197609829-4-14-2025-29-AS-KHEN-DG7VYW-20250429165148

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609829
Report Date: 04/14/2025
Date Signed: 04/14/2025 03:09:02 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
04/09/2025 and conducted by Evaluator Christine Yee

COMPLAINT CONTROL NUMBER: 29-AS-20250409102933

FACILITY NAME:	ARARAT BOARD AND CARE		FACILITY NUMBER:	197609829
ADMINISTRATOR:	SARGSYAN, KARINE		FACILITY TYPE:	740
ADDRESS:	6614 TEESDALE AVE		TELEPHONE:	(818) 624-4180
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY:	6	CENSUS: 5	DATE:	04/14/2025
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Mariam Panadzyan, Licensee		TIME COMPLETED:	03:10 PM

ALLEGATION(S):

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1. Staff refused to accept resident for re-admission
2. Staff does not ensure facility bathroom is in good repair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christine Yee conducted an unannounced complaint visit to investigate the above allegations and was let into the home by Gayane Adamyan, Staff. Mariam Panadzyan, Licensee, was contacted by telephone and she returned to the facility shortly after the call. The reason for today's visit was explained.

On today's visit, LPA Yee conducted an interview with Mariam Panadzyan, Licensee at 11:01am, toured the 4 bathrooms at 11:38am. Prior to today's visit, LPA Yee also conducted an interview with the Reporting Party at 1:40pm, Resident #1 at 2:38pm and Witness #1 at 3:16pm.

Per information provided from interviews conducted, regarding allegation that staff refused to accept resident for re-admission - Resident #1, who had been relocated to this home from a skill nursing facility on 3/31/25

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025

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

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250409102933

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: ARARAT BOARD AND CARE	FACILITY NUMBER: 197609829
	VISIT DATE: 04/14/2025

NARRATIVE

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and then was relocated to Providence Saint Joseph on 4/3/25 by local law enforcement for psychiatric observation because Staff had called 911 an alleged that Resident #1 had hit a facility staff twice on the head with a cane. Resident #1 denied hitting anyone. Resident #1 informed the hospital social worker that they did not like this home and did not want to return to the facility and new placement would have to be located upon discharge. Per information provided, Witness #1 was in the process of locating a new facility for the resident and had located a new home. Transportation arrangements were made by staff of the new location and Resident #1 was transported directly from Providence Saint Joseph to the new location. Resident #1 does not know the name of the home they were taken to. Per interview conducted with Witness #1 on 4/10/25, Resident #1 refused to enter the relocation home and they were transferred to LA General Hospital and was placed in the observation unit. Per interview conducted with Resident #1, they did not return to Ararat Board and Care or wanted to return to this facility and did not contact this facility to advise staff that they wanted to re-admitted when they were discharged for Providence Saint Joseph Hospital. The Licensee also confirms that Resident #1 did not call her at any time to say that they wanted to return to the facility. Based on the information received from interviews conducted, there is no evidence to support the allegation that Staff refused to accept resident for re-admission, therefore the allegation is unfounded at this time.

Regarding allegation #2 - Staff does not ensure facility bathroom is in good repair, per interview with Resident #1, they never told anyone that the bathroom at Ararat was in disrepair. The only complaint with the bathroom was that the bathroom would be occupied when they needed it. Per interview conducted with the Licensee, the bathrooms are working well and does not need repairs. A tour of all the bathrooms was conducted at 11:38am, also confirms that the bathrooms are working well. There is insufficient evidence to support the allegation that Staff does not ensure facility bathroom is in good repair, therefore the allegation is unfounded at this time.

Exit interview was conducted and a copy of this report was provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2025

LIC9099 (FAS) - (06/04)

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