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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610887
Report Date: 09/22/2026
Date Signed: 09/22/2026 12:18:52 PM

Document Has Been Signed on 09/22/2026 12:18 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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:CARING HEARTS ASSISTED LIVINGFACILITY NUMBER:
197610887
ADMINISTRATOR/
DIRECTOR:		AGARONYAN, LIANAFACILITY TYPE:
740
ADDRESS:7567 Bovey AVETELEPHONE:
(747) 202-0381
CITY:ResedaSTATE: CAZIP CODE:
91335
CAPACITY: 6CENSUS: 6DATE:
09/22/2026
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Aram Yeghiazaryan, Applicant/LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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At 9:25 am, Licensing Program Analyst (LPA), Huma Rahimi conducted an announced Pre-Licensing visit to the above facility and met with applicant/Licensee. LPA conducted an entrance interview with the applicant/Licensee. At the time of this visit LPA did observe six (6) residents present in the facility. Fire Clearance dated 10/15/2025 and is approved for 5 non-ambulatory and 1 bedridden in room #1. The purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22. LPA toured the physical plant inside and outside and observed the following:

The facility has 4 bedrooms and 2 bathrooms designated for a capacity of 6 residents. There are no bedrooms designated for staff. There will be a wake night staff. The licensee will have a dementia plan of operation. Hospice waiver is approved for six (6) residents.

KITCHEN: At 9:35 am, LPA toured the kitchen. The kitchen area is equipped with a refrigerator, microwave oven, sink. Stove was observed in a good working condition. LPA observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. Knives and sharps are observed to be locked in the kitchen drawer and inaccessible to residents. Toxins and cleaning solutions were locked under the sink. The dual smoke and carbon monoxide alarms are hardwired and interconnected and observed to be operational. Fire extinguisher is located at the dining area and observed to be full and was last purchased on 9/22/2026.

Medications: LPA observed that the medication are kept in the filing cabinet in the dining room. A separate filling cabinet was observed in the dining room where the residents and staff and residents files are kept locked and inaccessible. Continue on LIC 809C

Nichelle Gillyard
Huma Rahimi
DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2026
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 S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: CARING HEARTS ASSISTED LIVING
FACILITY NUMBER: 197610887
VISIT DATE: 09/22/2026
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Bedrooms: LPA observed total of four (4) bedrooms designated for residents use. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Facility has an awake staff.

Bathrooms: LPA observed two (2) bathrooms of which one is designated for staff and one for residents. Both appeared to be clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and resident’s bathroom had non-skid mat. Hot water temperature measured at 106.1°F.

Living and dining room furniture were checked. The living room is neat and clean along with the dining room. Furniture were observed to be in good repair and excellent condition. The facility maintains a comfortable temperature at 73°F.


Laundry room is located in the bedroom hallway. Laundry detergent, cleaning solutions and other toxins are observed to be locked inside the laundry room.
The Backyard/Outside: had a covered shaded area for residents with outdoor furniture. There is no body of water at the facility. The facility has only one emergency exit. The emergency exit was unlocked with an inward facing latch. Emergency exit paths were free from debris.

Garage: There is no garage at the facility only drive ways.



Between 10:25 AM to 11:45 AM, LPA reviewed records of six (6) residents and two (2) staff. Residents and staff records appeared to be complete and updated.


Component III was conducted with the Administrator.

Pursuant to Title 22, the facility is compliant to regulation, is not ready for licensure. This report will be forwarded to the Centralized Application Bureau (CAB). The applicant will be notified by the CAB Analyst when their license is approved.



Exit interview conducted and copy of this report signed and delivered.
NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Huma Rahimi
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026
LIC809 (FAS) - (06/04)
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