197610951-9-17-2026-31-AS-NMAN-DY6P3W-20260922105812

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610951
Report Date: 09/17/2026
Date Signed: 09/17/2026 02:45:00 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
09/10/2026 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20260910120202

FACILITY NAME:	TREE OF LIFE LIVING SOLUTIONS		FACILITY NUMBER:	197610951
ADMINISTRATOR:	PACHANYAN, HOVSEP		FACILITY TYPE:	740
ADDRESS:	11440 GOTHIC AVE		TELEPHONE:	(818) 571-4214
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 5	DATE:	09/17/2026
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Frida Chizikian		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff left resident in soiled diapers for an extended period of time
Uncleared adult at the facility
Staff did not ensure emergency paperwork was easily accessible in an emergency

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

At approximately 10:00 a.m. on 09/17/26 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with the licensee and disclosed the reason for the visit.

To investigate the allegations above, LPA conducted a file review prior to today’s visit of criminal background clearances at 1:00 p.m. on 09/15/26. Today, LPA interviewed four (04) out of five (05) residents, administrator, licensee, and witnesses between 11:00 a.m. and 2:15 p.m., toured the facility inside and out at 11:10 a.m., and conducted a record review of pertinent records, including but not limited to an admission agreement, face sheet, care plan and staff roster at 11:45 a.m.

Regarding the allegation "Staff left resident in soiled diapers for an extended period of time" it was alleged Resident #1 (R1) was found in soiled diaper that had not been changed for several hours. Interview with R1 at 12:45 p.m. today revealed they use a catheter for urine and can independently use the restroom for bowel movements. R1 did not have an issue with the incontinence care they receive.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
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 3

Control Number 31-AS-20260910120202

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: TREE OF LIFE LIVING SOLUTIONS	FACILITY NUMBER: 197610951
	VISIT DATE: 09/17/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Interview with Resident #2 (R2) at 1:30 p.m. today revealed staff regularly checked them for incontinence and changed them as needed. Interviews with the administrator at 11:30 a.m. and the licensee at 11:45 a.m. revealed R1 has an indwelling catheter for urinary incontinence which home health monitored. R1 is able to care for their own bowel movement incontinence but needed assistance with transferring out of bed. R1 wears a diaper since their catheter occasionally leaks. The administrator observed R1 had catheter complications on 09/05/26. The administrator later called 9-1-1 for R1. The licensee stated R1 was changed “about two hours” prior to their hospitalization. Telephonic interview with R1’s home health agency at 2:00 p.m. today revealed they observed dried fecal matter in R1’s diaper on 09/02/26. The administrator claimed it was not an issue afterwards. Record review of R1’s face sheet and care plan indicated R1 was alert and oriented and needed assistance with transferring and ensuring their catheter site was clean. R1’s care plan revealed they did not need assistance with incontinence care. Based on interviews and record review, R1 was able to care for their own bowel movement incontinence, and although the allegation may have occurred, there is no measurable and verifiable information to confirm validity of the complaint. Hence the allegation is UNSUBSTANTIATED at this time.

Regarding the allegation "Uncleared adult at the facility" it was alleged Visitor #1 (V1) was present in the facility without first obtaining a criminal background clearance. Interviews with the administrator and the licensee revealed V1 is not staff and was visiting Resident #3 (R3). Interview with R3 at 2:00 p.m. today confirmed V1 was their visitor, not a staff member. Telephonic interview with V1 at 1:45 p.m. today confirmed they were visiting R3. V1 did not provide care and supervision and is not a staff member. File review of criminal background clearances revealed V1 did not have a criminal background clearance associated to the facility. Based on file review and interviews, although V1 did not have a criminal background clearance, they were not required to obtain one as they were only a visitor. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Staff did not ensure emergency paperwork was easily accessible in an emergency" it was alleged the facility did not maintain records readily available for R1. Interview with the administrator revealed R1’s records were locked and stored confidentially. The administrator had the only key to the file cabinet while going out to their lunch break. The administrator returned within fifteen (15) minutes and provided all necessary paperwork. Interview with the licensee confirmed that the administrator had the only key to the locked file cabinet, went to lunch, and returned promptly to provide all necessary documents.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
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: 2 of 3

Control Number 31-AS-20260910120202

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: TREE OF LIFE LIVING SOLUTIONS	FACILITY NUMBER: 197610951
	VISIT DATE: 09/17/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Interview with R1 did not reveal pertinent information to this allegation. Record review of R1’s file revealed all required paperwork were available for audit today. Based on interviews and record review, it was concluded that although the allegation may have occurred, there is no measurable and verifiable information to confirm validity of the complaint. Hence the allegation is UNSUBSTANTIATED at this time.

No immediate health or safety concerns were observed during today’s inspection.

Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
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: 3 of 3