197603560-8-1-2024-29-AS-KHEN-D8M6JS-20240829205138

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603560
Report Date: 08/01/2024
Date Signed: 08/01/2024 02:29:14 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/26/2024 and conducted by Evaluator Christine Yee

COMPLAINT CONTROL NUMBER: 29-AS-20240726130820

FACILITY NAME:	COURTYARD PLAZA		FACILITY NUMBER:	197603560
ADMINISTRATOR:	EVELINA PAPAZYAN		FACILITY TYPE:	740
ADDRESS:	6951 LENNOX AVENUE		TELEPHONE:	(818) 780-5005
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91405
CAPACITY:	195	CENSUS: 84	DATE:	08/01/2024
		UNANNOUNCED	TIME BEGAN:	10:19 AM
MET WITH:	Evelina Papazyan, Administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Facility illegally evicted a resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst(LPA) Christine Yee conducted an unannounced complaint visit to investigate the above allegation and met with Evelina Papazyan, Administrator. The reason for today's was explained.

LPA Yee conducted interviews with the Administrator at 10:31am and 12:18pm, Resident #1 at 12:01pm, Resident #2 at 11:36am and Staff #1 at 12:37pm.

Per information received from interviews conducted with the Administrator and Staff #1 on today's visit, Resident #1 was never served a 30 day eviction notice and there has been no discussion with Resident #1 about eviction. Per interview conducted with Resident #1, they confirmed that they have not been served a 30 day eviction letter. LPA asked Resident #1 why they believed that they were being evicted. LPA was told by Resident #1 that the Administrator told them that they were going to be evicted and they would given a

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Christine Yee	TELEPHONE: (747) 230-3890
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024

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 29-AS-20240726130820

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: COURTYARD PLAZA	FACILITY NUMBER: 197603560
	VISIT DATE: 08/01/2024

NARRATIVE

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30 day eviction notice when they were called into the office to discuss the soup incident that occurred in the dining room. Resident #1 had thrown soup at Resident #2 on 7/20/24. The Administrator had concerns as this was the second time that Resident #1 had thrown a hot liquid at Resident #2 . On both occasions, law enforcement had been called and each time Resident #2 did not want to press charges. The Administrator denies that the subject of eviction was ever discussed with Resident #1 during the meeting conducted on 7/22/24 to address the soup incident. Staff #1 who usually sits in on office meetings with residents, also confirmed that eviction was not discussed during the meeting. Interviews conducted reveal that Resident #1, on their own, voluntarily contacted their placement agency in March 2024 and the placement agency is in the process of finding relocation sites for Resident #1, due to relationship issues going on at the facility.

Based on information received from interviews conducted, there is insufficient evidence to support the above allegation that facility illegally evicted a resident in care, therefore the above allegation is unsubstantiated.

Exit interview was conducted.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Christine Yee	TELEPHONE: (747) 230-3890
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024

LIC9099 (FAS) - (06/04)

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