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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610300
Report Date: 10/28/2025
Date Signed: 10/28/2025 03:13:28 PM

Document Has Been Signed on 10/28/2025 03:13 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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:QUEST BEHAVIORAL HEALTH INCFACILITY NUMBER:
197610300
ADMINISTRATOR/
DIRECTOR:		MELIKYAN, ARMENFACILITY TYPE:
772
ADDRESS:43828 47TH STREET WESTTELEPHONE:
(661) 579-6666
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 6CENSUS: 4DATE:
10/28/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Armen Melikyan - Executive Director and Alexis Garcia - LVNTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
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On 10/28/2025, LPA Evelin Rios arrived at the facility mentioned above to conduct an unannounced annual inspection. LPA was greeted by Alexis Garcia , the Licensed Vocational Nurse (LVN) and granted access. The LVN contacted the Program Director, Marine Guloyan and the Executive Director, Armen Melikyan by telephone to inform them LPA was at the facility. The Executive Director arrived to the facility at 10:57a.m., but could not stay and designated staff to sign todays report.

Resident Files: At approximately 10:50 a.m., with the assistance of the LVN, LPA conducted a file review of four (4) out of four (4) resident records for proper documentation. Resident records were reviewed for compliance and completeness. Files are kept electronically.

Medications: At approximately 11:19 a.m., LPA conducted a review of medications and medication documentation. Clients' Centrally Stored Medication and Destruction Records (CSMDR), as well as physician orders, are maintained electronically. All medications and corresponding records were securely stored in a locked cabinet within the designated medication office. Medications were observed to be properly labeled and appropriately stored. The first aid kit is located in the medication office and was observed fully stocked.

Staff Files: At approximately 11:30 a.m., with the assistance of the Executive Director, LPA conducted a file review of four (4) staff records to insure forms and training are up to date and in compliance. Files are kept electronically.

(continued on LIC 809-C)
NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Evelin Rios
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: QUEST BEHAVIORAL HEALTH INC
FACILITY NUMBER: 197610300
VISIT DATE: 10/28/2025
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(Continued from LIC809) A tour of the physical plant was initiated with the LVN. LPA observed the following:

LPA observed appropriate postings displayed along the wall near the facility’s main entrance, including, but not limited to, information on personal rights and the facility's emergency disaster plan. LPA also observed a sign in sheet for visitors.

Meal Service: The facility has a chef who prepares meals for clients three times daily, Monday through Friday. On weekends, residents may dine during outings, and the chef provides pre-made meals as needed. The kitchen was observed to be clean and free of clutter. LPA observed a two-day supply of perishable food and a seven-day supply of nonperishable items, all properly stored. Emergency food and water supplies were also observed in the gym and pantry closet.

Bedrooms: Personal accommodations in resident bedrooms were observed for safety, privacy, and comfort. Three (3) out of three (3) client bedrooms were inspected and observed with all required furnishings.

Bathrooms: There are two (2) bathrooms designated for clients use. They were properly supplied and had functional fixtures. Hot water temperature in client bathrooms were checked and measured at a range of 109.0°F to 110.2°F within the required range.

There are smoke/carbon monoxide detectors hard wired and interconnected through out the facility. LPA observed the Executive Director test the detectors at 12:03 p.m., and they were observed to be operational.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiency were observed during today's visit. Exit Interview Conducted. A copy of the report Issued.

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Evelin Rios
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
LIC809 (FAS) - (06/04)
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