Assisted Comfort Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 10:42AM. LPA met with staff and Administrator Mariam “Maya” Kevliyan. Reason for the visit was explained. Entrance interview conducted. Beginning at 10:44AM, LPA, along with the Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards. The following was observed: KITCHEN: LPA observed the kitchen/dining area. Knives are stored in a locked kitchen drawer. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Fire extinguishers were fully charged and last serviced 03/27/2026 during the visit. LAUNDRY/STORAGE ROOM: Washer, dryer and laundry supplies were observed inside the locked storage room by the kitchen inaccessible to residents. Cleaning solutions, emergency food and water, first aid kits, and additional incontinent care supplies were observed in the storage area. BEDROOMS: There are four (4) bedrooms total of which two (2) are for single resident-use and two (2) are for shared resident-use. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. There is a staff room on the premises. RESTROOMS: There are two (2) restrooms of which one (1) is attached to Bedroom #1 and one (1) is in the hallway. Restrooms were clean, sanitary, and in operating condition with grab bars and slip-resistant surfaces. Hot water temperatures were measured in restrooms and were between 106.3-108.3 degrees F, which is within the required range. Continued on LIC-809-C. COMMON AREAS: LPA observed common area to be clean and properly furnished. At 11:19AM, fire alarms/carbon monoxide detectors were tested and functioned properly. Night lights were present in the hallways and passages. All exits have functioning auditory devices which were repaired to be operational during the visit. LPA observed required postings throughout the common spaces. OUTDOOR SPACE: LPA observed the back patio which has a covered outdoor area for resident use. There is a gate on the side of the house designated for an emergency exit. Passageways were free and clear from obstruction. There are no bodies of water on the premises. MEDICATION REVIEW: At 11:22AM, LPA reviewed medications for two (2) residents. Medications are centrally stored in a locked filing cabinet near the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. LPA observed medications missing start dates on the centrally stored medications and destruction record. Administrator completed the missing start dates during the visit. RECORD REVIEWS: Beginning at 12:04PM, LPA reviewed six (6) out of six (6) resident files and four (4) personnel files for documents including but not limited to: medical records, care plans, resident Admission Agreement, TB test, health screening, staff training and fingerprint clearance. All resident and personnel files were in order. During the visit, LPA obtained copies of valid liability insurance, LIC 500, and resident roster. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. Emergency drill was last conducted on 08/15/2025. Administrator completed the drill for the current quarter during the visit. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Mar 27, 2026

The state marks this report as 8 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Office

Licensing Program Manager (LPM) Kristin Heffernan and Licensing Program Analyst (LPA) Angela Barutyan met with Licensee Representative/Administrator Mariam Kevliyan for this facility to hold an informal conference at the Woodland Hills North Adult and Senior Care Regional Office. This informal conference was held to discuss a recent Unlicensed Operation, which was operated by the licensee representative and administrator of the licensed facility, Assisted Comfort Home. On 01/27/2026, an application for RCFE Assisted Comfort Home #2 Lic. #195850734 was submitted for the property located at 23730 Killion St., Woodland Hills, CA 91367 which was in pending status as of today. On 12/15/2025, the Woodland Hills North Adult and Senior Care Regional Office received a complaint alleging unlicensed care at Assisted Comfort Home. The complaint was unfounded as it was intended for the property located across the street from the Licensed facility. On 12/30/2025, the allegation of "Unlicensed Care" was substantiated for three (3) individuals at the 23730 Killion Street address and a Notice of Violation (NOVL) letter was issued to the operator, Ms. Kevliyan. Therefore, this meeting was held to discuss the licensee representative's responsibilities and administrative qualifications and duties. The licensee representative, Mariam Kevliyan, stated that she understands that her actions were incorrect and that she takes full responsibilities for her actions. LPM reviewed the definition of unlicensed care and provided Ms. Kevliyan a copy of Health and Safety Code (HSC) section 1569.10. Ms. Kevliyan indicated that moving forward, she will follow the HSC and Title 22 Regulations. Other issues related to the pending application for Assisted Comfort Home #2 were also discussed at the time of this visit. Exit interview was conducted and a copy of report was issued.the state’s words, verbatim · CDSS document, Mar 24, 2026

Allegation investigated: Staff hits multiple residents

Licensing Program Analyst (LPA) Quoc Huynh conducted an initial complaint visit for the above allegation. The LPA arrived at 10:41AM and met with the Licensee’s Designee (LD) Karapet Klndjuyan who arrived shortly thereafter. Entrance interview conducted. During today’s visit between 11AM and 12:15PM, the LPA conducted a physical plant tour and reviewed and obtained pertinent documents. Report Continued on LIC 9099-C Unfounded The LPA and LD contacted the Licensee Smbat Klndjuyan and Administrator Mariam Kevliyan via telephone call who stated they were aware of the allegation as it was intended for their Independent Living residential home located across the street from the Licensed facility. Record review confirmed the reported resident did not reside at this facility therefore the allegation is deemed UNFOUNDED at this time. Due to their unavailability, the Licensee and Administrator provided verbal confirmation for the LD Karapet Klndjuyan to sign today’s report. No deficiency cited. Exit interview conducted. A copy of the report was reviewed and provided.the state’s words, verbatim · CDSS document, Dec 22, 2025 · control 29-AS-20251215095357

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Emily Peraldi and Quoc Huynh arrived at the facility unannounced to conduct a required annual visit. At 10:05 a.m., the LPAs met with staff and explained the reason for visit. At 10:15 a.m., the Administrator, Mariam Kevliyan arrived at the facility. At 10:20 a.m., the LPAs along with Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards. KITCHEN: The LPAs observed the kitchen/dining area. Knives are stored in a locked kitchen drawer. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 10:35 a.m., hot water measured at 106.0-degree Fahrenheit. Medications are located in a locked filing cabinet near the kitchen. BEDROOMS: The facility is a single-story residential home with four (4) bedrooms and two (2) bathrooms. The LPAs observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. RESTROOMS: Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid mats. At 10:21 a.m., hot water measured at 106.9-degree Fahrenheit. The sinks had sufficient liquid soap, and paper towels. OUTDOOR SPACE: The LPAs observed the back patio which has a covered outdoor area for resident use. There is a gate on the side of the house designated for an emergency exit. Passageways were free and clear from obstruction. There are no bodies of water on the premises. Continued on LIC-809-C. LAUNDRY/STORAGE ROOM: Washer, dryer and laundry supplies were observed inside the locked storage room inaccessible to residents. Cleaning solutions, first aid kits and additional incontinent care supplies were observed in the storage area. COMMON AREAS: The LPAs observed common area to be relatively clean and properly furnished. The LPAs observed the fire extinguisher to be fully charged and last serviced on 12/27/2024. At 10:25 a.m., fire alarms/carbon monoxide detectors were tested and functioned properly. Night lights were present in the hallways and passages. All exits have functioning auditory devices and were operational at the time of the visit. RECORD REVIEWS: Between 10:30 a.m. and 11:28 a.m., the LPAs conducted a file review for all residents and staff regularly scheduled and observed the following: Staff have current first aid. The Administrator stated that required annual training is going to be completed this month. Resident records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All files were in order. The LPAs also reviewed the facility's emergency disaster plan, which was observed to be complete and updated. Starting at 12:57 p.m., the LPAs conducted a review of medication and medication documentation with Administrator for three (3) out of five (5) residents. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Mar 11, 2025

The state marks this report as 6 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Valeria Conway arrived at 9:28 a.m. to conduct an unannounced Annual visit. The LPA was greeted at the door by staff, Lilit Grigorian. The Administrator, Mariam Kevliyan arrived shortly after at 9:36 a.m. and was explained the reason for the visit. At 9:55 a.m., The LPA toured the physical plant areas with staff to ensure client health and safety and to ensure the facility is in compliance with Title 22 regulations. The following was observed: Hardwired combination smoke and carbon monoxide detectors were tested at 10:52 a.m. and were functional at the time of the visit. Fire extinguishers were observed throughout the common areas and were fully charged and last serviced 12/27/2023. KITCHEN: The LPA observed the kitchen/dining area to be clean and kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. The LPA observed the kitchen refrigerator to be fully stocked at the time of visit. Knives and sharps are locked in a drawer at the kitchen island. Hot water temperature measured at 111.9 degrees Fahrenheit at 10:10 a.m. LPA observed soaps, detergents, cleaning compounds or similar substances to be locked and stored under the sink, however LPA observed cooking oil under the sink and explained to the administrator that cleaning supplies shall be in areas separate from food supplies. Continued on LIC 809C Continued from LIC 809-C BEDROOMS: There are (4) four bedrooms designated for resident use and (1) one bedroom designated for staff use. Staff bedroom is located adjacent to the kitchen. Bedroom #3 and Bedroom #4 have a direct exit to the exterior. The facility has furnished each room with clean linens, appropriate furnishings, and sufficient lighting for resident use. RESTROOMS: Resident bathrooms are clean, sanitary, and in operating condition with grab bars and non-skid surfaces. The LPA observed sufficient amounts of soap and paper products. The LPA observed signs in all bathrooms promoting good hand hygiene. Bathroom hot water measured between 118.6 and 119 degrees Fahrenheit during the time of the visit. COMMON SPACES: The LPA observed the living room area which is clean and properly furnished with seating, and a television for resident use. The LPA observed three (3) residents in the living room watching television during time of visit. Flooring was checked for cleanliness, all areas were clean, sanitary and in good repair. The LPA observed cameras in all common spaces and a screened fireplace in the living room. LAUNDRY/STORAGE ROOM: Washer, dryer and laundry supplies were observed inside the locked storage room inaccessible to residents. Also, emergency food, emergency water, extra disposable cutlery, first aid kit was observed to be complete including a manual. Additional incontinent supplies were observed in the locked laundry/storage room adjacent to the kitchen. At the moment, Administrator is upgrading cabinets in the storage room and an amount of carton boxes and harmless debris is on the side of the facility. These items are not obstructing any main exit/emergency route however Administrator agrees to clean it up right away. OUTDOOR AREA: The LPA observed a covered patio area with patio furniture including a table and chairs for resident use. Facility has one (1) fence gate that self-latches with clear passageways for emergency exit use. There were no bodies of water accessible to residents at the time of visit. Continued on LIC 809-C Continued from LIC 809C GARAGE: The facility does not have a garage. Emergency food supplies and additional incontinent supplies were observed in the locked laundry room adjacent to the kitchen. MEDICATION & OFFICE AREA: Medications were observed in a locked filing cabinet in the office area adjacent to the kitchen. Medication cabinet is always locked, and inaccessible to clients. At 12:30 p.m., medications were reviewed for four (4) clients. Medications observed were properly labeled and in compliance with regulation. At this time, medications reviewed were not logged on the centrally stored medication record. Administrator is using pharmacy medication list which it does not include all required information. LPA advised administrator to use form LIC622 (Centrally Stored Medication Record). STAFF/CLIENT FILE REVIEW/INTERVIEWS: LPA reviewed six (6) staff records during today's visit. LPA reviewed four (4) client file records during the visit. All staff and client records reviewed were in compliance with Title 22 regulation at the time of the visit. During today's visit, LPAs interviewed 3 (three) clients and 2 (two) staff. INFECTION CONTROL/DISASTER PREPAREDNESS: During today’s visit, the LPAs reviewed the facility's infection control policy and disaster preparedness policies. LPA communicate to Administrator that new version of the Emergency Disaster Plan for Residential Care facilities for the elderly is required. LPA printed new revision form and was given to Administrator to complete and post and explained that it needs to be yearly reviewed or updated if any changes occurs. All items reviewed were in compliance. Last emergency drill was completed on 12/15/2023. Exit interview conducted. No citations issued. A copy of the report was issued.the state’s words, verbatim · CDSS document, Mar 20, 2024