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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609920
Report Date: 07/14/2026
Date Signed: 07/14/2026 08:26:06 PM

Document Has Been Signed on 07/14/2026 08:26 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:BASSETT ASSISTED LIVINGFACILITY NUMBER:
197609920
ADMINISTRATOR/
DIRECTOR:		EMMA ARUTIUNIANFACILITY TYPE:
740
ADDRESS:16011 BASSETT STTELEPHONE:
(818) 442-5702
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY: 6CENSUS: 6DATE:
07/14/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:51 AM
MET WITH:Emma Arutiunian, AdministratorTIME VISIT/
INSPECTION COMPLETED:
08:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection and used the CARE Inspection Tool to conduct the visit. LPA Yee met with Emma Arutiunian, Administrator. LPA Yee had to wait for Laura Hovhannisyan, Backup Administrator to arrive to provide documents. She arrived at 11:47am to conduct the visit.

The facility is a single storey family home consisting of a living room, dining room, a kitchen, a family room, 7 bedrooms of which one is designated as a staff room/Office, a laundry room, 4 full bathrooms. Located behind the laundry room is a single room used by staff. Located in the back is also a storage shed.

On today's visit, all 12 domains of the Care Inspection Tool was reviewed, 6 resident and 6 staff files were reviewed and a tour of the entire facility, inside and outside, was inspected. The following was observed:
  • the living room, dining room, kitchen and family room were furnished with the appropriate furniture for its designated used for 6 residents. The fireplace located in the living room did not have a fire screen.
  • all 6 resident bedrooms were furnished with a hospital bed, a night stand, a lamp, a chair, a dresser and a built-in closet. Each room has a wall mounted television. Window dressings were observed. Licensee will provide a extra curtain panel in bedroom #3 to allow for resident privacy.
  • All three bathrooms, 2 private bathrooms are equipped with a walk in shower, a sink and a toilet. Slip resistant mats and grab bars were observed in the shower. No grab bars were observed by the toilets.
  • Bed linens and extra bed linens were observed.
continued on LIC809-C
NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
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: BASSETT ASSISTED LIVING
FACILITY NUMBER: 197609920
VISIT DATE: 07/14/2026
NARRATIVE
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  • Water temperature taken in the common bathroom read 103.1 degrees, the bathroom between between bedroom #3 and #5 read 103.20 degrees and the bathroom between bedroom #4 and #6 read 103.6 degrees Fahrenheit.
  • The only fire extinguisher located in the kitchen was purchased on 1/7/26.
  • The first aid kit containing the required tweezer, scissors, thermometer and dressings and first aid manual was observed.
  • Medications are centrally stored in a locked filing cabinet.
  • The facility has hardwired smoke detectors in all the 7 bedrooms and combination smoke/carbon monoxide detectors in the resident hallway, family room, in front of bedroom #2 and the staff room. They were operational when tested. The fire rated door located in the resident hallway was operational also.
  • The facility has current general liability insurance with the required Title 22 limits.
  • The laundry room contained a washer and dryer.
  • Overall, the facility, inside and outside, were observed to be clean.


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

Exit interview was conducted, Appeals Rights were discussed and a copy was provided.
NAME OF LICENSING PROGRAM MANAGER: Kristin Heffernan
NAME OF LICENSING PROGRAM ANALYST: Christine Yee
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2026
LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 07/14/2026 08:26 PM - It Cannot Be Edited


Created By: Christine Yee On 07/14/2026 at 07:34 PM
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: BASSETT ASSISTED LIVING
FACILITY NUMBER: 197609920

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87555(b)(26)
General Food Service Requirements
(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as it was observed that there was insufficient non-perishable foods stored in the pantry located in the laundry room which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/15/2026
Plan of Correction
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Licensee will purchase additional non-perishable foods such as canned chicken, fish, sauces, vegetables, snacks, soups to supplement the supply of food to last a minimum of 7 days by 7/15/26.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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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: 07/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/14/2026 08:26 PM - It Cannot Be Edited


Created By: Christine Yee On 07/14/2026 at 07:34 PM
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: BASSETT ASSISTED LIVING
FACILITY NUMBER: 197609920

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87303(e)(2)
Maintenance and Operation
(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as water temperature tested in all 3 bathrooms read 103.1, 103.2 and 103.6, did not attain the required temperature of 105-120 degrees Fahrenheit wate[count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/15/2026
Plan of Correction
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Licensee will adjust the thermostat on the water heater so that the water temperature is automatically maintained within the required range of 105 - 120 degrees Fahrenheit by 7/15/26
Type B
Section Cited
CCR
87303(e)(4)
Maintenance and Operation
(4) Grab bars shall be maintained for each toilet, bathtub and shower used by residents.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as all 3 bathrooms were observed without grab bars by the toilets which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/21/2026
Plan of Correction
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The Licensee will install grab bars in all three bathrooms, by the toilet area by 7/21/26.
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: 07/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2026


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 07/14/2026 08:26 PM - It Cannot Be Edited


Created By: Christine Yee On 07/14/2026 at 07:34 PM
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: BASSETT ASSISTED LIVING
FACILITY NUMBER: 197609920

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87307(e)(1)(A)
(e) The licensee shall supervise residents as needed and as determined by the resident's appraisal pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to or when there is use of the following items: (1) Ranges, ovens, heaters, fireplaces, wood stoves, inserts, and other heating devices. (A) Heating devices shall have protective mechanisms or other measures to prevent access to the device, or to make it inoperable when not in use, in order to reduce the risk of burns or fire.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as the fireplace located in the living room was observed without a fire screen which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/21/2026
Plan of Correction
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Licensee will purchase a fire screen and place in front of the fireplace so that the fireplace is made inacessible to the residenst in care by 7/21/26.
Section Cited
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
Plan of Correction
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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: 07/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2026


LIC809 (FAS) - (06/04)
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