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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610763
Report Date: 05/08/2026
Date Signed: 05/08/2026 04:33:03 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
04/30/2026 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20260430103732
FACILITY NAME:AMERICAN DREAM ASSISTED LIVINGFACILITY NUMBER:
197610763
ADMINISTRATOR:GASPARYAN, ANNAFACILITY TYPE:
740
ADDRESS:8542 LURLINE AVETELEPHONE:
(747) 254-5013
CITY:WINNETKASTATE: CAZIP CODE:
91306
CAPACITY:6CENSUS: 6DATE:
05/08/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Anna GasparyanTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff do not respond at night to resident's calls for assistance.
Staff did not treat resident with dignity or respect.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to this facility to investigate the above allegations. LPA met with Anna Gasparyan and explained the reason for the visit.

--- Staff do not respond at night to resident's calls for assistance.

It was alleged that staff are not responding to residents who call out for help with toileting, transferring, or food service, particularly around 12:30 a.m. To investigate the allegation, LPA requested documents at 10:00a.m., interviewed two (2) staff from 11:00a.m. to 12:00p.m. and five (5) out of six (6) residents from around 12:00p.m - 1:30p.m. LPA was unable to interview remaining resident as they were out in the community. A review of staff schedule shows there is at least one (1) caregiver and one (1) back-up such as an administrator and/or licensee present at all times. (CONT. on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026
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 2
Control Number 31-AS-20260430103732
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: AMERICAN DREAM ASSISTED LIVING
FACILITY NUMBER: 197610763
VISIT DATE: 05/08/2026
NARRATIVE
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During the night shift there is one (1) caregiver available. During interviews, Staff #1 (S1) and Staff #2 (S2) stated residents are checked on every hour or more if needed during the day and every two (2) hours at night. During interviews, Resident #1 (R1) stated S2 does not respond to calls for assistance for other residents. R1 added they are independent and do not require assistance. Four (4) out of five (5) residents stated staff respond to calls and they are checked on often, including overnight.

--- Staff did not treat resident with dignity or respect

It was alleged that Staff #2 (S2) pushes sofa while Resident #1 (R1) is sitting on it to clean. To investigate the allegation, LPA interviewed two (2) staff from 11:00a.m. to 12:00p.m. and five (5) out of six (6) residents from around 12:00p.m - 1:30p.m. LPA was unable to interview remaining resident as they were out in the community. Staff #1 (S1) and Staff #2 (S2) stated all residents are treated with respect and dignity. S2 added they do not recall pushing any furniture with residents sitting on it. During interviews, R1 stated S2 pushed the sofa while they were seated to clean and felt it was disrespectful. Four (4) out of five (5) residents stated they are treated with respect and dignity.

Based on interviews and record review, there is not enough information to verify the allegations, therefore, the allegations are UNSUBSTANTIATED at this time.

No health and safety hazards noted during the visit.

Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026
LIC9099 (FAS) - (06/04)
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