197610495-3-11-2026-31-AS-NMAN-DU7VQH-20260518163820

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610495
Report Date: 03/11/2026
Date Signed: 03/11/2026 01:11:43 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
11/10/2025 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20251110113211

FACILITY NAME:	ROSSMOYNE HILLS		FACILITY NUMBER:	197610495
ADMINISTRATOR:	ELENA KORDONSKIY		FACILITY TYPE:	740
ADDRESS:	1227 CAMPBELL STREET		TELEPHONE:	(747) 338-8394
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91207
CAPACITY:	0	CENSUS: 0	DATE:	03/11/2026
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Knarick Panosyan		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Unlicensed care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

At approximately 12:15 p.m. on 03/11/26 Licensing Program Analysts (LPAs) Antonia Alvizar-Ettima and Nicholas Reed conducted an unannounced complaint visit. LPAs met with the property owner's wife and disclosed the reason for the visit.

On 11/18/25, Licensing Program Analysts (LPA) Antonia Alvizar-Ettima and Nicholas Reed along with Adult Protective Services (APS) Social Worker (SW) Sona Shahumyan conducted an unannounced complaint visit. LPA Reed called an associate of the homeowner at 10:30 a.m. today and was notified that nobody was home and no clients were in care. Between 10:45 a.m. and 11:45 a.m., LPAs surveyed the outside of the building, interviewed four (04) neighbors, and contacted the Glendale Police Department (GPD).

On 02/11/26 Licensing Program Analysts (LPAs) Antonia Alvizar-Ettima and Nicholas Reed conducted an unannounced complaint visit. LPAs were joined by Adult Protective Services (APS) agent Arturo Torres.
Cont. on LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2026

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 3

Control Number 31-AS-20251110113211

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: ROSSMOYNE HILLS	FACILITY NUMBER: 197610495
	VISIT DATE: 03/11/2026

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

Cont. from LIC 9099

LPAs and APS met with the property owner’s daughter and disclosed the reason for the visit. LPA Reed entered the building at approximately 11:30 a.m. and toured the inside. No residents were observed inside of the facility.
Regarding the allegation “Unlicensed care”, it was alleged an individual requiring care and supervision was living in the building. It was further alleged that resident #1 (R1) residing at the facility require assistance with all Activities of Daily Living. (ADL) during a period the facility was unlicensed. Evidence obtained showed that R1 lived at the facility between 09/08/2025 to 09/30/2025.

During the course of the investigation, the LPA’s determined that the license for the facility was closed at effective 07/30/2025. Documentation obtained and reviewed during the investigation indicates that the facility continued operating after the licensee closure. Resident #1 (R1), who required care and supervision to retain activities of daily living, was residing at this location within the month of September 2025, after the facility license was forfeited and the file was closed. Operating a residential care facility for the elderly without a valid license is prohibited by law.

Based on the interviews, and pertinent information received from the credible witnesses, there is sufficient information to verify that the facility continued operating and providing care to R1 after the facility was unlicensed. Therefore, the allegation is deemed SUBSTANTIATED at this time.

A deficiency is issued on the corresponding LIC 9099-D page.

Exit interview conducted. Appeal rights discussed. Copy of report provided.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20251110113211

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: ROSSMOYNE HILLS	FACILITY NUMBER: 197610495
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/11/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 03/11/2026 Section Cited HSC 1569.10	1 2 3 4 5 6 7	1569.10 RCFE; license or permit; necessity - No person, firm, partnership, association, or corporation...shall operate ... a residential facility for the elderly in this state without a current valid license or current valid special permit therefor, as provided in this chapter. This requirement is not met as evidenced by	1 2 3 4 5 6 7	The deficiency has been cleared at this time due to the facilty having no staff or residents.
	8 9 10 11 12 13 14	Based on interviews the licensee did not comply with the section cited above and provided care and supervision to 1 resident after the facility license was closed which poses an immediate Health, Safety, or Personal Rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3