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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610625
Report Date: 12/18/2025
Date Signed: 12/18/2025 02:59:03 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
12/15/2025 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20251215223802
FACILITY NAME:GUARDIAN ANGELS BOARD AND CAREFACILITY NUMBER:
197610625
ADMINISTRATOR:GOR KHURSHUDYANFACILITY TYPE:
740
ADDRESS:11786 ENCINO AVETELEPHONE:
(818) 217-9444
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 5DATE:
12/18/2025
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Gor KhurshudyanTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Resident sustained an injury due to staff neglect or physical abuse
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegation. LPA met with the administrator, Gor Khurshudyan, and advised him of the complaint. Today's investigation consisted of interviews with the administrator, staff and residents. LPA also conducted a physical plant inspection and record review.

In regards to the allegation, it was reported that on or around 12/09/25, Resident1 (R1) sustained an unexplained injury due to staff neglect or abuse. It was also unclear on how long R1 was left unattended if R1 did experience a fall, resulting in these injuries. Reporting party did not identify any witnesses that can corroborate with this allegation.

Between 10:00am to 11:00am, interviews with the administrator and staff deny the allegation of neglect and abuse. Both stated that on or around 12/09/25, R1 experienced a fall. Paramedics were called immediatly

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
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 2
Control Number 31-AS-20251215223802
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: GUARDIAN ANGELS BOARD AND CARE
FACILITY NUMBER: 197610625
VISIT DATE: 12/18/2025
NARRATIVE
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for medical attention to treat R1's injuries. R1 was then taken to the hospital for evaluation and treatment. Administrator provided LPA a copy of facility incident report, explaining R1's fall, and steps staff took to address the fall and R1's injury.

At approximately 11:00am to 12:00pm, interviews with four (4) of four residents were made. LPA could not interview R1 as R1 was still at the hospital. Interviews with the four residents that are present in the facility could not confirm the allegation.

At approximately 12:00pm to 2:00pm, LPA made a physical plant inspection and record review to insure facility compliance.

At approximately 2:00pm to 2:30pm, LPA spoke with R1's responsible person, who confirmed R1's diagnosis and non-ambulatory/bedridden status, which can lead to falls. R1's responsible person placed no fault with facility, stating the incident is an accident. R1's responsible person also adds that while R1 was at the hospital, R1 also suffered another fall.

Based on the information obtained, there is insufficient evidence to prove that R1 sustained an injury due to staff neglect or physical abuse. Therefore the allegation is deemed Unsubstantiated at this time.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2