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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610152
Report Date: 12/23/2025
Date Signed: 12/23/2025 12:04:50 PM

Substantiated


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
06/18/2025 and conducted by Evaluator Huma Rahimi
COMPLAINT CONTROL NUMBER: 31-AS-20250618111717
FACILITY NAME:PALACE OF JOYFACILITY NUMBER:
197610152
ADMINISTRATOR:GRIGORYAN, MARINEFACILITY TYPE:
740
ADDRESS:6701 KURL WAYTELEPHONE:
(747) 265-6536
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:6CENSUS: 4DATE:
12/23/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Marine Grigoryan, AdministratorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff unable to meet residents needs due to language barrier.
INVESTIGATION FINDINGS:
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At 9:45 a.m., Licensing Program Analyst (LPA) Huma Rahimi conducted a subsequent complaint visit to investigate the above-stated allegation. LPA met with Staff #1 (S1), Lourdes Zapata, and the staff contacted the Administrator by telephone. LPA explained the reason for the visit, and the Administrator arrived shortly thereafter.

An initial complaint visit was conducted on 06/23/2025 by LPA Leslie Ngo-Castaneda. During that visit, LPA obtained copies of the client and staff rosters, residents’ physician reports, admission agreements, appraisals, and other relevant documents. LPA also conducted a physical plant tour of the facility. Interviews were conducted with the Administrator, three (3) staff members, and six (6) out of six (6) residents. During today's visit LPA Rahimi, conducted a physical plant tour of the facility.

Continue on LIC 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
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 6
Control Number 31-AS-20250618111717
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: PALACE OF JOY
FACILITY NUMBER: 197610152
VISIT DATE: 12/23/2025
NARRATIVE
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Allegation: Staff unable to meet residents needs due to language barrier.

It is alleged that facility staff are unable to meet resident needs due to a language barrier. To investigate this allegation, on 06/23/2025, LPA Ngo-Castaneda conducted interviews with the Administrator, residents, and staff, and observed staff-resident interactions.

During the inspection, LPA experienced difficulty communicating with staff and observed staff relying on cellular telephone translation applications to communicate with residents. LPA Ngo-Castaneda noted inaccuracies in the translations. One resident reported feelings of fear and frustration when attempting to communicate their needs due to unreliable translation.

For the first two (2) hours of the initial inspection conducted on 06/23/2025, the only staff present at the facility were non-English-speaking staff. After approximately two (2) hours, an additional staff member arrived who was able to communicate in English. Interviews with five (5) out of six (6) residents confirmed that staff frequently use cellular telephones to communicate. The Administrator acknowledged that some staff have a language barrier and rely on translation tools.



Based on interviews and direct observation, LPA determined that language barriers impacted effective communication with residents, the majority of whom speak English, regarding their basic needs and services. Therefore, this allegation is deemed Substantiated.

A deficiency was issued, and appeal rights were explained. An exit interview was conducted, and a copy of this report was signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 31-AS-20250618111717
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: PALACE OF JOY
FACILITY NUMBER: 197610152
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/30/2025
Section Cited
CCR
87411(d)(3)
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87411-Personnel Requirements General-(d)(3)Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents.,.This requirement is not met as evidenced by:
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The Administrator agreed to have at least one English-speaking staff on each shift. The administrator will monitor staff schedules and resident interactions weekly to ensure compliance. Currently the Administrator has one staff on each shift who speaks English. POC cleared during today's visit.
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Based on LPA Ngo-Castaneda’s interviews and observation, the administrator does not have staff available to communicate with residents to provide care which poses a potential risk to the residents in care.
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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.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
06/18/2025 and conducted by Evaluator Huma Rahimi
COMPLAINT CONTROL NUMBER: 31-AS-20250618111717

FACILITY NAME:PALACE OF JOYFACILITY NUMBER:
197610152
ADMINISTRATOR:GRIGORYAN, MARINEFACILITY TYPE:
740
ADDRESS:6701 KURL WAYTELEPHONE:
(747) 265-6536
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:6CENSUS: 4DATE:
12/23/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Marine Grigoryan, AdministratorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff did not administer resident’s medication as prescribed.
Staff discarded resident’s personal belongings.
Staff not providing adequate food service to resident.
Staff restricting resident from leaving the facility.
INVESTIGATION FINDINGS:
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At 9:45 a.m., Licensing Program Analyst (LPA) Huma Rahimi conducted a subsequent complaint visit to investigate the above-stated allegations. LPA met with Staff #1 (S1), Lourdes Zapata, and the staff contacted the Administrator by telephone. LPA explained the reason for the visit, and the Administrator arrived shortly thereafter.

An initial complaint visit was conducted on 06/23/2025 by LPA Leslie Ngo-Castaneda. During that visit, LPA obtained copies of the client and staff rosters, residents’ physician reports, admission agreements, appraisals, and other relevant documents. LPA also conducted a physical plant tour of the facility. Interviews were conducted with the Administrator, three (3) staff members, and six (6) out of six (6) residents. During today's visit LPA Rahimi, conducted a physical plant tour of the facility.

Continue on LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 31-AS-20250618111717
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: PALACE OF JOY
FACILITY NUMBER: 197610152
VISIT DATE: 12/23/2025
NARRATIVE
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Allegation: Staff did not administer resident’s medication as prescribed.
It is alleged that facility staff did not administer Resident #1’s (R1) medication as prescribed. To investigate this allegation, on 06/23/2025, LPA Ngo-Castaneda conducted interviews with the Administrator, facility staff, residents, a hospice nurse, and a witness. The Administrator and staff stated that all medications are administered according to physician’s orders and stored in a locked medication cabinet in compliance with Title 22 regulations. Staff reported that R1 requested to keep prescribed eye drops in their room; however, medications are not permitted to be kept in resident rooms.

Interview with a witness confirmed that R1 receives medications as prescribed. Interview with the hospice nurse assigned to another resident confirmed medications observed at the facility were in order. Interviews with five (5) out of six (6) residents stated they receive medications as prescribed and did not express concerns regarding medication administration. Based on interviews and observations, there was insufficient evidence to support the allegation; therefore, this allegation is deemed Unsubstantiated at this time.

Allegation: Staff discarded resident’s personal belongings.

It is alleged that facility staff discarded Resident #1’s personal belongings without consent.

To investigate this allegation, on 06/23/2025, LPA Ngo-Castaneda conducted interviews with the Administrator, staff, and residents. The Administrator and staff informed LPA that the facility only removed hazardous items such as razors, scissors, bodily waste, and spoiled food during cleaning for health and safety reasons only. Staff denied discarding non-hazardous personal belongings.

Interviews with five (5) out of six (6) residents stated they have not had personal belongings thrown away without their permission. Interview with the witness confirmed that R1 tends to hoard and bring dangerous items to the facility. Therefore, based on interviews this allegation is deemed Unsubstantiated at this time.

Allegation: Staff not providing adequate food service to resident.

It is alleged that facility staff do not provide adequate food service to residents. To investigate this allegation, on 06/23/2025, LPA Ngo-Castaneda conducted interviews with the Administrator, staff, and six (6) out of six (6) residents.

Continue on LIC 9099C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 31-AS-20250618111717
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: PALACE OF JOY
FACILITY NUMBER: 197610152
VISIT DATE: 12/23/2025
NARRATIVE
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The Administrator and staff stated that meals provided include protein such as chicken, beef, eggs, and sausage. Staff further reported that some residents maintain personal refrigerators for preferred food items. Interviews with five (5) out of six (6) residents did not express any concerns regarding food quality and reported that food portions were adequate and acceptable. The hospice nurse stated that nutritious food was observed during lunch/mealtime.

During today’s visit, LPA Rahimi conducted a physical plant tour of the facility and observed that the facility’s food supply included milk products, meat, vegetables, fruits, bread, cereals, juices, and desserts. Based on interviews and observations, there was insufficient evidence to support a violation related to food service. Therefore, this allegation is deemed Unsubstantiated at this time.


Allegation: Staff restricting resident from leaving the facility.

It is alleged that facility staff restrict R1 from leaving the facility. To investigate this allegation, on 06/23/2025, LPA Ngo-Castaneda interviewed the Administrator, staff, and five (5) out of six (6) residents. The Administrator and staff stated residents are not restricted from leaving; however, supervision is required for certain residents per Physician report/order. Additionally, staff reported accompanying residents when necessary for safety reasons.

Interviews with five (5) out of six (6) residents stated they are not restricted from leaving the facility and may access outdoor areas freely. Based on interviews and evidence, this allegation is deemed Unsubstantiated at this time.

Exit interview conducted and copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6