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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610356
Report Date: 02/23/2026
Date Signed: 02/23/2026 05:25:02 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
02/13/2026 and conducted by Evaluator Leslie Ngo-Castaneda
COMPLAINT CONTROL NUMBER: 31-AS-20260213125854
FACILITY NAME:BELOVED LIVINGFACILITY NUMBER:
197610356
ADMINISTRATOR:YEGISHYAN, VREJFACILITY TYPE:
740
ADDRESS:15842 ACRE STTELEPHONE:
(818) 726-2805
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY:6CENSUS: 4DATE:
02/23/2026
UNANNOUNCEDTIME BEGAN:
11:44 AM
MET WITH:Anush Badalyan- CEOTIME COMPLETED:
05:50 PM
ALLEGATION(S):
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Administrator is not on premises a sufficient amount of hours to manage facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced initial visit for the above allegation. LPA met with CEO, Anush Badalyan (S1), and explained the reason for the visit.

Entrance interview conducted. .

LPA took a tour of the physical plant. At 12:00 PM, LPA interviewed the CEO (S1) and staff #2 (S2). At 12:07 PM, LPA interviewed a total of four (4) residents. At 1:00 PM LPA conducted a records review of R1's file, as well as other relevant documents, including the physician's report, admission agreement, LIC 500 (staff roster), resident roster (LIC 9020), intake sheet, hospice records and other pertinent documents. Interview with W1 at 12:25PM. LPA interviewed two (2) staff, four (4) residents, and one (1) witness from 12:07-12:30PM.

Continue to LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026
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 5
Control Number 31-AS-20260213125854
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: BELOVED LIVING
FACILITY NUMBER: 197610356
VISIT DATE: 02/23/2026
NARRATIVE
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Allegation #1: Administrator is not on premises a sufficient amount of hours to manage facility

It was alleged that the facility administrator is not on premises a sufficient amount of hours to manage facility. Interview with staff revealed that facility administrator is a nurse practitioner (NP) and that ‘their [NP] is really busy seeing patients outside.’ and usually spends their time here at the facility to conduct tours with potential residents. If facility residents have an emergency, the two (2) staff will provide assistance with emergency. Interview with residents and staff revealed that facility’s administrator rarely and never comes to the facility, they do not know how the facility’s administrator looks like. Record Review revealed that S1 does not have LIC 308 to be the facility responsibility designee. Per LIC 500 administrator is listed to be at the facility between Monday to Friday from 10:00AM to 2:00PM. Facility does not follow LIC 500 schedule.

Based on interviews there is sufficient information to verify validity of the complaint. Therefore, the allegation is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

Health and safety issues were noted at the time of this visit address in a case management visit. An exit interview was conducted, and a copy of this report, LIC 9099-D, and appeal rights were provided.
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
02/13/2026 and conducted by Evaluator Leslie Ngo-Castaneda
COMPLAINT CONTROL NUMBER: 31-AS-20260213125854

FACILITY NAME:BELOVED LIVINGFACILITY NUMBER:
197610356
ADMINISTRATOR:YEGISHYAN, VREJFACILITY TYPE:
740
ADDRESS:15842 ACRE STTELEPHONE:
(818) 726-2805
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY:6CENSUS: 4DATE:
02/23/2026
UNANNOUNCEDTIME BEGAN:
11:44 AM
MET WITH:Anush Badalyan- CEOTIME COMPLETED:
05:50 PM
ALLEGATION(S):
1
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9
Staff do not provide adequate supervision to resident in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced initial visit for the above allegation. LPA met with licensee Anush Badalyan (S1) and explained the reason for the visit.

LPA took a tour of the physical plant. At 12:00 PM, LPA interviewed the CEO (S1) and staff #2 (S2). At 12:07 PM, LPA interviewed a total of four (4) residents. At 1:00 PM LPA conducted a records review of R1's file, as well as other relevant documents, including the physician's report, admission agreement, LIC 500 (staff roster), resident roster (LIC 9020), intake sheet, hospice records and other pertinent documents. Interview with W1 at 12:25PM. LPA interviewed two (2) staff, four (4) residents, and one (1) witness from 12:07-12:30PM.

Allegation #1 : Staff do not provide adequate supervision to resident in care.

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: 02/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 31-AS-20260213125854
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: BELOVED LIVING
FACILITY NUMBER: 197610356
VISIT DATE: 02/23/2026
NARRATIVE
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It is alleged that the facility does not provide adequate supervision to residents in care. R3 sustained facial scratches from R1. S2 was at the adjacent room and redirected R1 immediately to another activity. Record review revealed that R1 is on hospice, R2 is on Home Health, R3 is non-ambulatory, and R4 is bedbound. Interview with residents revealed that R1 can be aggressive and disruptive towards other residents’. Interview with W1 revealed that R1 can get aggressive that needs more staff supervision.

Based on interviews and record review, there is insufficient information to verify validity of the complaint. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted, copy of this report give to CEO (S1).
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20260213125854
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: BELOVED LIVING
FACILITY NUMBER: 197610356
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/23/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/09/2026
Section Cited
CCR
87495(a)
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Administrator - Qualifications and Duties All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and
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The facility administrator will provide an updated LIC 500 with corrected time for administrator, LIC 308, and a written certification that administrator will be at the facility a sufficient amount of hours and available for emergencies to the department by POC due date.
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 shall be on the premises a sufficient number of hours to permit ...This requirement was not met as evidenced by: facility administrator is never at the facility, residents and staff is not even aware what they look like.
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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: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5