197610483-3-19-2024-31-AS-RORN-D5WPGQ-20240604111842

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610483
Report Date: 03/19/2024
Date Signed: 03/19/2024 02:33:37 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
03/15/2024 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20240315154808

FACILITY NAME:	LIFELONG SENIOR LIVING		FACILITY NUMBER:	197610483
ADMINISTRATOR:	KAPIKYAN, ANDRANIK		FACILITY TYPE:	740
ADDRESS:	16003 LUDLOW ST		TELEPHONE:	(818) 371-5979
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 6	DATE:	03/19/2024
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Adranik Kapikyan		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Wrongful eviction.
Staff do not ensure that residents have access to a telephone.
Facility has fire hazards.
Staff do not ensure residents have access to the grounds outside
Licensee did not ensure residents personal property was safely secured

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Raymond Comer and Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPAs met with the administrator, Adranik Kapikyan, and advised him of the complaint. Today's investigation consisted of interviews with the administrator, two (2) staff, and six (6) residents. LPAs also conducted a physical plant inspection.

Wrongful Eviction:
In regards to the allegation, it was reported that Resident 1 (R1) was evicted for no proper reason. It was also reported that another resident (see control #31-AS-20240301105312) was unlawfully evicted on or around 03/01/24. According to the administrator and staff, R1 was never evicted. R1 stayed at the facility for approximately a week, and decided to move out on their own on 03/15/24 because they couldn't afford rent. Administrator stated R1 called a taxi service for pick up and left vountarily. Interviews with staff also confirm that R1 left on their own. Interviews with the six (6) residents could not confirm R1 was wrongfully

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2024

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-20240315154808

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: LIFELONG SENIOR LIVING	FACILITY NUMBER: 197610483
	VISIT DATE: 03/19/2024

NARRATIVE

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evicted. Based on the information obtained, there wasn't enough evidence to prove R1 was wrongfully evicted. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff do not ensure that residents have access to a telephone/Staff do not ensure residents have access to the grounds outside:
In regards to the allegations, it was reported that the house phone was removed, leaving the residents with no access to the telephone, and the residents are not allowed to leave the home, or have access to the outside grounds. Interviews with six (6) of six residents deny the allegation, stating they do have access to the phone to make and receive calls. In addition, these six residents also stated that they can leave the facility when they want without interference from staff, and they are allowed to sit at the outside patio area when they please. LPAs tested the telephone lines and observed it to be able to take incoming calls. LPA checked all the exits, and observed that all exits were free of obstruction. Based on the information obtained, there was insufficient evidence to prove that the residents don't have access to a telephone, or have access to the grounds outside. Therefore, the allegation is deemed Unsubstantiated at this time.

Facility has fire hazards:
In regards to the allegation, it was alleged that there are fire hazards in the home. During the course of the investigation, LPA conducted a physical plant inspection of the home to insure exits and passageways are clear of obstruction. The fire extinguisher is brand new, and located in the living room. The smoke detectors are interconnected. There are fire doors installed in four bedrooms and one bathroom. LPAs also interviewed staff and residents, who deny any fire hazards. Based on the information obtained, there wasn't enough evidence to prove that facility has fire hazards. Therefore, the allegation is deemed Unsubstantiated at this time.

Licensee did not ensure residents personal property was safely secured:
In regards to the allegation, it was reported that R1's personal belongings were reported missing during their stay at the facility. According to the administrator, R1 never reported anything missing during their stay. R1 completed an inventory list at admission, and everything on that list was accounted for when R1 left the facility. Interviews with six (6) of six residents expressed no complaints of their belongings being not properly secured. Based on the information obtained, there was insufficient evidence to prove licensee did not ensure R1's property was safely secured. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2024

LIC9099 (FAS) - (06/04)

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