191290706-2-8-2024-31-AS-NMAN-D9XQR7-20241011122326

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191290706
Report Date: 02/08/2024
Date Signed: 02/08/2024 05:03:17 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
02/01/2024 and conducted by Evaluator Rosaura Valenzuela

COMPLAINT CONTROL NUMBER: 31-AS-20240201141701

FACILITY NAME:	HAMILTON HOUSE		FACILITY NUMBER:	191290706
ADMINISTRATOR:	PETERSON, JANICE		FACILITY TYPE:	735
ADDRESS:	739 W. GLENOAKS BLVD.		TELEPHONE:	(818) 502-9188
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91202
CAPACITY:	11	CENSUS: 7	DATE:	02/08/2024
		UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Kathy Solorzano, Facility Representative		TIME COMPLETED:	05:05 PM

ALLEGATION(S):

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Facility does not provide a resident with activities.

Staff speaks to a resident in an aggressive manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced visit for the above noted allegations. LPA met with Facility Representative Kathy Solorzano and explained the reason for the visit.

It was reported that facility does not provide a resident with activities. To investigate this allegation on 2/08/2024, LPA conducted file review before going to the facility. Between 9:00am and 9:30am, LPA reviewed facility files and saw a monthly activity schedule and a program schedule from 30 years ago. LPA could not find an updated activity schedule on file. Between 2:00pm to 3:00pm, staff interviews were initiated. Interviews revealed that currently the facility is not offering its residents any activities. In addition, LPA did not observe any activity board posted on the facility walls. Staff told LPA that a couple of years ago activities were provided, but that with the change of administrators the activities came to a halt. Furthermore, between 3:00pm and 4:00pm, resident interviews were initiated. Four out of seven residents that were present at the time of the visit were interviewed. Continue on 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Rosaura Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024

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 31-AS-20240201141701

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: HAMILTON HOUSE	FACILITY NUMBER: 191290706
	VISIT DATE: 02/08/2024

NARRATIVE

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Interviews confirmed what staff had told LPA. The facility is not providing any activities to residents in care. Residents interviewed stated that they are bored and have nothing to do.

Based on interviews, record review, and observation, there is sufficient information to support this allegation.
Therefore, this allegation is SUBSTANTIATED at this time.

It was alleged that staff speaks to a resident in an aggressive manner. To investigate this allegation between 2:00pm and 3:00pm, staff interviews were initiated. Interviews revealed that Staff #2 (S2) does speak aggressively towards Resident #1 (R1) especially when they complain about something in the facility. Between 3:00pm and 4:00pm, three out of seven residents present at the facility at the time of this visit were interviewed. Interviews confirmed what was reported to LPA. Residents expressed a sense of fear and unwillingness to discuss problems at the facility due to retaliation. Moreover, on a prior visit LPA observed S2 speaking to R1 in an aggressive and defensive manner.

Based on interviews and observation, there is sufficient information to verify this allegation. Therefore, this allegation is SUBSTANTIATED at this time.

Exit interview conducted and a copy of the report was issued.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Rosaura Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024

LIC9099 (FAS) - (06/04)

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