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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609829
Report Date: 06/18/2025
Date Signed: 06/18/2025 01:58:41 PM

Unsubstantiated


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
04/03/2025 and conducted by Evaluator Christine Yee
COMPLAINT CONTROL NUMBER: 29-AS-20250403164233
FACILITY NAME:ARARAT BOARD AND CAREFACILITY NUMBER:
197609829
ADMINISTRATOR:SARGSYAN, KARINEFACILITY TYPE:
740
ADDRESS:6614 TEESDALE AVETELEPHONE:
(818) 624-4180
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY:6CENSUS: 4DATE:
06/18/2025
UNANNOUNCEDTIME BEGAN:
09:51 AM
MET WITH:Mariam Panadzyan, LicenseeTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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1. Staff did not keep facility free of cigarette smoke.
2. Staff are not allowing a resident in care to close their bedroom door.
3. Staff yells at residents in care and calls them inappropriate names.
4. Staff did not provide a meal to a resident in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christine Yee conducted a subsequent unannounced complaint visit to conduct further investigation and to deliverr the findings of the above allegations and met with Mariam Panadzyan, Licensee. The reason for today's visit was explained.

On the initial visit conducted on 4/8/25, LPA Yee conducted an interview with the Witness #1 at 11:13am via telephone, Licensee at 12:20pm, Staff #1 at 12:32pm, Resident #1 at 1:50pm, Resident #2 at 1:46pm, Resident #3 at 1:20pm, Resident #4 at 1:24pm, Resident #5 at 1:24pm and Witness #2 via telephone at 2:30pm. Prior to conducting today's visit, LPA Yee also conducted an interview with Resident #6 on 4/7/25. No documents were collected on today's visit since Resident #6 lived at this home for about 3 days and no files were created. Resident #6's documents were requested from Witness 2 to be emailed over to LPA.

continued on LIC9099-D
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
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 4
Control Number 29-AS-20250403164233
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: 06/18/2025
NARRATIVE
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Per interviews conducted on today's visit, LPA Yee has determined that additional investigation is needed to make a finding for the above allegation. Exit interview was conducted.

On today's visit, LPA Yee conducted another interview with Mariam Panadzyan at 10:47am, Staff #1 at 10:37am and Resident #4 at 11:13am to obtain additional information and to clarify information that was provided during the initial visit conducted on 4/8/25.

Per information received regarding allegation #1 - Staff did not keep facility free of cigarette smoke, it is alleged that facility staff are smoking at the front door and the smoke is coming into their room. Per Resident #6, who lives in Bedroom #3, they are taking an amino immunal modular medication and cannot be exposed to the smoke. Per interviews conducted related to the allegation, staff deny smoking by the front door. The Administrator is a non-smoker and Staff #1 admits to smoking about 5-6 cigarettes a day. Per Staff #1. they smoke in the designated smoking area located in the backyard by the food storage building and once in a while will smoke a cigarette by the trash cans located by the front gate. The designated smoking area and the trash cans are not located close to Bedroom #3. Per the Administrator, another staff who works on weekends about 4 times a month smokes some times. All staff smoke in the designated smoking area. Per the Administrator, none of the residents smoke. Residents who were interviewed deny smelling smoke in their rooms. However, per the Administrator, she observed something that resembled smoke coming from Bedroom #3, twice when Resident #6 lived here for 3 days. The smoke was sweet smelling. Per interview conducted with Witness #2, Resident #6 does marijuana and edibles. Per interview with Resident #6, they deny that they smoke. Per information obtained during the investigation, there is insufficient evidence to support the allegation that staff did not keep facility free of cigarette smoke, therefore the allegation is unsubstantiated at this time.

Per investigation into Allegation #2 that - Staff are not allowing a resident in care to close their bedroom door interviews reveal that the residents are encouraged to close their bedroom doors. Resident #1, who has dementia, wanders into everyone's room. Residents interviewed also confirm that they have never been told not to close their door. The Administrator and Staff #1, who work at the facility regularly, deny that the
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 29-AS-20250403164233
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: 06/18/2025
NARRATIVE
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residents are told that cannot close their doors. During the tour of the facility and Bedroom #3 conducted on 4/8/25 and today, LPA Yee observed that all the residents were in their rooms with their doors closed. Bedroom #3 was locked to secure Resident #6's belongings as they no longer reside at the facility. Per the Administrator and Staff #1, they have to knock on the residents' doors to enter the room. Based on the information obtained during the investigation, there is insufficient evidence to support the allegation that Staff are not allowing a resident in care to close their bedroom door, therefore the allegation is unsubstantiated at this time.

Per LPA Yee's investigation into Allegation #3 - Staff yells at residents in care and calls them inappropriate names, interviews with the Administrator and Staff #1 they both deny yelling and calling the residents names. They are respectful with the residents. They both state that it is Resident #6 that uses bad language. Resident #6 curses at them and calls them names. There was an incident at the facility on 4/3/25 when Resident #6 hit Staff #1 on the head with their cane twice. The police were called out to the home and removed the resident. During that incident, Resident #6 called them names and cursed them out. The f... word was used liberally. Residents interviewed deny that staff yell at them and call them inappropriate names. Based on the information obtained during the investigation, there was insufficient evidence to support the allegation that Staff yells at residents in care and calls them inappropriate names, therefore the allegation is unsubstantiated at this time.

LPA Yee also investigated Allegation #4 - Staff did not provide a meal to a resident in care and the investigation revealed that Resident #6 moved into the facility in the late afternoon of 3/31/25 and was transferred on the afternoon of 4/3/25 to the hospital psychiatric unit, for observation after hitting Staff #1 with their cane . The resident was being transferred from a skilled nursing facility. The nursing home did not advise the Administrator that the new resident preferred a vegan diet. Staff would offer Resident #6 food and they would refuse to eat it because it was not vegan. The social worker of the nursing home purchased food for Resident #6 on the first day since they had gone to lunch. On the second day, Resident #6 requested oatmeal cooked with water and sugar for breakfast and did not eat much of it. On the second and third day, Resident #6 ate their own food that the nursing home had delivered, including the extra food from the
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 29-AS-20250403164233
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: 06/18/2025
NARRATIVE
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nursing home kitchen. Per the nursing home social worker, they buy their food in bulk and was able to give some to Resident #6. Per the Administrator, they continued to give Resident #6 a facility meal. The resident kept refusing their food. On 4/3/25 Staff #1 took lunch to Resident #6's room and this resulted in staff getting hit on the head by resident's cane. As a result of this behavior, Resident #6 was removed for observation in the psychiatric unit of the local hospital at the request of the police. File review was not conducted since the Facility was not able to collect any documents in the short time Resident #3 was at the facility. Per information provided by Witness #2, Resident #6 will get violent when they don't get their way and has attacked nursing home staff when they don't get their way and will only eat vegan food. Per the social worker, Resident #6 has a history of fabrication. Per information gathered during the investigation, there was insufficient evidence to support the allegation that Staff did not provide a meal to a resident in care, therefore the allegation is unsubstantiated 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: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4