198603885-5-8-2026-28-AS-WSHO-DU8UZD-20260519160122

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603885
Report Date: 05/08/2026
Date Signed: 05/08/2026 11:26:19 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/12/2025 and conducted by Evaluator Glenn Trueman

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20251212145452

FACILITY NAME:	DIGNITY FIRST ASSISTED LIVING FACILITY		FACILITY NUMBER:	198603885
ADMINISTRATOR:	HALLADJIAN,PAULINE		FACILITY TYPE:	740
ADDRESS:	1016 EAST LEADORA AVE		TELEPHONE:	(626) 376-6144
CITY:	GLENDORA	STATE: CA	ZIP CODE:	91741
CAPACITY:	6	CENSUS: 3	DATE:	05/08/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Owner Kevork Halladjian		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff did not issue a refund to a resident in care.

INVESTIGATION FINDINGS:

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The purpose of this visit 5/8/2026 is to reissue citation and to include additional information.
The initial visit was conducted on 12/18/2025 and included the following:
Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Owner Kevork Halladjian and explained the reason for the visit.
The purpose of the visit is to conduct a 10 day complaint visit in regards to the above allegation.
At today's visit the following was done:
Owner Kevork Halladjian was interviewed.
Staff S1 was interviewed.
Administrator was interviewed telephonically.
Attempts were made to interview Resident R1 were unsuccessful with being unable to respond to questioning.
Interview was conducted with the Administrator telephonically.
Interview was conducted with the Hospice Agency Nurse.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Glenn Trueman
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)

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Control Number 28-AS-20251212145452

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: DIGNITY FIRST ASSISTED LIVING FACILITY	FACILITY NUMBER: 198603885
	VISIT DATE: 05/08/2026

NARRATIVE

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File was reviewed for Resident R1 and Death Report, Physician's Report and Admission Agreement to be submitted. Resident and Staff Roster submitted,
File of Resident 1's Hospice agency was reviewed.
In regards to the allegation Staff did not issue a refund to a resident in care, based on interviews conducted and information gathered the Owner and the Administrator both confirmed that Resident R1 did not get a refund with Admission date 12/04/25 and passing away on 12/05/25.
Administrator stated that there was no refund based on having to prep the room and time it will take to get another resident.
Owner stated he said no to a refund because family agreed that if it's 1 day or 30 the month is paid in full.
Said that family had a contract with the Hospice Agency.
Staff S1 stated that Resident R1 was only here for 1 day and was declining.
Nurse from Hospice Agency stated that they are only paid by reimbursement from Medicare and that there is not a contract between resident and Hospice.
Personal belongings of Resident R1 were picked up from the facility on 12/05/2026. This was confirmed by
Owner Kevork Halladjian, Administrator, Staff S1 and family member of Resident R1.
LPA reviewed and obtained R1's Admission Agreement. The agreement indicates "No refunds will be issued under any circumstances".
Facility refund policy is not in compliance with Title 22 and Health and Safety Code and is addressed on a Case Management visit dated 5/8/2026.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies are being cited according to California Code of Regulations, Title 22 and Health and Safety Code.

Exit interview conducted and copy provided to Owner Kevork Halladjian.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Glenn Trueman
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)

Page: 2 of 3

Control Number 28-AS-20251212145452

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: DIGNITY FIRST ASSISTED LIVING FACILITY	FACILITY NUMBER: 198603885
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/08/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/15/2026 Section Cited HSC 1569.652(c)	1 2 3 4 5 6 7	A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed.	1 2 3 4 5 6 7	Facility by the POC due date will issue a refund for the days pre-paid after the passing of R1 on 12/5.(12/6-12/31) and submit proof to licensing by 5/15/2026.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by Resident R1's death was on 12/05 and facility would not refund for 12/6-12/31 with Personal belongings of Resident R1 were picked up from the facility on 12/05/2026. This was confirmed by Owner Kevork Halladjian, Administrator, Staff S1 and family member of Resident R1 which poses a potential risk to residents in care. which poses a potential risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Glenn Trueman
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026

LIC9099 (FAS) - (06/04)

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