331881373-9-17-2026-18-AS-APEZ-DYCUGJ-20260928153426

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881373
Report Date: 09/17/2026
Date Signed: 09/17/2026 09:50:01 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/23/2026 and conducted by Evaluator Seo Jeon

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20260823110640

FACILITY NAME:	COTTON VILLA RCFE		FACILITY NUMBER:	331881373
ADMINISTRATOR:	MESROPYAN, ANAHIT		FACILITY TYPE:	740
ADDRESS:	64982 COTTON CT		TELEPHONE:	(818) 807-1338
CITY:	DESERT HOT SPRINGS	STATE: CA	ZIP CODE:	92240
CAPACITY:	6	CENSUS: 4	DATE:	09/17/2026
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Ben Zhumanazarov, Caregiver		TIME COMPLETED:	10:10 AM

ALLEGATION(S):

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Staff do not safeguard residents personal belongings
Staff does not ensure resident is served nutritious meals
Staff serve resident expired food
Staff do not ensure resident's basic needs are being met
Facility is not sufficiently staffed to meet the needs of residents in care
Staff do not ensure resident is provided prescribed medications as needed

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced visit to the facility to deliver findings of the above allegations. LPA met with Ben Zhumanazarov, Caregiver, and informed them of the purpose of the LPA’s visit. The Department’s investigation involved interviews with staff and resident and review of records.

On August 23, 2026, Community Care Licensing (The Department) received a complaint report with the following allegations:

Staff do not safeguard resident’s personal belongings. Staff do not ensure resident is served nutritious meals. Staff serve resident expired food. Staff do not ensure resident’s basic needs are being met. Facility is not sufficiently staffed to meet the needs of residents in care. Staff do not ensure resident is provided prescribed medications as needed. (Continued on LIC9099-C)

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Jacob Garber
LICENSING EVALUATOR NAME: Seo Jeon
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)

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Control Number 18-AS-20260823110640

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: COTTON VILLA RCFE	FACILITY NUMBER: 331881373
	VISIT DATE: 09/17/2026

NARRATIVE

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Information received indicated that Resident #1 (R1) did not receive assistance with activities of daily living (ADL) from staff members. LPA conducted an interview with R1, who stated that they did not require staff assistance with ADL. R1 provided a tour of the room and stated that R1 could cook and manage their own medications. R1 did not express any concerns with their ADL. R1 expressed their concern with rent payment. R1 did not understand why they must pay monthly rent. LPA conducted an interview with Staff #1 (S1), who stated that R1 was a tenant at an independent studio of the facility building, not a resident of the licensed facility. LPA and S1 conducted a tour of the facility. LPA observed that R1 did not have access to any part of the facility, including the backyard. S1 pointed out that R1’s room was not a part of the facility.

Based on interviews conducted and observations, R1 was not a resident at the facility. This allegation is Unfounded. A finding of Unfounded means the allegation could not have happened, is false, and/or is without a reasonable basis.

An exit interview was conducted where a copy of this report was provided.

SUPERVISORS NAME: Jacob Garber
LICENSING EVALUATOR NAME: Seo Jeon
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)

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