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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195850497
Report Date: 10/16/2026
Date Signed: 10/16/2026 02:57:47 PM

Document Has Been Signed on 10/16/2026 02:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:VALLEY'S BEST HOMECAREFACILITY NUMBER:
195850497
ADMINISTRATOR/
DIRECTOR:		KUYUMCHYAN, GAMLETFACILITY TYPE:
740
ADDRESS:6236 HALBRENT AVENUETELEPHONE:
(818) 472-9945
CITY:VAN NUYSSTATE: CAZIP CODE:
91411
CAPACITY: 6CENSUS: 4DATE:
10/16/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:17 PM
MET WITH:Liana AtabekyanTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Trevor Byrne conducted a case management - deficiencies visit. LPA arrived to the facility at 12:59 PM. LPA met with the facility Designee Liana Atabekyan who contacted the Administrator Gamlet Kuyumchyan. The Administrator stated that they were unable to come to the facility during today’s visit but has designated the Designee to sign this report on their behalf. Entrance interview conducted and the reason for the visit was explained.

During today’s visit LPA conducted a file review for one (1) resident, obtained copies of pertinent documentation, and interviewed the Designee, and Administrator between approximately 01:00 PM and 02:45 PM.

On 10/13/2026 at 11:42 AM the Administrator notified Community Care Licensing Division (CCLD) that the facility had sent Resident #1 (R1) to the hospital due to a foul smelling healing surgical wound. LPA asked the Administrator if a pre admission appraisal was conducted of R1 prior to them arriving to the facility. The Administrator stated that an in-person pre-admission appraisal was not conducted prior to accepting R1. The Administrator Instead, relied on the medical documentation provided by the discharging facility, as well as their communications with the discharge planning personnel. LPA informed the Administrator that prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria.

CONTINUED ON LIC 809C.

Kasandra Lopez
Trevor Byrne
DATE: 10/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: VALLEY'S BEST HOMECARE
FACILITY NUMBER: 195850497
VISIT DATE: 10/16/2026
NARRATIVE
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LPA asked the Administrator if the resident was admitted with Home Health, Hospice, or wound care in place to provide medical care for the healing wound. The Administrator stated that R1 arrived with medical orders; however, home health or hospice services had not been established at the time of admission and no wound care provider or service had been established prior to R1's arrival. LPA informed the Administrator that the licensee shall be permitted to accept or retain a resident who has a healing wound only when care is performed by or under the supervision of an appropriately skilled professional. LPA reviewed the incident report and observed that R1 arrived to the facility on 10/09/2026 and upon admission R1 was observed to have a large, deep open wound on the resident's right hip. The report stated that on 10/11/2026 R1 reported pain in the area. The report stated that there was a foul odor was coming from the wound. The report stated that the Administrator contacted 911 and R1 was transported to the hospital on 10/12/2026 at approximately 03:00 PM. LPA asked the Administrator why there was a delay in obtaining timely medical care for R1. The Administrator stated that upon assessing R1’s condition on 10/09/2026, they became concerned that R1’s medical and care needs exceeded the facility’s capabilities. The Administrator stated that they attempted to relocate R1 to an appropriate care setting on 10/10/2026 and 10/11/2026. The Administrator stated that they observed the change in the wounds condition on 10/11/2026 and arrangements were made on 10/12/2026 to send R1 to the hospital for treatment. LPA reviewed the physician’s report that the facility had on file for R1. LPA observed the physician’s signature section on page nine (9). LPA observed a signature in this section but no printed name, address, phone number, email address, length of time R1 had been their patient, or date. LPA asked the Administrator why this physician’s report was accepted without the identifying information of the physician and if they could confirm who had signed this report. The Administrator stated that the physician’s report was provided to the facility as part of the R1’s discharge documentation. The Administrator stated that their understanding was that the signing physician was associated with R1’s care at the discharging facility. The Administrator stated that they could not verify the identity of the signature. Additionally, the Administrator stated that because the resident remained at the facility for only a short period, they did not have the opportunity to arrange an evaluation by another physician and obtain a replacement report. LPA informed the Administrator that prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice.

Pursuant to Title 22 of the CA Code of Regulations and/or the Health and Safety Code, the following deficiencies were cited (refer to LIC 809-D’s). This report was read to the Administrator via telephone call. Exit interview conducted and copy of the report was issued and appeal rights provided.

NAME OF LICENSING PROGRAM MANAGER: Kasandra Lopez
NAME OF LICENSING PROGRAM ANALYST: Trevor Byrne
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2026
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 10/16/2026 02:57 PM - It Cannot Be Edited


Created By: Trevor Byrne On 10/16/2026 at 01:48 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VALLEY'S BEST HOMECARE
FACILITY NUMBER: 195850497

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/17/2026
Section Cited
CCR
87464(f)(1)

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87464 Basic Services
(f) Basic services shall at a minimum include:
(1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).
This requirement is not met as evidenced by:
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Administrator agreed to update and certify the facility's plan of operation to include how the facility will appropriately respond to resident's medical emergencies in a timely manner. Additionally, the Administrator agreed to submit a signed statement confirming that...
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Based on interviews and record review the Licensee did not comply with the section cited above as R1 had a wound observed and was not sent to the hospital for 3 days which posed an immediate health risk to clients in care.
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 ...they will seek timely medical treatment for residents as soon as a change of condition is noticed. Administrator agreed to submit the updated plan of operation and signed statement to CCLD no later than POC due date.
Type A
10/17/2026
Section Cited
CCR87631(a)(1)

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87631 Healing Wounds
(a) ...shall be permitted to accept ...a healing wound under the following circumstances:
(1) When care is performed by ...an appropriately skilled professional.
This requirement is not met as evidenced by:
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Administrator agreed to submit a signed statement confirming that they would not admit any future residents with healing or chronic wounds without the appropriate skilled professionals in place to provide the needed care...
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Based on interviews and record review the Licensee did not comply with the section cited above as R1 was admitted to the facility with a healing wound without appropriate care in place which posed an immediate health risk to clients in care.
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... prior to the persons acceptance into the facility. Additionally the Administrator agreed to not re-admit R1 to the facility without all required documents/care in place prior to R1 returning to the facility. Administrator agreed to submit the statement to CCLD no later than POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kasandra Lopez
NAME OF LICENSING PROGRAM MANAGER:
Trevor Byrne
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/16/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2026


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 10/16/2026 02:57 PM - It Cannot Be Edited


Created By: Trevor Byrne On 10/16/2026 at 01:52 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VALLEY'S BEST HOMECARE
FACILITY NUMBER: 195850497

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/30/2026
Section Cited
CCR
87457(c)

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87457 Pre-Admission Appraisal
(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal...
This requirement is not met as evidenced by:
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Administrator agreed to submit a signed and dated statement of understanding confirming that they will conduct a thorough and complete pre-admission appraisal of all future residents and that they will not solely rely on discharging facility's assessments...
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Based on interviews and record review the Licensee did not comply with the section cited above as the facility did not complete a pre-admission appraisal of R1 prior to accepting them into the facility which posed a potential health, safety, or personal rights risk to clients in care.
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...Administrator agreed to submit the statement to CCLD no later than POC due date.
Type B
10/30/2026
Section Cited
CCR87458(a)

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87458 Medical Assessment
(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional ...
This requirement is not met as evidenced by:
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Administrator agreed to submit a signed and dated statement of understanding confirming that they will review all future medical assessments for required physician contact info prior to acceptance. Administrator agreed to submit the statement to CCLD no later than POC due date.
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Based on interviews and record review the Licensee did not comply with the section cited above as the facility accepted an LIC 602A with no printed name, address, phone number, date, etc. which posed a potential health, safety, or personal rights risk to clients 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.
Kasandra Lopez
NAME OF LICENSING PROGRAM MANAGER:
Trevor Byrne
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/16/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2026


LIC809 (FAS) - (06/04)
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