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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610176
Report Date: 09/26/2025
Date Signed: 09/26/2025 11:54:12 AM

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
09/23/2025 and conducted by Evaluator Raymond Comer
COMPLAINT CONTROL NUMBER: 31-AS-20250923105953
FACILITY NAME:ESSENTIAL CARE ASSISTED LIVINGFACILITY NUMBER:
197610176
ADMINISTRATOR:KHACHATRYAN, VERZHINEFACILITY TYPE:
740
ADDRESS:3132 WAVERLY DR.TELEPHONE:
(818) 284-7607
CITY:LOS ANGELESSTATE: CAZIP CODE:
90027
CAPACITY:6CENSUS: 1DATE:
09/26/2025
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Verzhine Khachtryan-AdministratorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff are impeding Ombudsman's access to the home to contact residents.
INVESTIGATION FINDINGS:
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On 9/26/25, at 8:15 am, Licensing Program Analyst, (LPA) Raymond Comer, conducted an unannuouned, initial10- day visit to investigate the above allegation. LPA met with Administrator,Verzhine Khachtryan, presented official CDSS badge identification, and reason for the visit was disclosed.

At 8:25 am, LPA conducted a physical plant tour; LPA observed that Long Term Care Ombudsman (LTCO) information was publicly posted. However, the facility's local LTCO phone number was not displayed on the posting.

To investigate this allegation, LPA reviewed facility resident roster, and staff roster. From 8:35 am to 11:30 am, LPA conducted interviews with the Reporting Party, (RP) and Administrator.

Allegation: It was reported that staff did not allow the Ombudsman entrance into the facility.
[LIC9099C]- Continued
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025
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 3
Control Number 31-AS-20250923105953
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: ESSENTIAL CARE ASSISTED LIVING
FACILITY NUMBER: 197610176
VISIT DATE: 09/26/2025
NARRATIVE
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 LPA conducted Interviews with the Administrator which revealed the following. On Monday, 9/15/25, LTCO representative (A1) arrived and requested facility access. The Administrator stated they were not on site at that time. A facility staff spoke to A1; however, A1 was denied access into the facility by staff.
Based on LPA interviews with the Administrator, the allegation is SUBSTANTIATED.

Deficiency cited (refer to LIC 9099-D). Appeal Rights provided. Exit interview conducted and report issued.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20250923105953
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: ESSENTIAL CARE ASSISTED LIVING
FACILITY NUMBER: 197610176
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2025
Section Cited
CCR
87468.1(a)(11)
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Personal Rights (a)Residents...shall have all of the following personal rights:
(11) To have their visitors, including ombudspersons...permitted to visit privately during reasonable hours and without prior notice...This requirement is not met as evidenced by:

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Administrator agreed to schedule vendorized training for all staff by 10/10/25 and submit to CCL the vendor information and scheduled date of training. Training certifications to be submitted to CCL upon completion
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Based on interviews conducted, licensee did not comply with the section cited above as Staff denied Ombudsman facility access, which posed an immediate health and safety risk to persons 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: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3