197610506-5-7-2026-31-AS-AJWR-DXCLSF-20260827090039

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610506
Report Date: 05/07/2026
Date Signed: 05/07/2026 04:01:43 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
04/30/2026 and conducted by Evaluator Angela Panushkina

COMPLAINT CONTROL NUMBER: 31-AS-20260430120837

FACILITY NAME:	BEST CARE ASSISTED LIVING ON HASKELL		FACILITY NUMBER:	197610506
ADMINISTRATOR:	GEVORKYAN, SIRANUYSH		FACILITY TYPE:	740
ADDRESS:	9756 HASKELL AVE		TELEPHONE:	(310) 720-4551
CITY:	NORTH HILLS	STATE: CA	ZIP CODE:	91343
CAPACITY:	6	CENSUS: 6	DATE:	05/07/2026
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Siranuysh Gevorkyan, Administrator		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff did not safeguard resident's personal belogings.

INVESTIGATION FINDINGS:

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At 12:00pm LPA, Licensing Program Analyst (LPA) Angela Panushkina, conducted an unannounced complaint visit in response to the above-mentioned allegation. LPA met with the Administrator and explained the reason for the visit.

At 12:05pm, LPA requested resident and staff roster. At 12:10pm, LPA requested copies of pertinent information which include, but not limited to Admission Agreement, Physicians Report, Appraisal Needs and Services Plan, Theft and Loss Policy, Staff Training, etc. relevant to the investigation. At approximately 12:20pm, LPA conducted a physical plant tour. Between 12:30am – 2:30pm, LPA conducted an interview with the Administrator, two (2) staff and six (6) residents.

Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

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-20260430120837

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: BEST CARE ASSISTED LIVING ON HASKELL	FACILITY NUMBER: 197610506
	VISIT DATE: 05/07/2026

NARRATIVE

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Allegation: Staff did not safeguard resident's personal belongings.

It was alleged that R1 was hospitalized in December 2025 and subsequently transferred to a rehabilitation on 12/05/2025, where R1 remained until 03/20/2026, and the staff did not safeguard R1’s personal belongings. LPA conducted an interview with the Administrator, who denied the allegation and stated that R1 has a history of reporting missing items at various times. Administrator reported that the facility made arrangements for R1 to pick up belongings and requested that law enforcement be present to ensure transparency and safety during the process. According to the Administrator, R1 refused to participate in the police accompanied pick-up and allowed the Administrator to video the process of collecting some or all of their belongings. Staff interviewed confirmed the statement provided by the Administrator and stated that they do not recall an instance of R1’s personal items being mishandled or lost while stored at the facility. Staff confirmed that some belongings were stored in boxes, due to R1’s extended absence but stated they were maintained in R1's room #1, which was kept locked during that time. All six (6) residents interviewed denied having any issues with staff safeguarding their belongings. Each resident stated they had never experienced missing personal property, and they had not observed staff mishandling or misplacing items/belongings of the residents. Lastly, LPA was provided with pictures of R1's room and observed, multiple empty bottles and gloves, cream, coins, trash, etc. on the floor. R1's bed was piled up with purses, hangers and various items. LPA was informed that R1 refused to comply with the facility house rules and did not allow staff to clean their room. Therefore, based on interviews and information gathered this allegation is deemed Unsubstantiated, at this time.

No deficiency issued during today's visit.
Exit interview conducted and copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

LIC9099 (FAS) - (06/04)

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