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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603605
Report Date: 05/13/2025
Date Signed: 05/13/2025 12:31:00 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
04/10/2025 and conducted by Evaluator Leizl De La Cerra
COMPLAINT CONTROL NUMBER: 31-AS-20250410153508
FACILITY NAME:ARARAT GARDENSFACILITY NUMBER:
198603605
ADMINISTRATOR:KESHISHYAN, VARSENIKFACILITY TYPE:
741
ADDRESS:1230 EAST WINDSOR ROADTELEPHONE:
(818) 244-7219
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:175CENSUS: 77DATE:
05/13/2025
UNANNOUNCEDTIME BEGAN:
10:11 AM
MET WITH:Varsenik Keshishyan, Executive DirectorTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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9
Staff did not repsond to call signal system in a timely manner.
Staff handled resident in a rough manner
INVESTIGATION FINDINGS:
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Thiis is an amendment to the report previously issued on 04/16/2025.
The report was amended to make corrections.
On 4/16/25 Licensing Program Analyst (LPA) Leizl Delacerra conducted an unannounced initial complaint visit to this facility to investigate the allegations listed above. LPA met with Varsenik Keshishyan, Executive Director. LPA disclosed the purpose of the visit. On 5/13/2025 LPA de la Cerra conducted a subsequent complaint visit and met with the Executive Director for signature of the amended report. Copy of amended reprt wss provided to Executive Director.

Allegation: Staff did not respond to call signal system in a timely manner.
It was alleged that on the evening of 04/08/2025 that resident - R1 used their pull cord so they could get bathroom assistance, and facility staff did not respond to R1 in a timely manner, so R1 attempted to get out of bed on their own but slipped during their attempt.
To investigate the allegation, on 04/16/2025 between 10:30am to 12:30pm LPA conducted a physical plant tour, interviewed four (04) staff members, and at 12:30pm to 2:30pm interviewed eight (08) out of Seventy-Five (75) residents including R1, requested police incident narrative, and conducted record reviews provided by the facility.
Continue to LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leizl De La Cerra
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
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 3
Control Number 31-AS-20250410153508
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: ARARAT GARDENS
FACILITY NUMBER: 198603605
VISIT DATE: 05/13/2025
NARRATIVE
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During physical plant tour, LPA De la Cerra pulled an emergency cord and staff responded within 4 minutes.Staff revealed that R1 or other residents are getting assistance immediately. Interviews conducted with R1, and seven (07) residents revealed that the facility staff responds to their calls in a timely manner.
LPA’s review of the facility’s call signal response log revealed that R1's call signal button/pendant was pushed two (02) times on the evening of 4/08/2025. The times were, 7:51pm and 8:24pm. During the time R1 pushed the button on their call pendant at 7:51pm, 1st time staff responded within 1 minute and 21 seconds and the second
time R1 the button on their call pendant was pushed at 8:24pm, log shows that it took 3 minutes and 09 seconds for the staff member to respond to R1.

Based on observation, inspection and record review, the facility staff responded to resident’s emergency call within reasonable time frame.
Therefore, this allegation is deemed Unsubstantiated.

Allegation: Staff handled resident in a rough manner.
It was alleged that on 04/08/2025 that resident - R1 fell/slipped on the floor during their attempt to get out of their bed and the facility staff who assisted R1 off the floor, handled R1 in a rough manner.
To investigate the allegation, on 04/16/2025 between 10:30am to 12:30pm LPA conducted a physical plant tour, interviewed four (04) staff members, and at 12:30pm to 2:30pm interviewed eight (08) out of Seventy-Five (75) residents including R1, requested police incident narrative, and conducted record reviews provided by the facility.



SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leizl De La Cerra
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20250410153508
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: ARARAT GARDENS
FACILITY NUMBER: 198603605
VISIT DATE: 05/13/2025
NARRATIVE
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Interview with the staff member - S2 regarding the incident on 4/08/25 revealed that S2 requested assistance from another staff member - S3 to lift R1 off the floor. Both staff members, S2 and S3 informed LPA that R1 was not handled in a rough manner. Interviews with other staff members- S1 and S4 revealed that they have never witnessed neither S2 and S3 handled R1 or any other residents roughly.
Interviews with other residents revealed that they have never been handled roughly by a staff member, nor they have witnessed neither S2 nor S3 handle any other residents roughly. Interview with R1 revealed that R1 was assisted by staff #2 (S2) and staff #3 (S3) on 4/08/25, R1 confirmed with LPA that S2 and S3 did not handle them in a rough manner when both staff lifted R1 off the floor.
A review of the incident record provided by Glendale Police Department revealed that during their interview with R1 on 4/11/25, R1 did not mention about being handled in a rough manner on 4/08/25.

Based on LPA observations, interviews and record reviews, this there is no sufficient information to verify the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

No health and safety issues were noted at the time of this visit. An exit interview was conducted, and a copy of the report was issued.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leizl De La Cerra
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3