197610911-7-23-2026-31-AS-NGID-DWAT52-20260724142450

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610911
Report Date: 07/23/2026
Date Signed: 07/23/2026 01:22:10 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
07/21/2026 and conducted by Evaluator Perchui Khurshudyan

COMPLAINT CONTROL NUMBER: 31-AS-20260721085726

FACILITY NAME:	HEALING PINES SENIOR LIVING LLC		FACILITY NUMBER:	197610911
ADMINISTRATOR:	GHUKASYAN, KRISTINE		FACILITY TYPE:	740
ADDRESS:	19733 HEMMINGWAY ST		TELEPHONE:	(747) 352-2385
CITY:	WINNETKA	STATE: CA	ZIP CODE:	91306
CAPACITY:	6	CENSUS: 6	DATE:	07/23/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Ronny Rjung - Caregiver/Staff		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Staff do not ensure the facility is clean and sanitary.

INVESTIGATION FINDINGS:

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On 7/23/26 Licensing Program Analyst (LPA) Perchui Milena Khurshudyan conducted an initial 10-day complaint visit to investigate the above allegation. Upon arrival, LPA met with the Staff/Caregiver Ronny Tjhung, introduced herself by showing the Department badge and gained access to the facility. LPA contacted the Administrator over the phone and explained the reason for the visit.

During the course of investigation, LPA requested staff and residents’ rosters. At approximately 9:15am LPA accompanied Staff 1 (S1), conducted physical plant tour throughout the facility to ensure health and safety of the residents are protected. No health and safety hazards noted during the visit.
At 9:40am LPA requested copies of Admission Agreement, Appraisal Needs and Services, Physician Report, copy of CSMDR/MAR, and reviewed other pertinent documents relevant to the investigation. LPA also conducted interviews with the Administrator, two (2) staff members, six (6) out of six (6) residents.

Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260721085726

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: 07/23/2026

NARRATIVE

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Allegation: Staff do not ensure the facility is clean and sanitary.

To investigate the allegation, LPA interviewed the Administrator, staff, and residents. The administrator denied the allegation and stated that the facility is cleaned daily, and that hygiene items and cleaning supplies are maintained and readily available for residents. Administrator further denied ever refusing residents food or any prescribed medications. Staff members interviewed also denied refusing residents’ food, medications, and stated that the residents receive meals, medications, and hygiene supplies as needed. Staff walked with LPA throughout the facility and showed the locations where hygiene supplies, including soap, toilet paper, personal hygiene items, and cleaning supplies are stored and maintained for residents’ use.

During the visit LPA inspected the house, including all residents’ bedrooms, common / living areas, kitchen, and bathrooms. LPA observed the facility to be generally clean, sanitary, organized, and in good repair with no objectionable odors or evidence of unsanitary conditions. LPA inspected two of two bathrooms and observed soap and toilet paper available in each restroom. The LPA also observed additional stock of hygiene supplies stored inside the supply closet located in the hallway. Furthermore, LPA interviewed six (6) out of six (6) residents residing in a facility. Five (5) out of six (6) residents denied concerns regarding the cleanliness and sanitary condition of the facility. Residents further stated they have never observed the bathrooms without soap or toilet paper and confirmed that hygiene items are available when needed. LPA inspected the kitchen and food storage areas and observed the adequate supply of food, including at least two days supply of perishable foods and seven days’ supply of non-perishable foods available for residents. Based on interviews conducted, observations, and evidence obtained during the investigation, there is insufficient evidence to support the allegation that staff did not ensure the facility is clean and sanitary. Therefore, the allegation is Unsubstantiated at this time.

Exit interview conducted, and a copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026

LIC9099 (FAS) - (06/04)

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