197609006-2-27-2026-29-AS-CYEE-DRPTWZ-20260227140620

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197609006
Report Date: 02/24/2026
Date Signed: 02/27/2026 02:06:51 PM

Document Has Been Signed on 02/27/2026 02:06 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME:	VICTORY PLACE HOME		FACILITY NUMBER:	197609006
ADMINISTRATOR/ DIRECTOR:	AKHPARIAN, ANDREW		FACILITY TYPE:	735
ADDRESS:	6353 BABCOCK AVE		TELEPHONE:	(818) 585-0095
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY: 4		CENSUS: 3	DATE:	02/24/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:19 AM
MET WITH:	Diana Gevorgyan, House Manager		TIME VISIT/ INSPECTION COMPLETED:	06:25 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool and was let into the home by Diana Gevorgyan. Andrew Akhparian, Administrator was also present in the home on today's visit. The reason for today's visit was explained. The home is a single storey family home consisting of a living room, dining room, kitchen, 5 bedrooms, 2 full bathrooms and a detached garage that was converted into and ADU in 2019 with a separate address. Located on the property is a swimming pool. The facility is fire cleared for 4 AMBULATORY clients. The home is vendorized by the North Los Angeles County Regional Center as a level II home.. On today's visit, LPA Yee reviewed all 12 domains of the CARE Inspection Tool, reviewed 3 client and 3 staff files and conducted a tour of the physical plant, inside and outside and the storage shed. The following was observed on today's visit: the living room, dining room and kitchen are furnished and equipped with the appropriate seating and furnishing for it's designated use. Bedroom #2 and Bedroom #4 were inspected on today's visit. Bedroom #2 is vacant and in the process of being painted and is only furnished with a twin bed, a portable closet and a working table. Bedroom #4 has the required Title 22 furniture but no was no lamp observed. continued on LIC9099-C

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VICTORY PLACE HOME	FACILITY NUMBER: 197609006
	VISIT DATE: 02/24/2026

NARRATIVE

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Bedroom #1 and Bedroom #3 could not be inspected because the Clients have installed locks on their doors and will not provide the facility with a key or access to the staff for emergencies. Client #1 was present during the visit and refused to allow LPA Yee to inspect the room. The window blinds in bedroom #1 was observed to be broken from the front yard.
The only common bathroom located by bedroom #3 has a shower, a toilet and a single sink. A slip resistant mat was observed. The water temperature was tested and read 119.9 degrees Fahrenheit.
The air vents located in the common bathroom and right outside the bathroom were observed to be covered in dust.
The live in staff's room contains a queen size bed, a sofa, chest of drawers, a desk, a refrigerator and other personal belongings. Located inside is a private bathroom equipped with a shower, a toilet and a 2 sink vanity.
During the tour of the kitchen, sufficient perishable foods for a minimum of 2 days and non-perishable foods for a minimum of 7 days were observed.
Per review of the first aid kit, a tweezer, a pair of scissors, a thermometer, bandages, gauze, band aids were observed. Also observed were ointments and alcohol swabs but they expired on 6/2025. A first aid manual was observed.
A copy of the surety bond in the amount of $3,000 was observed.
P and I ledgers for Client #2 and Client #3 were reviewed.
Medications for Client #3 was reviewed. Client #1 and Client #2 do not take any medications.
The two fire extinguishers, one large and one small, observed in the kitchen were observed in the green. However the small one was purchased on 6/30/24 and the date the large fire extinguisher was purchased is unknown.
The only carbon monoxide detector mounted on the wall by the door of the staff bedroom was tested and was operational.
All the smoke detectors located inside the resident bedrooms, kitchen, hallway, living room were tested individually and were operational. The staff room does not have a smoke detector.
The front yard was observed to be clean.
Located in the back of the home is a swimming pool secured by a 5 foot rod iron fence and was locked.

continued on LIC9099-C

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VICTORY PLACE HOME	FACILITY NUMBER: 197609006
	VISIT DATE: 02/24/2026

NARRATIVE

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Also located in the back is a shed used for storage. The backyard was observed with stacked chairs and a folded umbrella. The backyard needs general cleaning. Items like ladders, pull cart, bricks, brick slab, bucket, broken broom head, pressure washer needs to be discarded or stored away.
Trash cans were put out on the side walk for pick up.

Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8.

Exit interview was conducted, APPEALS RIGHTS discussed and a copy was given on February 27/2026 due to issues encountered with the CARE Inspection Tool on 2/24/26. A report could not be provided during that visit.

NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/27/2026 02:06 PM - It Cannot Be Edited

Created By: Christine Yee On 02/25/2026 at 10:20 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VICTORY PLACE HOME	FACILITY NUMBER: 197609006
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/24/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

80073(a)

Telephones

(a) All facilities shall have telephone service on the premises. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above as the facility was not operational when LPA Yee called the facility phone during the visit, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/06/2026
	Plan of Correction
1 2 3 4	Licensee will contact the telephone company to troubleshoot the facility telephone to have services reinstated and provide evidence that the phone is operational by 3/6/26

Type B

Section Cited

CCR

80087(a)

Building and Grounds

(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above as the slates in the window blinds in bedroom #1 was observed to be broken, the air vents inside and outside the common bathroom was observed with dust and needs cleaning and the backyard need discarde bricks, ladders, pressure hose, pull cart, dust pan, broken broom needs to be stored awayor discarded which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/06/2026
	Plan of Correction
1 2 3 4	Licensee will inspect all the facility blinds and replace all broken blinds in the clients bedrooms and in the common areas, cliean the air vents and the backyard. Provide evidence that all blinds, and cleaning have been conducted and the blinds are in good repair by 3/6/26.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Kristin Heffernan
NAME OF LICENSING PROGRAM MANAGER:

	Christine Yee
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/27/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/27/2026 02:06 PM - It Cannot Be Edited

Created By: Christine Yee On 02/25/2026 at 10:20 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VICTORY PLACE HOME	FACILITY NUMBER: 197609006
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/24/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1565(f)(2)(A)

Other Provisions

(f) A facility shall have both of the following in place: (2) A set of keys available for use during an evacuation that provides access to all of the following: (A) All occupied resident units, if applicable. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observationand interview conducted, the licensee did not comply with the section cited above as the facility does not have set of keys available for Bedroom #1 and Bedroom #3 for emergencies or emergency entry into the room which posed/poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/06/2026
	Plan of Correction
1 2 3 4	Licensee will ensure that a set of keys are obtained and available for all occupied resident units for emergency evacuations and for emergency entry due to health and safety concerns by 3/6/26. *****corrected as observed on the visit conducted on the 2/27/26 *****

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Kristin Heffernan
NAME OF LICENSING PROGRAM MANAGER:

	Christine Yee
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/27/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026

LIC809 (FAS) - (06/04)

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