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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610911
Report Date: 08/31/2026
Date Signed: 08/31/2026 11:40:06 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
08/07/2026 and conducted by Evaluator Leslie Ngo-Castaneda
COMPLAINT CONTROL NUMBER: 31-AS-20260807082630
FACILITY NAME:HEALING PINES SENIOR LIVING LLCFACILITY NUMBER:
197610911
ADMINISTRATOR:GHUKASYAN, KRISTINEFACILITY TYPE:
740
ADDRESS:19733 HEMMINGWAY STTELEPHONE:
(747) 352-2385
CITY:WINNETKASTATE: CAZIP CODE:
91306
CAPACITY:6CENSUS: 5DATE:
08/31/2026
UNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:James Pangalila- Staff designeeTIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Staff allow residents to use a resident's bedroom as a passageway to the bathroom.
Staff did not serve resident with proper eviction.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced subsequent visit for the above allegation. LPA met with facility staff designee, James Pangalia, and explained the reason for the visit.

On 8.11.2026, LPA Shahbazian conducted a physical plant tour and requested copies of LIC 500 (staff roster), LIC 9020 (resident roster). On 8.31.2026, LPA Ngo-Castaneda crequested copies of pertinent information at 9:00 AM, which include, but are not limited to, Physician’s report, Admission Agreement, appraisal needs and service plan, and relevant documents to the investigation. LPA interviewed the Administrator over the phone at 8:37 AM, staff designee, and five (5) out of five (5) residents.

Allegation: Staff allow residents to use a resident's bedroom as a passageway to the bathroom.

Continue to LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2026
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 2
Control Number 31-AS-20260807082630
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: HEALING PINES SENIOR LIVING LLC
FACILITY NUMBER: 197610911
VISIT DATE: 08/31/2026
NARRATIVE
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It is alleged that residents use another resident's bedroom as a passageway to the bathroom. Interview with staff revealed that resident #1 (R1) has been reminded numerous times not to use the private bathroom inside bedroom #3 where females reside. Interview with resident #3 (R3) and #5 (R#5), who reside in bedroom #3, did not give permission to R1 to enter their bedroom to use their private bathroom. During today's visit, LPA Ngo-Castaneda observed at 9:56 AM that R1 just barged into bedroom #3 to use their private restroom. Interview with R1 at 10:01 AM revealed that using the private bathroom in bedroom #3 is a shorter path to walk, and they absolutely do not want to wait for the hallway bathroom to be vacant, if occupied. R1 also stated that they have the right to use the private bathroom and go wherever in the facility. During record review at 10:15 AM, it is revealed on R1 care plan stated that staff that they were told and numerous times not to enter private bedroom #3, to follow house rules, and respect R3 R5 privacy.

Based on interviews, observation, and record review conducted, there is insufficient evidence to support the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation: Staff did not serve resident with proper eviction.

It was alleged that staff did not serve the resident with proper eviction. An interview with R1 today at 10:01 AM revealed that S1 gave R1 a 30-day eviction notice on 8.1.2026. A copy of the eviction letter was sent to LPA Ngo-Castaneda on 8.6.2026. A telephonic interview with the administrator at 8:37 AM today revealed R1 does not abide by the house rules, does not respect the personal rights of the residents, and took personal belongings from bedroom #1. R1 took a television remote that is connected, belongs to bedroom #1, and is being use by resident #2 (R2). Interview with R3 and R5 revealed that R1 enters bedroom #3 without knocking and uses their private bathroom. Interview with R2 revealed that R1 took their remote and entered bedroom #1 without knocking. Interview with R1 at the dining table at 10:01 AM revealed that they refuse to sign the eviction letter and that they can do whatever they want living at the facility. Record review revealed R1’s care plan and admission agreement revealed pertinent information for the investigation.

Based on interviews and record review, the facility did not illegally evict a resident. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health or safety concerns were observed during today’s visit. Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2026
LIC9099 (FAS) - (06/04)
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