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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610318
Report Date: 09/17/2026
Date Signed: 09/17/2026 01:26:38 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/21/2026 and conducted by Evaluator Tihesha Smith
COMPLAINT CONTROL NUMBER: 31-AS-20260821123643
FACILITY NAME:EMERALD SENIOR CARE,INC.FACILITY NUMBER:
197610318
ADMINISTRATOR:HOVHANNES PAPAZYANFACILITY TYPE:
740
ADDRESS:10401 Encino AVETELEPHONE:
(747) 300-2232
CITY:Granada HillsSTATE: CAZIP CODE:
CAPACITY:6CENSUS: 6DATE:
09/17/2026
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Hayk Margaryan,AdministratorTIME COMPLETED:
01:35 PM
ALLEGATION(S):
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Licensee is operating over capacity

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tihesha Smith conducted an unannounced complaint visit to the facility to deliver findings. LPA Smith was greeted by staff and disclosed the purpose of the visit.
Licensee Is Operating Over Capacity
On 8/21/26, Licensing Program Analyst (LPA) Smith conducted a tour of the facility. During the tour, LPA Smith observed seven (7) residents present in the home with one (1) caregiver on duty. During an interview, the administrator stated that the facility has an approved capacity of six (6) residents. A review of the facility fire clearance confirmed that the facility is cleared for a total capacity of six (6) residents.
Based on observation, record review and administrator admission the facility was operating over its approved capacity at the time of the visit there is sufficient information to support the allegation. Therefore, the allegation is deemed substantiated at this time.
Deficiency cited on 9099D
No hazards observed at time of visit
Exit interview conducted/copy of report delivered

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2026
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 4
Control Number 31-AS-20260821123643
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: EMERALD SENIOR CARE,INC.
FACILITY NUMBER: 197610318
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/18/2026
Section Cited
CCR
87204(a)
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A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time.
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Administrator to remove additional resident and provide admissions agreements for all residents admitted to facility, and provide LIC 9020, cleient register/ LIC 500 Personal. POC due date:09/18/26
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This requirement was not met based on observation/administrator admission 7 residents were in the home on 08/21/26. This poses a risk to residents in care.
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LPA Smith toured the facility and observed only 6 residents in facility, therefore /over capacity is cleared. However administrator must provide additional documents aboved
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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 Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/21/2026 and conducted by Evaluator Tihesha Smith
COMPLAINT CONTROL NUMBER: 31-AS-20260821123643

FACILITY NAME:EMERALD SENIOR CARE,INC.FACILITY NUMBER:
197610318
ADMINISTRATOR:HOVHANNES PAPAZYANFACILITY TYPE:
740
ADDRESS:10401 Encino AVETELEPHONE:
(747) 300-2232
CITY:Granada HillsSTATE:CAZIP CODE:
CAPACITY:6CENSUS: DATE:
09/17/2026
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Hayk Margaryan,AdministratorTIME COMPLETED:
01:35 PM
ALLEGATION(S):
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9
Unlawful eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tihesha Smith conducted an unannounced complaint visit to the facility to deliver findings. LPA Smith was greeted by staff and disclosed the purpose of the visit.

Unlawful Eviction

On 08/21/26, LPA Smith briefly observed facility grounds at 3:20 pm and requested copies of facility documents relevant to the investigation at approximately 3:45pm. LPA Smith also attempted to interview R1 on 8/21/26, regarding the allegation; however, R1 is nonverbal and did not respond to the questions. R1 stared ahead and did not provide a physical response, such as a nod or gesture. When the administrator arrived, the administrator asked R1 whether R1 was leaving or being evicted. R1 appeared to shake their head. During interview with the administrator, he revealed that R1 had been transferred from the adjacent sister facility Imperial Senior Care INC and would be going back.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2026
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 4
Control Number 31-AS-20260821123643
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: EMERALD SENIOR CARE,INC.
FACILITY NUMBER: 197610318
VISIT DATE: 09/17/2026
NARRATIVE
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(cont from 9099A)

The administrator further indicated that an admission agreement for R1 had not been signed and/or was not available for review at the time of the visit.

LPA Smith requested to review all resident records, including LIC 9020 Client register, to verify which residents were admitted to the facility and which residents were admitted to the adjacent facility, Imperial Senior Care Inc. The requested records were not available for review at the time of the visit and administrators revealed R1 is resident from next door Imperial Senior Care Inc and had not been admitted to Emerald Senior Care, Inc .

Based on the information obtained during the investigation, there is not sufficient information to support the allegation. Therefore, the allegation is deemed unsubstantiated at this time.

No hazards observed at time of visit

Exit interview conducted copy of report delivered.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4