197610649-8-5-2026-31-AS-TAGD-DY6NPN-20260922103833

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610649
Report Date: 08/05/2026
Date Signed: 08/05/2026 03:17:06 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.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
06/03/2026 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20260603162301

FACILITY NAME:	HAPPY RESIDENTS LIVING CENTER		FACILITY NUMBER:	197610649
ADMINISTRATOR:	NSHANIAN, HAKOP		FACILITY TYPE:	740
ADDRESS:	13127 BEAVER ST		TELEPHONE:	(818) 426-1413
CITY:	SYLMAR	STATE: CA	ZIP CODE:	91342
CAPACITY:	6	CENSUS:	DATE:	08/05/2026
		UNANNOUNCED	TIME BEGAN:	09:08 AM
MET WITH:	Hermine Nshanian - Co Administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Licensee does not ensure staff are properly trained
Staff did not seek medical attention in a timely manner
Staff did not address the resident's change in conditions
Questionable Death

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Tan conducted an unannounced subsequent complaint visit to this facility to further investigate the above allegations. LPA met with Co-Administrator Hermine Nshanian and explained the reason for the visit.

LPA conducted a physical plant tour at 9:18 AM, requested copies of facility documents relevant to the investigation at 9:46 AM, reviewed records between 10:00 AM to 11:00 AM and interviewed residents and staff between 11:00 AM to 1:00 PM. Regarding the allegation that Licensee does not ensure staff are properly trained, it was alleged that Staff #1 (S1) was not properly trained on CPR. LPA's record review today between 10:00 AM to 11:00 AM revealed that S1 had a First Aid/CPR certification from National CPR Foundation which will expire on 10/26/27.

(continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2026

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 31-AS-20260603162301

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: HAPPY RESIDENTS LIVING CENTER	FACILITY NUMBER: 197610649
	VISIT DATE: 08/05/2026

NARRATIVE

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(continued from LIC 9099)

Regarding the allegation that Staff did not seek medical attention in a timely manner, it was alleged that hospital doctor believes that Resident #1 (R1) could have been brought to the hospital much sooner. LPA record review today revealed that R1 was brought and arrived at the hospital at 10:54 AM. LPA interview with Home Health nurse on 06/04/26 at around 10:00 AM revealed that the nurse arrived at the facility at around 10:00 AM and looked at R1, upon assessment the nurse immediately called 911 and administered CPR to R1 until paramedics arrived. Further interview revealed that the nurse was doing a regular visit to R1 to treat R1's wound caused by prolong use of Intravenous (IV) drugs. LPA interview with the staff also revealed that R1 usually woke up late but still tried to wake up for breakfast at 8:00 AM but still snoring so the staff let R1 sleep. Further interview with staff also revealed that the staff did not observe anything alarming with R1 during the staff visit at 8:00 AM.

Regarding the allegation that Staff did not address the resident's change in conditions, it was alleged that the staff did not properly observe R1's condition. LPA's interview with the staff also revealed that R1 usually woke up late but still tried to wake up for breakfast at 8:00 AM but still snoring so the staff let R1 sleep. Further interview with staff also revealed that the staff did not observe anything alarming with R1 during the staff visit at 8:00 AM. LPA's record review also revealed that staff did not have any medical background or were medically trained to observe medical issues with any resident as this is a non-medical facility.

Regarding the allegation of questionable death, it was alleged that during R1's hospitalization on 05/29/26, R1 “did not look good" and was displaying shallow breathing and eventually died at the hospital on 05/31/26. LPA's record review today between 10:00 AM to 11:00 AM revealed that R1 had a very long list of diagnosis including psychiatric issues and documented history of IV drug use. LPA's interview with the Home Health Nurse revealed that R1 was still alive when brought to the hospital and lived for another two (2) days until R1 passed at the hospital on 05/31/26.

Based on the information gathered during this and prior visit, these allegations are deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2026

LIC9099 (FAS) - (06/04)

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