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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608986
Report Date: 03/30/2026
Date Signed: 03/30/2026 11:37:33 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
10/06/2025 and conducted by Evaluator Brian Balisi
COMPLAINT CONTROL NUMBER: 29-AS-20251006194233
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: DATE:
03/30/2026
UNANNOUNCEDTIME BEGAN:
10:23 AM
MET WITH:TIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility retained residents with prohibited health conditions
Staff does ensure resident's medical needs are being met.
Staff are not fingerprint cleared.
Staff is administering insulin to resident.
Staff are mismanaging resident's medications.
Staff do not provide adequate food service to residents.
Staff are not properly trained.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent unannounced complaint visit to deliver findings. Due to the closure of the facility license effective 01/16/2026, today’s visit was conducted telephonically with former Licensee Sarkis Dovlatyan.
On 10/07/2025, from 10:58 a.m. to 05:15 p.m., LPA’s Byrne and Urena conducted an initial 10-day complaint visit to investigate the allegations listed above. LPA’s conducted a physical plant tour, interviewed staff, residents and reviewed and obtained copies of pertinent documentation relevant to the investigation. On 10/22/2025, from 09:30 a.m. – 2:00 p.m., LPA Balisi conducted a tour of the physical plant, interviewed staff, residents and reviewed and obtained copies of facility documents while on site for an unannounced Case Management visit.
On 11/03/2025, from 10:00 a.m. to 02:30 p.m., LPAs Balisi and Arroyo conducted a physical plant tour, interviewed staff, residents and reviewed and obtained copies of facility documents while on site for an unannounced Plan of Correction visit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
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-20251006194233
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: 03/30/2026
NARRATIVE
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Continued from 9099
On 12/11/2025, from 09:40 a.m. to 02:00 p.m. LPA Balisi conducted a physical plant tour, interviewed staff, residents and reviewed and obtained copies of facility documents while on site for an unannounced Case Management Visit. On 12/30/2025, from 09:30 a.m. to 01:00 p.m., LPA Balisi conducted a physical plant tour, interviewed staff, residents and reviewed and obtained copies of facility documents while on site for an unannounced Case Management Visit. On 01/05/2026, from 11:00 a.m. to 02:30 p.m., LPA Balisi conducted a physical plant tour, interviewed staff, residents and reviewed and obtained copies of facility documents while on site for an unannounced Case Management Visit.
It was reported that "Facility retained residents with prohibited health conditions" and "Staff does not ensure resident's medical needs are being met as it was alleged that a resident was retained with a prohibited health condition and was not seen by home health for wound care. Interviews conducted and records review revealed Resident #1 (R1) and Resident #2 (R2) resided at the facility with prohibited health conditions. R1 had a stage 3 wound on their left ankle and R2 had a stage 4 wound on their hip. Administrator Lala Soghomonyan claimed residents were receiving home health services for wound care, however there was no documentation on site to review and confirm. LPA did not observe any exception requests on file for the (2) residents with prohibited health conditions to be accepted and retained in the facility. Interviews with residents reflected that no health care professional provided any services. Based on information gathered during the investigation, the department has sufficient evidence to confirm that multiple residents were retained with prohibited health care conditions and that facility staff did not meet the residents’ needs due to failure to follow up with any physician. Therefore, the above listed allegations "Facility retained residents with prohibited health conditions” and "Staff does not ensure resident's medical needs are being met” have been Substantiated at this time.
It was reported that "Staff are not fingerprinted cleared" as it was alleged that staff do not have criminal record clearance. Interviews conducted and records reviewed revealed during LPA's Byrne and Urena's initial 10-day visit conducted on 10/07/2025, LPA's observed Staff #1 (S1) in the facility providing service to residents in care, however it was observed S1 was not associated to the facility. On 10/16/2025, while on site for a health and safety check visit at approx. 09:55 a.m. LPA reviewed caregiver background check on Guardian and observed Staff #2(S2) to not be associated to the facility. On 12/01/2025, while on site for a health and safety check visit at approx. 11:30 a.m. LPA reviewed caregiver background check on Guardian and observed association status of Staff #3 (S3) to be "In-process". Based on information gathered during the investigation, the department has sufficient evidence to confirm these allegations occurred Therefore, the allegation of “Staff are not fingerprinted cleared" have been Substantiated at this time.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
LIC9099 (FAS) - (06/04)
Page: 7 of 7
Control Number 29-AS-20251006194233
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: 03/30/2026
NARRATIVE
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Continued from 9099-C
It was reported that " Staff is administering insulin to resident" as it was alleged that unqualified staff are administering insulin to R1. Interviews conducted and records review reflected that on 09/04/2025 from 09:30 a.m. to 05:15 p.m., while on site for a separate investigation, LPA’s Balisi and Arroyo observed Staff #4 (S4), who is not an Appropriately Skilled Professional (ASP), administer insulin to R1. LPA's records review of LIC 602 dated 08/19/2025 revealed R1 is Diabetic, unable to administer own medications and needs constant medical supervision. LPA's interview with S4 confirmed that S4 has administered the insulin to R1 at least once daily and they have not observed any nurse visit the facility to administer insulin to R1. Former administrator Lala Soghomonyan stated to LPA that a nurse came in every day to administer insulin to R1, however there were no records of visits on site to review to confirm the visits. LPA's interview with four (4) residents in care including R1, at the time of the complaint revealed that they do not recall a nurse coming to visit to administer insulin to R1. Based on the information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegation that "Staff is administering insulin to resident” has been Substantiated at this time.

It was reported that “Staff are mismanaging residents’ medications” and “Staff and are not properly trained” as it was alleged that residents are not receiving prescribed medications due to lack of staff training. Interviews and records reviewed during the investigation revealed that, during the initial 10-day visit on 10/07/2025 from 10:58 a.m. to 5:15 p.m., Resident #2 (R2) had not been administered simvastatin for approximately five (5) days. During the same visit, Resident #3 (R3) reported being aware of their prescribed medications and stated they must remind staff when medications are not provided. During a case management visit on 12/11/2025 from 9:40 a.m. to 2:00 p.m., it was observed that Resident #4 (R4)’s centrally stored medication list had not been updated for December 2025. Subsequent visits on 12/30/2025 from 9:30 a.m. to 1:00 p.m. and 01/05/2026 from 11:00 a.m. to 2:30 p.m. revealed that R5 was accessing the centrally stored medication cabinet on both dates. In an interview, R5 stated a preference to access and self-administer their medications, citing a lack of trust in staff to administer them correctly. Additionally, on 10/22/2025 during a case management visit from 9:30 a.m. to 2:00 p.m., Staff #5 (S5) did not have a complete personnel file available onsite for review. On 11/03/2025 during a case management visit from 10:00 a.m. to 2:30 p.m., records review revealed that S5 did not have valid first aid and CPR certification. Based on information gathered during the investigation, the department has sufficient evidence to confirm these allegations occurred. Therefore, the allegations of "Staff are mismanaging resident's medications" and “Staff are not properly trained” have been Substantiated at this time.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 29-AS-20251006194233
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: 03/30/2026
NARRATIVE
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Continued from 9099-C2

It was reported that "Staff do not provide adequate food service to residents" as It was alleged that the Administrator does not purchase food for residents. Interviews conducted and observations made by LPA during the course of the investigation reflected that during a separate investigation on 10/16/2025, it was revealed that Resident #5 (R5) provided their Electronic Benefit Transfer (EBT) card to the former Administrator for the purpose of purchasing food items. However, R6 reported that the requested items were not received. The EBT card was subsequently observed to have a zero balance. On 12/11/2025, during a physical plant tour conducted between 9:40 a.m. and 2:00 p.m., the LPA observed cucumbers with visible mold and cabbage that appeared significantly discolored and spoiled. On 12/30/2025, during a physical plant tour conducted between 9:30 a.m. and 1:00 p.m., the LPA observed that the facility did not maintain a sufficient supply of perishable food items in the refrigerator, including an absence of milk, eggs, and vegetables. Additionally, the LPA observed that the pantry door was secured with a lock, rendering non-perishable food items not readily accessible to residents in care. Based on information gathered during the investigation, the department has sufficient evidence to confirm these allegations occurred Therefore, the allegations of “Staff do not provide adequate food service to residents" has been Substantiated at this time.


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: 03/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 29-AS-20251006194233
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: 03/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/30/2026
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 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 / records review, licensee did not comply as R1and R2 were retained in the facility with prohibited health conditions, which posed an immediate health / safety risk to residents in care.
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Type A
03/30/2026
Section Cited
CCR
87355(e)(1)
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All individuals subject to a criminal record review ...(b) shall prior to working... in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department…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 observation and record review, the licensee did not comply with the section cited above as a criminal background fingerprint clearance was not conducted for S1, S2 and S3, which posed an immediate health and safety risk to persons 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: 03/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 29-AS-20251006194233
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: 03/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/30/2026
Section Cited
CCR
87629(b)(1)
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Ensuring that injections are administered by an appropriately skilled professional should the resident require assistance. 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, observations and records review, the licensee did not comply with the section cited above as S4 is not an appropriately skilled professional, but was observed administering insulin to R1, which posed an immediate health and safety risk to persons in care.
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Type A
03/30/2026
Section Cited
CCR
87465(h)(2)
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Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. 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 with the regulation cited above as R4 was observed accessing the centrally stored medication cabinet , which posed an immediate health, safety and personal rights risks to persons 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: 03/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 29-AS-20251006194233
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: 03/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/30/2026
Section Cited
CCR
87412(c)(1)(A)
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For staff who assist with personal activities of daily living, there shall be documentation of at least ten hours of initial training within the first four weeks of employment... specified in Section 87411(c)(2). 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 records review, the licensee did not comply with the section cited above as S5 did not have at least (10) hours of initial training , which posed a potential health and safety concern for residents in care.
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Type B
03/30/2026
Section Cited
CCR
87555(b)(26)
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Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. 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 observations, the Licensee did not comply with the regulation cited above as the Licensee failed to maintain a sufficient supply of foods such as milk, eggs, and produce, which posed a potential health, safety and personal rights risks to persons 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: 03/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 7