<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610911
Report Date: 07/08/2026
Date Signed: 07/08/2026 11:02:37 AM

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
07/02/2026 and conducted by Evaluator Leslie Ngo-Castaneda
COMPLAINT CONTROL NUMBER: 31-AS-20260702083316
FACILITY NAME:HEALING PINES SENIOR LIVING LLCFACILITY NUMBER:
197610911
ADMINISTRATOR:GHUKASYAN, KRISTINEFACILITY TYPE:
740
ADDRESS:19733 HEMMINGWAY STTELEPHONE:
(747) 352-2385
CITY:WINNETKASTATE: CAZIP CODE:
91306
CAPACITY:6CENSUS: 4DATE:
07/08/2026
UNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Isaiah Phiri- staff designeeTIME COMPLETED:
11:32 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff mishandled a resident's medication.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately 8:20 AM, Licensing Program Analysts (LPA), Leslie Ngo-Castaneda arrived at the facility in response to the above-mentioned allegation. LPA met with the staff designee (S#2) and explained the reason for the visit. At 9:31 AM, LPA spoke with the administrator by phone regarding the reason for the visit.

At approximately 8: 50 AM, LPA conducted a physical plant tour to ensure the health and safety of the residents are protected. At 8:40 AM, LPA requested copies of pertinent information, which include, but are not limited to, Physician’s report, Admission Agreement, LIC 500 (staff roster), LIC 9020 (resident roster), needs and service plan, and relevant documents to the investigation. LPA interviewed the Administrator over the phone, staff designee who are in the facility, and four (4) out of four (4) residents.

Allegation: Staff mishandled a resident's medication.

Continue to LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
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-20260702083316
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: HEALING PINES SENIOR LIVING LLC
FACILITY NUMBER: 197610911
VISIT DATE: 07/08/2026
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
To investigate the allegation, License Program Analysts (LPA) Leslie Ngo-Castaneda reviewed all of the residents' Centrally Stored Medication and Destruction Records (CSMDR). Records reveal that medications were administered in a timely manner, that no medications were missing for the residents, and that everything is accounted for. LPA observe S2 knocking on bedroom #4 for R1 insulin before serving breakfast and was ignored at 8:25 AM and 9:00 AM. R1 eventually came out of their bedroom at 11:00 AM and requested for his insulin. LPA interviewed residents on 7.8.2026, and it was revealed that residents do not have concerns about being managed by facility staff. Interviews with staff revealed that all medications are provided to clients as prescribed.

Therefore, based on interviews and a review of records, and due to a lack of supporting evidence, the allegation is unsubstantiated at this time.


An exit interview was conducted, and a copy of the report was given to staff.

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2