been Substantiated at this time.

It was reported that “Staff do not ensure residents grooming needs are being provided” as it was alleged that R1 toenails were observed overgrown and unhygienic. On 06/06/2025, at approximately 9:45 a.m., during a physical plant inspection, the LPA 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 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 3 (R3) also had not received a shower for an extended period and had been observed to be unkept on multiple occasions while residing at the facility. Interview with R3 revealed they were awaiting services from a home health nurse. No records onsite indicated R3 were being seen by any home health agencies. Interviews with staff revealed they were not aware when home health services were to begin. Based on information gathered during the investigation, the department has sufficient evidence to confirm these allegations occurred. Therefore, the allegation that “Staff do not ensure residents grooming needs are being provided” has been Substantiated at this time.

It was reported that “Staff do not ensure residents medications are dispensed as prescribed” as it was alleged that R1 has not been receiving their medications as prescribed. At the time of the visit, no documentation was available on site to confirm medication was being administered as prescribed.
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-20250701165718
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
During the course of the investigation, it was revealed that Resident #4(R4) had been residing at the facility for approx. twelve (12) days and their insulin was never obtained, and Glucose testing was not conducted. R4’s file was not on site for review. Based on information gathered during the investigation, the department has sufficient evidence to confirm these allegations occurred. Therefore, the allegation that “Staff do not ensure residents medications are dispensed as prescribed” has been Substantiated at this time.

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
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:
FACILITY NUMBER:
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
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 / records review, licensee did not comply as , R1 was admitted into a local 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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Type A
01/28/2026
Section Cited
CCR
87468.1(a)(1)
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To be accorded dignity in their personal relationships with staff, residents, and other persons. 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, the licensee did not comply with eh section cited as it was reported that residents were not treated with dignity and respect by S2 on multiple occasions, which posed an immediate health, safety and 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: 5 of 7
Control Number 29-AS-20250701165718
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
87468.1(a)(6)
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To leave or depart the facility at any time and to not be locked into any room...such as locking doors at night to protect residents, or barring windows against intruders, with permission from the Department. 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, the licensee did not comply with the section cited as it was reported that residents were confined to their room on multiple occasions which posed an immediate health, safety and person rights risk to residents in care.
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Type A
01/28/2026
Section Cited
CCR
87465(a)(4)
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The Licensee shall assist resident with self-administered medication as needed. 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 records review the licensee did not comply with the section cited as there were no records on site to review to confirm R1 received their medications as prescribed, which posed an immediate health, safety and 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-20250701165718
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 and as indicated in the pre-admission appraisal...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 and with toenails unkept. R1 / R2 were also 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