197610498-8-7-2026-31-AS-AJWR-DXCLM6-20260827085211

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610498
Report Date: 08/07/2026
Date Signed: 08/07/2026 03:13:09 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
07/29/2026 and conducted by Evaluator Huma Rahimi

COMPLAINT CONTROL NUMBER: 31-AS-20260729120151

FACILITY NAME:	LOS ANGELES ASSISTED LIVING		FACILITY NUMBER:	197610498
ADMINISTRATOR:	ARZUMANYAN, ANUSH		FACILITY TYPE:	740
ADDRESS:	15216 CHATSWORTH STREET		TELEPHONE:	(424) 666-5666
CITY:	MISSION HILLS	STATE: CA	ZIP CODE:	91345
CAPACITY:	6	CENSUS: 6	DATE:	08/07/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Anush Arzumanyan, Administrator		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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Staff are not scheduling resident's medical appointments.

INVESTIGATION FINDINGS:

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At 9:30 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced initial complaint visit to this facility. LPA met with the Administrator and explained the reason for the visit.

At 9:35 AM, LPA requested resident and staff roster. At approximately 9:40 AM, LPA conducted a physical plant tour of the facility. At 9:45 AM, LPA requested copies of pertinent information which include, but not limited to Staff training, Physician Report, Admission Agreement, Appraisal Needs and Services Plan, and ect., relevant to the course of investigation. Between 10:00 AM –11:50 AM, LPA conducted an interview with the Administrator, R1's Case Manager, and four (4) out of six (6) residents who were available.

Continue on LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026

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-20260729120151

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: LOS ANGELES ASSISTED LIVING	FACILITY NUMBER: 197610498
	VISIT DATE: 08/07/2026

NARRATIVE

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Allegation: Staff are not scheduling resident's medical appointments.

It was alleged that facility staff failed to schedule Resident #1’s (R1) medical appointments, resulting in incomplete referrals and tests. To investigate this allegation, LPA conducted interviews with the Administrator, R1’s Case Manager, and four (4) out of six (6) residents who were available.

The Administrator stated that R1’s medical appointments and referrals are coordinated by the Case Manager and that the facility’s role is limited to assisting with communication and transportation. The Case Manager confirmed they are responsible for scheduling R1’s medical appointments and referrals and stated R1 has not missed any appointments. R1 confirmed that the Case Manager schedules all medical appointments and denied missing appointments or experiencing delays in care. Interviews with four (4) residents did not identify concerns regarding facility assistance with medical care.

Based on interviews, LPA was unable to obtain evidence that facility staff failed to schedule R1’s medical appointments or that R1’s care was affected due to facility actions. Therefore, the allegation is Unsubstantiated.

Appeal rights explained and exit interview conducted. Copy this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026

LIC9099 (FAS) - (06/04)

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