197610602-1-21-2026-31-AS-NGID-DT5TY8-20260414150816

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610602
Report Date: 01/21/2026
Date Signed: 01/21/2026 12:48:03 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
08/27/2025 and conducted by Evaluator Huma Rahimi

COMPLAINT CONTROL NUMBER: 31-AS-20250827102708

FACILITY NAME:	MAYALL ASSISTED LIVING		FACILITY NUMBER:	197610602
ADMINISTRATOR:	DISHOYAN, ARMINE		FACILITY TYPE:	740
ADDRESS:	20507 MAYALL STREET		TELEPHONE:	(818) 809-8559
CITY:	CHATSWORTH	STATE: CA	ZIP CODE:	91311
CAPACITY:	6	CENSUS: 3	DATE:	01/21/2026
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Arpenik Oganisyan, Staff		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff hit resident.

Staff are not properly supervising residents who may be a fall risk.

INVESTIGATION FINDINGS:

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

At 10:00 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced subsequent complaint visit. LPA met with Staff #1 (S1), Vazganush Mihranyan, and the staff contacted the Administrator via telephone. LPA explained the reason for the visit. The Administrator was unable to come to the facility; however, designated Staff #2 (S2) Arpenik Oganisyan to sign and receive today's report.

LPA Jose Tan conducted an initial complaint visit on 08/29/2025. At approximately 9:45 AM, LPA Tan requested the resident and staff roster. At approximately 9:31 AM, LPA Tan conducted a physical plant tour. At approximately 10:00 AM, LPA Tan obtained copies of facility documents relevant to the investigation. Between 10:15 AM and 12:30 PM, LPA Tan conducted interviews with staff and residents.
During today’s visit, LPA Rahimi conducted additional interviews between 10:15 AM and 11:00 AM with Staff #1 (S1) and the Administrator.

Continue on LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

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-20250827102708

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: MAYALL ASSISTED LIVING	FACILITY NUMBER: 197610602
	VISIT DATE: 01/21/2026

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

Allegation: staff hit resident.
It was alleged that Staff #1 (S1) hit Resident #1 (R1). To investigate this allegation, LPA Tan conducted interviews with S1 and residents on 08/29/2025, and on 01/21/2026, LPA Rahimi conducted interviews with the Administrator and S1.

During interviews, S1 denied striking, kicking, restraining, or biting R1 during the incident which occurred on 08/27/2025. S1 stated that R1 intentionally slid from the bed and that S1 attempted to assist R1 back into bed. S1 reported that R1 grabbed, scratched S1, removed clothing, and attempted to pull S1 closer. S1 stated that minimal physical contact was used only to create distance. S1 further reported that R1 bit S1’s fingers, resulting in bleeding, and that emergency medical services were contacted, with R1 transported to the hospital the same night.

During interviews on 01/21/2026, the Administrator stated that the facility does not permit the use of physical force or restraints and that staff are trained in de-escalation techniques. The Administrator denied that S1 hit R1.

LPAs reviewed the facility incident report and available documentation. No documentation or independent evidence was observed substantiating that staff struck R1. However, during the initial and subsequent visits, LPAs were provided with photographs showing S1’s injuries to the neck and fingernails resulting from the incident.

Based on interviews, photographs, and record reviews, LPAs were unable to verify that staff hit R1. Therefore, this allegation is deemed Unsubstantiated, at this time.

Allegation: Staff are not properly supervising residents who may be a fall risk.

It was alleged that staff failed to properly supervise a resident who may be a fall risk. To investigate this allegation, LPA Tan conducted interviews with S1 and residents on 08/29/2025, and on 01/21/2026, LPA Rahimi conducted interviews with the Administrator and S1.

Continue on LIC 9099C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20250827102708

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: MAYALL ASSISTED LIVING	FACILITY NUMBER: 197610602
	VISIT DATE: 01/21/2026

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

During the interview with the Administrator on 01/21/2026 LPA Rahimi was informed that R1 was assessed as a fall risk and admitted with hospice services and a physician’s order for full bed rails. However, R1’s family member refused the use of bed rails and removed them without facility authorization. Additionally, the Administrator stated staff were instructed to provide continuous supervision due to R1’s fall risk.

Moreover, S1 stated supervision was provided at the time R1 slid from the bed on 08/27/2025, and that assistance was rendered immediately. The Administrator stated emergency medical services were contacted shortly after the incident.

LPAs reviewed incident documentation and available facility records. No evidence was observed indicating R1 was left unattended at the time of the incident. Although documentation confirming authorization for bed rail removal by the family was not available, staff reported supervision was provided.

Based on interviews and records reviewed, LPAs were unable to verify that staff failed to properly supervise R1. Therefore, the allegation is deemed Unsubstantiated, at this time.

Appeal rights explained and exit interview conducted.

Copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3