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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603100
Report Date: 05/20/2025
Date Signed: 05/20/2025 01:30:09 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
12/26/2024 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20241226152447
FACILITY NAME:NO PLACE LIKE HOME FOR GOLDEN AGES 2 LLCFACILITY NUMBER:
198603100
ADMINISTRATOR:TOPADZUIKYAN, EMMAFACILITY TYPE:
740
ADDRESS:1444 WESTERN AVETELEPHONE:
(818) 245-6614
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY:5CENSUS: 3DATE:
05/20/2025
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Emma TopadzuikyanTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Resident sustained pressure injuries while in care
INVESTIGATION FINDINGS:
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At approximately 10:45 a.m. on 05/20/25, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced, subsequent complaint visit. LPA met with staff and disclosed the reason for the visit.

To investigate the allegation above, LPA conducted an initial visit on 01/03/25 and interviewed staff and residents between 1:30 p.m. and 2:45 p.m., conducted a record review of pertinent records, including but not limited to, a medical assessment and hospice documents at 2:00 p.m., and toured the facility inside and out at 1:30 p.m. Today, LPA toured the facility at 11:00 a.m.

Regarding the allegation “Resident sustained pressure injuries while in care” it was alleged Resident #1 (R1) acquired a pressure injury at the facility. Record review of R1’s medical assessment revealed they had no history or signs of skin breakdown as of 11/06/24. Review of R1’s hospice documents revealed they acquired hospice services on 11/09/24 and were observed to have a Stage 1 pressure injury on their coccyx. The hospice agency provided wound treatment services.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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 5
Control Number 31-AS-20241226152447
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: NO PLACE LIKE HOME FOR GOLDEN AGES 2 LLC
FACILITY NUMBER: 198603100
VISIT DATE: 05/20/2025
NARRATIVE
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 It was noted that R1 had a loss of appetite, body weakness, and overall cognitive and physical decline. On 12/03/24, a hospice nurse observed Stage 2 injuries on R1’s coccyx and spine. On 12/18/24, a wound care agency assessed R1 to have a Stage 4 injury on their back and a Stage 3 injury on their sacrum. Both injuries were noted to be unrelated to R1’s hospice diagnosis. R1’s hospice care plan was also not updated to include the wound care and excisional debridement performed by the wound care agency. Interview with the administrator at 1:30 p.m. on 01/03/25 revealed staff were instructed to reposition R1 every two (02) hours but not to transfer them due to skin integrity issues. Interview with Staff #1 (S1) at 2:00 p.m. on 01/03/25 confirmed that all staff had been trained by the hospice agency on R1’s care. S1 repositioned R1 every two (02) hours, assisted with incontinence care, and ensured their back and coccyx were dry and free of redness. LPA was unable to interview R1. Interviews with three (03) out of three (03) other residents interviewed revealed they had no issues with pressure injuries. Interview with Resident #2 (R2) at 2:25 p.m. on 01/03/25 revealed S1 reminds them to reposition themselves often. Based on interviews and record review, although R1’s pressure injuries were appropriately cared for by R1’s hospice agency and facility staff, the facility should have applied for an exception to retain R1 in the facility while they received wound treatment unrelated to their hospice diagnosis. Therefore, the allegation is deemed SUBSTANTIATED at this time. Deficiency is cited on the LIC 9099-D page.

Exit interview conducted. Appeal rights discussed. Copy of report provided.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
12/26/2024 and conducted by Evaluator Nicholas Reed
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20241226152447

FACILITY NAME:NO PLACE LIKE HOME FOR GOLDEN AGES 2 LLCFACILITY NUMBER:
198603100
ADMINISTRATOR:TOPADZUIKYAN, EMMAFACILITY TYPE:
740
ADDRESS:1444 WESTERN AVETELEPHONE:
(818) 245-6614
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY:5CENSUS: 3DATE:
05/20/2025
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:LuciaTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff restrained a resident in care resulting in injury.
INVESTIGATION FINDINGS:
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At approximately 10:45 a.m. on 05/20/25, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced, subsequent complaint visit. LPA met with staff and disclosed the reason for the visit.

To investigate the allegation above, LPA conducted an initial visit on 01/03/25 and interviewed staff and residents between 1:30 p.m. and 2:45 p.m., conducted a record review of pertinent records, including but not limited to, a medical assessment and hospice documents at 2:00 p.m., and toured the facility inside and out at 1:30 p.m. Today, LPA toured the facility at 11:00 a.m.

Regarding the allegation “Staff restrained a resident in care resulting in injury” it was alleged Resident #3 (R3) was restrained in bed at night and fell due to the restraints. LPA observed a pink luggage strap on R3’s nightstand during a facility tour at 10:00 a.m. on 12/20/24. Interview with R1 at 11:30 a.m. on 12/20/24 revealed they were tied up one night but did not explain further details.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 31-AS-20241226152447
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: NO PLACE LIKE HOME FOR GOLDEN AGES 2 LLC
FACILITY NUMBER: 198603100
VISIT DATE: 05/20/2025
NARRATIVE
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Interview with S1 at 2:00 p.m. on 01/03/25 revealed R3 nor any other residents were tied up. S1 further stated that R3 constantly fabricated about staff abuse. Interview with the administrator confirmed R3 was not tied up and the facility had no physician orders for restraints to be used. Interviews with three (03) out of three (03) other residents interviewed revealed they had never been tied up or witnessed anyone tied up. Record review of an incident report submitted by the facility revealed R3 fell on the morning of 12/30/24 and bruised their eye. R3 had no other injuries. Based on observations, interviews, and record review, although the allegation is valid, there is insufficient evidence to verify that staff restrained a resident. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health or safety concerns were observed during today’s visit.

Exit interview conducted. Copy of report provided.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20241226152447
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: NO PLACE LIKE HOME FOR GOLDEN AGES 2 LLC
FACILITY NUMBER: 198603100
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/30/2025
Section Cited
HSC
1569.73(b)
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§1569.73 Terminally ill residents... (b) At any time that… the facility... determines that the resident's condition has changed ... the facility may initiate procedures for a transfer.
This requirement was not met as evidenced by:This requirement was not met as evidenced by:
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Licensee has agreed to apply for an exception for Resident #2 (R2) who has a worsening Stage 2 pressure injury to demonstrate and establish compliance with the cited section by the POC due date.
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Based on interviews and record review, the licensee did not comply with the section cited above by retaining Resident #1 (R1) with a worsening prohibited health condition and not applying for an exception which posed a potential Health, Safety, or Personal Rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5