Golden Bliss Board and Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA was greeted by licensee Marianna Ghazaryan, and was explained the reason for the visit. At 9:49 AM, with the assistance of licensee, LPA took a tour of the physical plant. Required postings were observed in the entry area. At 9:56 AM the smoke alarms were tested and are operational, they are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the kitchen and the office. The charge date of 5.5.2026. During the visit the facility is at 75 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory resident, one (1) bedridden bedroom #3, and is cleared for five (5) hospice waiver. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away under the sink. Bedrooms: There were three (3) bedrooms designated for residents. Room #1 is shared, bedroom #2 is private. bedroom #3 is shared. Bedrooms that are used by residents were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Continue to LIC 809-C Bathrooms: There are two (2) bathroom designated for residents' use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 115.8 degrees Fahrenheit for bathroom #1 located in the hallway beside room #1. Bathroom #2 is in inside bedroom #3. Hot water temperature was measured at 111.1 degrees Fahrenheit. There is enough clean linen available in the cabinets in the hallway. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control: Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or body of water. There is no garage only car port. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Office space is beside the dining table. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. Medications: LPA observed that the medication are kept in the living room in a locked cabinet and inaccessible to residents in care. First-aid has all proper items and is current. Resident records were reviewed for requirements and legibility: Planned activities are offered. LPA reviewed five (5) of the five (5) records and LPA found all files to be complete. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies were found, exit interview conducted, copy of report has been issued and discussed.the state’s words, verbatim · CDSS document, Jun 1, 2026

Allegation investigated: Staff engaged in financial misconduct involving a resident’s bank account. Staff did not accord a resident privacy during visits.

At approximately 9:20 AM, Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced initial complaint visit in response to the above-mentioned allegations. LPA met with Staff#1 (S1), who granted access to the facility. Entrance interview conducted. During investigation LPA conducted a physical plant tour at 9:30 AM. LPA interviewed two (2) staff and four (4) out of four (4) residents between 10:14 AM to 11:47 AM. Between 11:48 AM and 12:00 PM, LPA requested and reviewed copies of pertinent information, which included, but were not limited to, LIC 500 (Staff Roster), LIC 9020 (Client Roster), R1’s Physician’s report, Admission Agreement, Identification and Emergency Information, Inventory record of personal belongings, and other documents relevant to the investigation. In addition, at 1:10pm, LPA spoke with R1’s family member/responsible party over the phone. Continue to LIC 9099-C Unsubstantiated Allegation #1: Staff engaged in financial misconduct involving a resident’s bank account. It was alleged that staff engaged in financial misconduct regarding resident #1 (R1) bank account. LPA interview with licensee and residents revealed that residents do not have any issues with their finances or monthly dues. Interview with licensee at 10:37 AM, revealed that they were aware that bank fraud occurred with R1 bank account. However, the Licensee or other staff have no access to R1’s bank account. R1’s checks for Monthly dues are handled by R1’s friend. Record review revealed that R1’s rent is being paid from R1’s bank account and the checks are written by R1’s friend. Based on the information, observation, and record review gathered during this, the allegation is deemed unsubstantiated. Allegation #2: Staff did not accord a resident privacy during visits. It was alleged that staff would hover or be near R1 bedroom when R1 had visitors, and privacy would not be given to them. LPA interview with four (04) residents revealed no issues or concerns regarding privacy from visitors. Residents stated that when they have visitors, privacy is given to them by the staff. According to staff interviews, they always give visitors their privacy and attend to tidying-up and do chores at the facility. LPA interview with S1 revealed that previously R1 had a visitor and did not recognize who the visitor was. Therefore, staff verified who the visitor was for safety reasons. Interview with a family member verified the information received by the facility staff. Based on interviews and observation, there is no sufficient information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Dec 17, 2025 · control 31-AS-20251210155414

Allegation investigated: Staff retaining resident against her will. Staff do not provide resident medications as prescribed. Staff ignored resident's request for medical treatment.

On 9.15.2025 at 11:10 AM, Licensing Program Analyst (LPA) Leslie Ngo-Castaneda arrived at this facility to conduct an unannounced subsequent complaint visit to deliver final determination of the above noted allegations. LPA was granted entry into the facility by the staff #1 (S1). An entrance interview was conducted. At the time of this visit, at approximately 11:15 AM, LPA conducted a physical plant tour of the facility. LPA did not observe any immediate health and safety issues. To investigate the allegations, LPA Ngo-Castaneda conducted an initial complaint visit on 06.19.2025 at which time, at approximately 11:16 AM, LPA conducted a physical plant tour of the facility. While conducting the physical plant tour, LPA interviewed a resident 1 (R1), who was sitting at the patio, and three (3) other residents who were present in the facility. Per LPAs observation R1 was using a walker and able to respond to the questions. Continue to LIC 9099-C Unsubstantiated At 11:30 AM, LPA interviewed licensee; staff #1 (S1), staff # 2 (S2). At 12:30 PM, LPA Ngo-Castaneda requested and obtained copies of relevant documents, including, but not limited to, the following: client roster, personnel report, R1's physician’s report, admissions agreement, appraisal needs and service plan, incident reports and other documents. Prior to this visit on 6.19.2025 at 1:00 PM LPA reviewed the documents previously gathered from the facility. Allegation #1: Staff retaining resident against her will It was alleged that staff restrained a resident #1 (R1) by not letting them leave the facility. R1 wanted to be relocated to another facility. Staff revealed that R1 is looking for another facility and has all the freedom to be relocated. Staff denied not allowing R1 from leaving facility. They stated that per doctor’s report R1 cannot leave the facility unassisted. Therefore, they made sure that R1 is leaving with staff assistance. Residents interviewed during investigation revealed that they are not restrained from leaving the facility. A review of R1’s facility record revealed that R1 is requiring assistance to leave the facility. Based on observation, interviews and record review, there is insufficient evidence to support the allegation that staff inappropriately restrained residents. Therefore, the allegation is deemed Unsubstantiated at this time. Allegation #2: Staff do not provide resident medications as prescribed. It was alleged that staff failed to administer prescribed medications to residents. Staff revealed that they are providing medication assistance and R1 refuses to take the medication. Staff also stated they sent documentation to R1’s PCP for not taking their medication and PCP consented. Incident report(s) for medication refusal was sent to Woodland Hiss Licensing Office. Interview with R1 at the patio confirmed that R1 is getting medication assistance. However, they refuse to take their medication. Other residents had no concerns regarding their medication assistance. A review of R1’s medication records and other documents verified the information revealed from interviews. Based on observation, interviews, and record review there is no sufficient information to verify the allegation. Therefore, the allegation is deemed Unsubstantiated at this time. Continue to LIC 9099-C Allegation #3: Staff ignored resident's request for medical treatment It was alleged that R1 was ignored when requesting to be sent to the hospital for pain. Staff revealed that on 06/11/25 R1 did not fall well and requested to be sent to the hospital. 911 was called and R1 was transported to the hospital by paramedics. Although R1 verified that they were sent to hospital, they assumed they were ignored. Other residents did not address any concerns regarding their medical treatments. A review of incident report submitted by the facility verified the information revealed from interviews. Based on interviews and documentation review, there is insufficient evidence to support the allegation. Therefore, the allegation is Unsubstantiated at this time. No deficiencies cited. Exit interview conducted, a copy of this report was signed and delivered.the state’s words, verbatim · CDSS document, Sep 15, 2025 · control 31-AS-20250617185613

Allegation investigated: Facility staff do not maintain documentation of resident(s) records.

On 06/03/2025 Licensing Program Analysts (LPAs) Lorena Casillas and Leslie Ngo-Castaneda conducted an unannounced initial complaint visit to investigate the above stated allegations. LPAs were greeted and allowed entry by Administrator Marianna Ghazaryan. LPAs explained the reason for the visit and an entrance interview was conducted. From 10:00 am to 2:00 pm LPAs toured the facility with Administrator, interviewed three (3) out of three (3) clients, and reviewed facility files. LPA Casillas requested copies of client roster, LIC 500, liability insurance and Administrator Certificate. LPAs also requested copies of pertinent information relevant to the investigation including but not limited to client medical records and any information pertaining to clients in care. Continued on LIC9099-C Substantiated Allegation: Facility staff do not maintain documentation of resident(s) records. It is alleged that facility staff do not maintain documentation of resident records. Regarding this allegation it is reported that Administrator retained and admitted residents into the facility without proper documentation. LPAs interviewed Administrator who admitted to accepting Resident #1 (R1) on 05/26/25, however Administrator stated that they were within the seven (7) days allotted to obtain a signed and finalized Admission Agreement. LPAs inquired on the rest of the documents required for each resident file and Administrator stated that they were not able to complete a file for R1 as R1 was admitted to the hospital the following day on 05/27/25. Administrator admitted to not having a medical assessment for R1 prior to admitting R1 as a resident in the facility. LPAs reviewed resident files and discovered that all documents that are required were in three (3) out of three (3) current resident files. Interviews with Staff #1 (S1) revealed that they are not involved in anything pertaining to documents, they simply care for the residents. Therefore, based on file reviews and interviews, this allegation is deemed substantiated. Citation issued. Appeal rights discussed and provided. Exit interview conducted and a copy of report given to Administrator. Allegation: Facility placed resident on hospice without proper consent. It is alleged that facility placed resident on hospice care without proper consent. Regarding this allegation it is reported that Resident #1 (R1) was placed on hospice, which was later revoked, without meeting the criteria for terminal illness. It is also reported that it is unclear as to who authorized hospice services or if a proper diagnosis was established. Interview with Administrator revealed that they had no knowledge of R1 being on hospice or needing hospice services. Administrator stated that R1 was admitted to the facility on 05/26/25 and was in the facility for less than 24 hours before emergency services were called for R1 and as a result R1 was admitted to the hospital where they are still under care. LPA Casillas contacted alleged hospice agency, Superb Hospice Inc., and they were able to confirm that R1 was on hospice care with from 01/30/2025 to 05/07/25. This places R1 on hospice for dates prior to being admitted to the facility. Therefore, based on interviews this allegation is deemed unsubstantiated. Exit interview conducted and copy of report was provided to Administrator.the state’s words, verbatim · CDSS document, Jun 3, 2025 · control 31-AS-20250529092935

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87458(a) · Plan of correction due date: Jun 17, 2025

Medical Assessment (a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional…and made within the last year, to be kept in the resident's record. This was not met as evidence by: Based on interviews and file reviews the Administrator failed to have a medical assessment for R1 prior to accepting R1 to the facility. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jun 3, 2025

Plan of correction: Administrator discussed POC with LPA and agreed to voluntary TSP participation as well as writing a statement indicating how compliance will be maintained by POC due date.

Allegation investigated: Staff inappropriately handled resident in care. Staff yelled at resident in care.

At 1:05 PM, Licensing Program Analyst (LPA) Leslie Ngo-Castaneda arrived at the facility in response to the abovementioned allegations. LPA met with the licensee, Marianna Ghazaryan, and explained the reason for the visit. This agency has investigated the complaint alleging: Allegation #1: Staff inappropriately handled the resident in care. Allegation #2: Staff yelled at the resident in care. To investigate the allegation, LPA requested a copy of the facility records. At 1:05 PM, LPA conducted a tour of the facility, made observations, and interviewed the licensee (S1) and staff #2 (S2). LPA observed that LIC 9020 did not show that the individual in question is a current resident at this facility. Interviews with the licensee, S2, and two (2) residents revealed that the individual in question was never a resident of this facility. Continue to LIC 9099-C Unfounded It is also confirmed by staff that the individual in question was residing at 8607 Aqueduct Avenue, North Hills, CA 91343, which is not licensed by the Department of Social Services / Community Care Licensing. LPA interviewed staff at the unlicensed home and confirmed that the resident in question used to reside there. This agency has investigated the complaint allegations above. We have found that the complaint is unfounded, meaning that the allegation was false, could not have happened, and/or is without a reasonable basis. We have therefore dismissed the complaint.the state’s words, verbatim · CDSS document, May 14, 2025 · control 31-AS-20250509155907

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA was greeted by licensee Marianna Ghazaryan, and was explained the reason for the visit. At 9:30 AM, with the assistance of licensee, LPA took a tour of the physical plant. Required postings were observed in the entry area. At 10:30 AM the smoke alarms were tested and are operational, they are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the kitchen and the office. The charge date of 3.5.2025. During the visit the facility is at 70 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory resident, one (1) bedridden bedroom #3, and is cleared for five (5) hospice waiver. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away under the sink. Bedrooms: There were three (3) bedrooms designated for residents. Room #1 is shared but is currently only occupied by one (1) resident. Bedroom #2 is private. Bedroom #3 is shared. Bedrooms that are used by residents were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Continue to LIC 809-C Bathrooms: There are two (2) bathroom designated for residents' use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 116.4 degrees Fahrenheit for bathroom #1 located in the hallway beside room #1. Bathroom #2 is in inside bedroom #3. Hot water temperature was measured at 115.8 degrees Fahrenheit. There is enough clean linen available in the cabinets in the hallway. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control: Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or body of water. There is no garage only car port. Laundry service: There is enough linen available to change weekly or more if need. Cleaning supplies are being stored in a locked cabinet in the kitchen under the sink. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Office space is beside the kitchen. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. The administrator file was reviewed for current first aid, fingerprint clearance, administrator certificate, and HIV/AIDS and TB training. Continue to LIC 809-C Medications are in a centrally stored and locked place in a cabinet in the hallway, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the clients’ doctor. Proper medication dispensing instruction are followed and checked for contamination. First-aid has all proper items and is current. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies were found, exit interview conducted, copy of report has been issued and discussed.the state’s words, verbatim · CDSS document, May 14, 2025

Type of visit: Prelicensing

At 10:10 am Licensing Program Analyst (LPA) Tihesha Smith conducted an announced pre-licensing visit with the licensee and administrator. Identification of the Licensee and administrator was verified by photo ID.The facility has a capacity of six (6). Application received for 1 bedridden and (5) Non-ambulatory residents. Purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with the rules and regulations of California Code of Regulations, Title 22, Division 6. The facility is a single-story building. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following: The common areas (kitchen, living room, and dining areas) were appropriately furnished, and lighting was adequate. The facility has a variety of adequate perishable and non-perishable food supply. Appliances in the kitchen appeared to be functional. The living room has a television and comfortable furniture. Games and activities for residents stored in coffee table. There is one (1) fire extinguishers: one (1) is located in garage attached to kitchen/dining room wall and observed to be fully charged with receipt Dec 2023. Dual Smoke and Carbon Monoxide detectors were observed all over the facility, tested, and observed to be operational at time of visit. An emergency exit plan/sketch is posted near each entrance/exit wall with other posting requirements. There are two (2) bathrooms in the facility. The Hot water was tested for resident bathroom and measured 115.9 and 117.1 °F. Bathrooms has trash cans with lids and bathroom has functional grab bars. (Cont from 809) There are three (3) resident bedrooms, designated as follows: B1: Non ambulatory/Shared B2: Non-Ambulatory/Shared B3 Non-Ambulatory and Bedridden/shared No room is designated for staff use. Extra linen stored in living room Television console and each bedroom has own linen storage in closet The sharps are stored and locked in drawer in kitchen. Medications locked in upper kitchen cabinet. Toxins locked under kitchen sink. The first aid kit is stored in kitchen counter. Laundry is in hall closet and appliances observed to be in good repair. There is a large patio table with six (6) chairs, and umbrella for residents to conduct outdoor activities. The garage is detached There is no body of water on the facility. Component III was conducted with the administrator and licensee. Both individuals confirmed understanding of Title 22. At time of visit this facility is not ready to be licensed. The following corrections must be made: · Install functioning telephone/landline on the premises. · Remove personal items from garage or designate not part of the facility · Water and Electric not listed correctly on facility sketch · Submit new sketch with corrections made. This report will be forwarded to the Centralized Application Bureau (CAB). Exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 15, 2024

Type of visit: Office

COMP II by CAB successfully completed Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 3 independent living persons Method: Telephone call with CAB COMP II Participants: Nvart Terzyan, Administrator, Marianna Ghazaryan, Owner; Shannon Betker, analyst. Applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Mar 26, 2024

Allegation investigated: Unlicensed Care

Licensing Program Analyst (LPA)Tihesha Smith made an unannounced subsequent complaint visit to this location at approximately 10:10 am. LPA was greeted by staff who informed Marianna was on the way. Marianna arrived shortly and LPA disclosed the purpose of the visit. On 11/02/2023, a Notice of Operation in Violation of Law (NOVL) and citation under Health and Safety Code 1569.44 was issued. During the initial visit Tenant #1 (T1) was determined to have needed care and supervision. Prior to this visit operator notified LPA Smith that T1 was relocated to a licensed facility on 11/04/2023. During today’s visit, LPA conducted a brief tour of the facility and confirmed that T1 is no longer living at the facility and T1’s bed is cleared. LPA observed the facility to be clean and has a sufficient supply of food. Substantiated (Cont from 9099) LPA Smith’s interview with the operator revealed that there was no untoward incident at the facility since LPA’s last visit and there are no tenants in the home that require care and supervision. The operator has submitted an application at the Woodland Hills Adult and Senior Care Regional Office located 21731 Ventura Blvd STE 250, Woodland Hills, 91364 for licensure within 15 calendar days of the issuance of the Notice of Operation in Violation of Law (NOVL). Operator was also reminded to not accept any client that requires any element of care and supervision until the facility is licensed. No health and safety issues observed during this visit. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Feb 3, 2024 · control 31-AS-20231024152959