197610320-7-30-2026-31-AS-MGFS-DWTQ6C-20260810115315

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610320
Report Date: 06/29/2026
Date Signed: 07/30/2026 03:08:13 PM

Unsubstantiated

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
05/18/2026 and conducted by Evaluator Leslie Ngo-Castaneda

COMPLAINT CONTROL NUMBER: 31-AS-20260518135718

FACILITY NAME:	WINNETKA HOME CARE		FACILITY NUMBER:	197610320
ADMINISTRATOR:	KAPIKYAN, ANDRANIK		FACILITY TYPE:	740
ADDRESS:	19733 HEMMINGWAY ST		TELEPHONE:	(818) 434-9916
CITY:	WINNETKA	STATE: CA	ZIP CODE:	91306
CAPACITY:	0	CENSUS: 4	DATE:	06/29/2026
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Isaiah Phirii- staff designee		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff does not ensure facility is a comfortable temperature.
Staff does not prevent resident from getting bitten by bugs.
Staff does not ensure to provide hygiene products to resident in care.
Facility is in disrepair.
Staff does not provide activities for residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced subsequent visit for the above allegation. LPA met with facility staff, Isiah Phiri (S2), and explained the reason for the visit.

On 5/26/2026 at 8:50 AM, LPA Ngo-Castaneda conducted a physical plant tour and requested copies of pertinent information at 10:30 AM, which include, but are not limited to, Physician’s report, Admission Agreement, LIC 500 (staff roster), LIC 9020 (resident roster), needs and service plan, and relevant documents to the investigation. LPA interviewed the Administrator over the phone, staff designees in the facility, and five (5) of five (5) residents at 9:10 AM.

Continue to LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026

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-20260518135718

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: WINNETKA HOME CARE	FACILITY NUMBER: 197610320
	VISIT DATE: 06/29/2026

NARRATIVE

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Allegation: Staff does not ensure facility is a comfortable temperature.

It was alleged that staff did not ensure the facility was at a comfortable temperature. During the physical plant tour, LPA observed that the wall temperature at the facility was set at 73°F. LPA interview with facility staff revealed that the facility shares a common temperature and did not receive any complaint from any resident about their room temperature because if they did, they would have adjusted the temperature to their preference. LPA interviews with residents revealed that they did not have any problem with the temperature in their respective rooms.

Based on the interview and observation, there is insufficient information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Allegation: Staff does not prevent resident from getting bitten by bugs.

It was alleged that the facility had bugs that bit the residents. During the facility inspection, LPA inspected all of the residents’ bedrooms and found no signs of bugs. Staff denied seeing bugs in the facility. Interviews with residents revealed that they did not see any bugs at the facility, nor did they experience being bitten by one.

Based on the interview and observation, there is insufficient information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Allegation: Staff does not ensure to provide hygiene products to resident in care.

It was alleged that the facility does not provide hygiene products to residents in care. During the physical plant tour, LPA observed the facility hallway lock cabinets to be fully stock of hygiene products. Interviewed staff who revealed that there is no shortage of personal or hygiene supplies. Staff informed LPA that they are always provided with a supply of shampoos, soaps, and any required items. Interviews with residents revealed that they have no issue with hygiene products, which facility staff always provide.

Continue to LIC 9099-C

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260518135718

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: WINNETKA HOME CARE	FACILITY NUMBER: 197610320
	VISIT DATE: 06/29/2026

NARRATIVE

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Based on interviews and observations, the allegation is UNSUBSTANTIATED at this time.

Allegation: Facility is in disrepair.

Regarding the allegation that the facility is in disrepair, it was alleged that the bathroom sink drains are not working, leaving dirty water and detritus residents in the sink, leaving residents unable to wash their hands. During the physical plant tour, LPA observe and tested all bathroom sinks to be working properly. LPA interview with residents revealed that the sinks in the bathroom they use are all working. LPA interview with staff also revealed that the reported facility bathroom sinks are working, and no issue was ever raised.

Based on interviews and observations, the allegation is UNSUBSTANTIATED at this time.

Allegation: Staff does not provide activities for residents.

It is being alleged that facility staff does not provide activities for residents. During LPA physical plant tour, LPA witnessed the activities in the living such as: books, puzzles, cards, and game boards in the living room. LPA interviewed facility staff who confirmed the activities are offered, but residents decline to do any of it. LPA interviewed residents revealed that they decline to do activities and prefer to watch television.

Based on interviews and observations, the allegation is UNSUBSTANTIATED at this time.

Exit interview conducted. A copy of this report issued.

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026

LIC9099 (FAS) - (06/04)

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