197609877-8-3-2026-31-AS-NMAN-DY2VKV-20260918163056

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609877
Report Date: 08/03/2026
Date Signed: 08/03/2026 08:02:16 PM

Unsubstantiated

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., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/26/2026 and conducted by Evaluator Tihesha Smith

COMPLAINT CONTROL NUMBER: 31-AS-20260726111850

FACILITY NAME:	IN HOME CARE CENTER		FACILITY NUMBER:	197609877
ADMINISTRATOR:	DOVLATYAN, KRISTINE		FACILITY TYPE:	740
ADDRESS:	9023 GAVIOTA AVE		TELEPHONE:	(747) 998-7577
CITY:	NORTH HILLS	STATE: CA	ZIP CODE:	91343
CAPACITY:	6	CENSUS: 4	DATE:	08/03/2026
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Mikayel Bejanyan, Staff		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Resident sustained multiple injuries due to staff neglect
Staff did not seek medical attention for resident in a timely manner
Staff did not ensure resident's basic needs are met.
Staff are unable to clearly communicate with residents

INVESTIGATION FINDINGS:

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Licensing program analyst (LPA) Tihesha Smith made an unannounced complaint visit to this facility on 08/03/26 to investigate the allegations above. LPA Smith met with staff Mikayel Bejanyan as the administrator was unavailable and disclosed the purpose of the visit.

Resident sustained multiple injuries due to staff neglect
Staff did not seek medical attention for resident in a timely manner
Staff did not ensure resident's basic needs are met.
Staff are unable to clearly communicate with residents

LPA Smith conducted a facility tour at 10:20 a.m., requested the LIC 500 Personnel Report and LIC 9020 Client Register at 10:35 a.m., and interviewed staff at 10:45 a.m. During the tour, LPA Smith observed that the home displayed a second numbered address on the house to the right of the facility’s posted

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2026

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 31-AS-20260726111850

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., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: IN HOME CARE CENTER	FACILITY NUMBER: 197609877
	VISIT DATE: 08/03/2026

NARRATIVE

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(Cont from 9099)

address, as well as an open gate leading toward that adjacent area. Additionally, during the tour LPA Smith observed three (3) residents in the home. One resident was asleep, and the other two residents were awake, communicative, and reported that they were doing well and that their needs were being met. LPA Smith did not observe any individual matching description contained in the complaint. Per staff interview, the facility currently has four (4) residents, with one (1) resident away at work. Staff confirmed that none of the residents match the description or health concerns identified in the complaint.

Based on information obtained during the visit, it was determined that the individual referenced in the complaint does not reside at the facility. Therefore, the allegations are unsubstantiated at this time.

No hazards observed at time of visit, however, LPA Smith reminded lead staff to inform all facility staff that licensing representatives must be granted entry to the facility when a badge is presented. LPA Smith also instructed staff to remove the two vehicles (covered with car covers that have cobwebs and leaves underneath) that are parked on the front grounds of the facility. Staff acknowledged the instruction and will have the vehicles removed from the facility within the next seven days.

Exit interview conducted/copy of report provided.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2026

LIC9099 (FAS) - (06/04)

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