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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609609
Report Date: 07/01/2026
Date Signed: 07/01/2026 01:44:34 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/23/2026 and conducted by Evaluator Antonia Alvizar-Ettima
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20260623124729
FACILITY NAME:KDAD INCFACILITY NUMBER:
197609609
ADMINISTRATOR:ADAMYAN, ARMINEFACILITY TYPE:
735
ADDRESS:9500 NATICK AVETELEPHONE:
(818) 326-4433
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY:4CENSUS: 3DATE:
07/01/2026
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Administrator, Armine Adamyan, DSP's Vartouhie Elias, Sahak Sam Daragchyan, Karapet Gary DaragchyanTIME COMPLETED:
01:50 PM
ALLEGATION(S):
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Staff pushed resident
INVESTIGATION FINDINGS:
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At 9:15a.m., Licensing Program Analyst (LPA) Antonia Alvizar- Ettima conducted an unannounced initial visit to investigate the above noted allegation. LPA met with the Licensee/Administrator, three (3) Direct Support Professional (DSP) staff and explained the reason for the visit.

At about 9:30a.m., LPA requested residents and staff roster, facility file of client #1 (C1), including Identification Information, Physician Report, Individual Program Plan (IPP), Unusual Incident Report, and other pertaining information. At approximately 9:45a.m., Administrator and LPA conducted a physical plant tour to assure the health and safety of the clients. Between 10:05a.m. – 11:05a.m. LPA conducted interviews with Administrator, Staff #1- #3 (S1-S3) and one (01) out of three (03) clients. The other two (02) clients are out of the facility attending Day Program at the time of this visit. At approximately 11:40a.m., LPA obtained copies of records relevant to the investigation and reviewed.

Cont. on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2026
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 2
Control Number 31-AS-20260623124729
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: KDAD INC
FACILITY NUMBER: 197609609
VISIT DATE: 07/01/2026
NARRATIVE
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Cont. from LIC 9099

Staff pushed resident

It was alleged that staff #1 (S1) had pushed Client (C1) on both shoulders from behind because S1 wanted C1 to leave the home and wait outside for transportation to the day program.

During investigation, the Administrator and staff #1 – through Staff #3 (S1-S3) denied the allegation. Staff stated that no physical contact occurred. C1 exited the home independently and waited outside for transportation per daily facility’s routine. Staff further stated that they have not observed S1 use physical force toward clients. The Administrator reported that C1 initially made the allegation to the day program staff but later changed the allegation. Administrator also stated that, following the allegation, the facility conducted an internal review, temporarily reassigned S1 from direct contact with C1, and reviewed available exterior surveillance footage. According to the Administrator, the internal review did not identify evidence that S1 pushed C1. LPA interviewed Client #2 (C2), who reported having no concerns regarding S1’s interaction with clients and stated that had not witnessed S1 push C1 or any other client. During the visit, LPA did not observe staff using inappropriate physical contact with client. Client appeared appropriately supervised, and staff interactions with client were observed to be respectful and appropriate.

Based on interviews, observations, and information obtained during the investigation, there is an insufficient evidence to support the allegation that S1 pushed C1. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2026
LIC9099 (FAS) - (06/04)
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