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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610566
Report Date: 06/01/2026
Date Signed: 06/01/2026 02:43:58 PM

Substantiated


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
05/26/2026 and conducted by Evaluator Mariana Agban
COMPLAINT CONTROL NUMBER: 31-AS-20260526085332
FACILITY NAME:A-1 ASCENDED SENIOR CARE 2FACILITY NUMBER:
197610566
ADMINISTRATOR:TOPCHYAN, HARUTFACILITY TYPE:
740
ADDRESS:19911 VINTAGE STREETTELEPHONE:
(818) 667-4915
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:6CENSUS: 5DATE:
06/01/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:HARUT TOPCHYAN- AdministratorTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Staff do not provide adequate supervision resulting in resident eloping
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced initial complaint visit regarding the above allegation. LPA arrived at the facility and was granted entry by facility staff. The purpose of the visit was explained. Administrator Harut Topchyan was contacted and arrived shortly thereafter.LPA requested and reviewed pertinent records, including, but not limited to, the staff roster, resident roster, and Resident #1's (R1) file. LPA also conducted a physical plant tour to ensure that residents' health and safety needs were being met and that the facility was operating in compliance with applicable Title 22 regulations. During the visit, LPA interviewed the Administrator, three (3) staff members, and one (1) resident. LPA also attempted to interview four (4) additional residents.

Regarding the Allegation: Staff do not provide adequate supervision resulting in resident eloping
It is alleged that on 05/22/2026, at approximately 7:15 PM, Resident #1 (R1) was observed traveling unassisted in a wheelchair on a public street.
(Continue on 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2026
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-20260526085332
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: A-1 ASCENDED SENIOR CARE 2
FACILITY NUMBER: 197610566
VISIT DATE: 06/01/2026
NARRATIVE
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Staff #1 (S1) stated that R1 exited the facility through the side door located in the backyard on 05/22/26 afternoon. S1 mentioned that staff were unaware that R1 had left the facility until a neighbor knocked on the front door and informed staff that R1 was outside on the street. S1 further stated that R1 subsequently returned to the facility through the same side door. Interview with the Administrator confirmed the incident and stated that the side door remained unlocked as part of the facility's emergency evacuation procedures. The Administrator further indicated that R1 appeared to have taken advantage of a time when only one staff member was on duty. Administrator stated that S1 mentioned that R1 was gone for 10 minutes or less near the front door. LPA attempted to interview R1; however, R1 was not present at the facility during the visit. LPA reviewed R1's Medical Assessment dated 06/24/2025, which indicated that R1 was not capable of leaving the facility unsupervised due to physical and cognitive limitations.

Based on interviews conducted and records reviewed, there is sufficient evidence to support the allegation that the facility failed to provide adequate supervision to prevent R1 from leaving the facility unsupervised. Therefore, the allegation is deemed Substantiated at this time.

An exit interview was conducted. A citation was issued pursuant to Title 22, California Code of Regulations, as referenced on the LIC 9099-D. A copy of this report was reviewed with and provided to the facility Administrator.
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20260526085332
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: A-1 ASCENDED SENIOR CARE 2
FACILITY NUMBER: 197610566
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/01/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/02/2026
Section Cited
CCR
87468.2(4)
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Additional Personal Rights
To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by:
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Administrator agreed to conducted in service training for all staff. Staff attendance sheet will be submitted to LPA by 06/03/26. In addition, Administrator will update R1's Appraisal Needs and service plan and submitted to the LPA by 06/03/26.
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Based on interview and records reviews, licensee did not comply with the section cited above. Facility failed to provide adequate supervision to prevent R1 from leaving the facility unsupervised. This poses an immediate health, safety or personal rights risk to persons in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3