<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610495
Report Date: 10/30/2024
Date Signed: 10/30/2024 04:53:51 PM

Document Has Been Signed on 10/30/2024 04:53 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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:ROSSMOYNE HILLSFACILITY NUMBER:
197610495
ADMINISTRATOR/
DIRECTOR:		AVETISYAN, ARMINEFACILITY TYPE:
740
ADDRESS:1227 CAMPBELL STREETTELEPHONE:
(747) 324-6116
CITY:GLENDALESTATE: CAZIP CODE:
91207
CAPACITY: 6CENSUS: DATE:
10/30/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:52 PM
MET WITH:UnknownTIME VISIT/
INSPECTION COMPLETED:
02:53 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/30/24 at around 1:00 PM, Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced visit. LPA met with unknown individual who refused to identify himself.

During the course of investigating complaint #31-AS-20240807095448, the unknown individual contacted the administrator Armine Avetisyan and put her on speakerphone to speak with the LPA. When LPA asked how many caregivers are currently in the facility, the administrator got frustrated and stated, “Well how many people do you see there? You see them, right?” LPA responded, “Well, I see multiple people walking around”. Administrator then states, “There are two caregivers, and the others you see there are owners of the property”. As the LPA was conducting the physical plant tour and greeting residents, LPA asked the unknown individual questions about the physical plant and his every response was “what does it look like”, gesturing with his hands halfway in the air, shoulders shrugged.

As LPA was walking back towards the residents, the unknown individual contacted the administrator again and placed the call on speaker. The administrator then accused the LPA of being racist, being sarcastic and making fun of staff. LPA then contacted Licensing Program Manager (LPM) Naira Margaryan who tried to explain the importance of compliance and allowing the LPA to conduct the investigation. As the LPM was explaining, the unknown caregiver stated twice that he was going to sue the LPA.

LPM instructed LPA to immediately terminate the visit.

As LPA was leaving the facility, the unknown caregiver paused at the door, placed his hand on the lock for an abnormal time and stated, “Next time you come in this house, you better be careful”. It should also be noted that during a previous visit on 08/15/2024, the Administrator began shouting to the caregiver Kanarick Panosyan, “call the police, call the police”.

(CONT on LIC809-C)

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: ROSSMOYNE HILLS
FACILITY NUMBER: 197610495
VISIT DATE: 10/30/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Moments later the police arrived at the facility and began to interrogate the LPA, asked for LPA’s badge and why LPA was at the facility. LPA fully cooperated with the police and explained the reason for the visit. The officers then explained to the LPA that the administrator contacted the police on behalf of the caregiver for their safety and the person who called stated they suspect LPA was falsifying identity, posing as a government agent.

The administrator was informed that they may be called in to the Woodland Hills South Regional Office for a meeting.

Due to the hostility of the unknown caregiver and administrator, and for the safety of the LPA, no signature at this time.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2