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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610582
Report Date: 03/03/2026
Date Signed: 03/03/2026 01:51:38 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
01/19/2026 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20260119231501
FACILITY NAME:DIGNITY SENIOR CARE INC.FACILITY NUMBER:
197610582
ADMINISTRATOR:SOGHOMONYAN, LALAFACILITY TYPE:
740
ADDRESS:10421 GERALD AVETELEPHONE:
(818) 219-6455
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 3DATE:
03/03/2026
UNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Hilma Annabella Garcia TorresTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff did not provide adequate care and supervision to the residents
INVESTIGATION FINDINGS:
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This is an amended report to the complaint investigation, that was conducted on 02/18/26. Based on the information obtained then, there was insufficient evidence to corroborate the above allegation. During this visit, made on 03/03/26, Licensing Program Analysts (LPAs) LPAs Antonia Alvizar-Etima, Nicholas Reed and Michael Cava, along with Licensing Program Manager (LPM) Naira Margaryan, obtained additional information pertaining to the above allegation, which is as follows:

- Resident 1 (R1) had a fall the night of 01/16/26.
- Staff stayed with R1 all night, but was afraid to call paramedics for fear, possibly from the licensee becoming upset with them
- Staff did notify family, who came first thing in the morning.
- Family came on the morning 01/17/26, and at approximately 10:40am, paramedic were called.
- R1 was taken to the hospital, requiring surgery for a broken hip and dislocated shoulder.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
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-20260119231501
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: DIGNITY SENIOR CARE INC.
FACILITY NUMBER: 197610582
VISIT DATE: 03/03/2026
NARRATIVE
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- R1 is currently at a nursing facility for rehabilitation.
- R1 will not be returning to the facility.
- Interview with staff corroborates with the incident of R1 having a fall, but paramedics were not called for fear that licensee/operator will be upset and threaten them, like before.

Based on the additional information obtained, the allegation of staff not providing adequate care and supervision is Substantiated. Citation(s) issued on the 9099D. A copy of this report issued.
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20260119231501
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: DIGNITY SENIOR CARE INC.
FACILITY NUMBER: 197610582
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/03/2026
Section Cited
CCR
87411(a)
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Personnel Requirements - General: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by: On the night of 01/16/26, R1 had a fall and was not provided immediate medical
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R1 is no longer at the facility, therefore, no POCs will be issued at this time.
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attention until the followng morning of 01/17/26, when R1's family called 911. This posed an immediate health and safety risk to the resident in care.
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Type B
03/03/2026
Section Cited
CCR
87211(a)(1)(D)
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Reporting Requirements: A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff
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R1 is no longer at the facility, therefore, no POCs will be issued at this time.
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or other residents, or unexplained absence of any resident. This was not met as evidenced by: During file review, no Incident Report was submitted for R1's fall on 01/16/26.
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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: Mary G Flores
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3