197603652-8-19-2022-31-AS-RRAZ-CJ4SCT-20220909134605

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603652
Report Date: 08/19/2022
Date Signed: 08/19/2022 01:00:19 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/11/2022 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20220811150301

FACILITY NAME:	AMBASSADOR GARDEN		FACILITY NUMBER:	197603652
ADMINISTRATOR:	SOFI DRUKER		FACILITY TYPE:	740
ADDRESS:	7324 CANBY AVENUE		TELEPHONE:	(818) 705-3404
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	158	CENSUS: 76	DATE:	08/19/2022
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Sofi Druker		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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9

Illegal eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced complaint visit to investigate the allegation above. LPA met with the administrator and explained the reason for this visit.
Illegal eviction
It is alleged that resident # 1 (R1) was being illegally evicted because R1 did not pay all of their rent and the facility is not accepting partial payment. LPA conducted interview with R1 from 10:50-11:30am regarding this allegation. LPA interviewed the administrator regarding this allegation from 11:30-12:10pm. LPA reviewed R1's facility file and obtained copies of pertinent information from 12:10-12:40pm. Information obtained from interviews and documentation R1 has not paid their full proper rent for the months of June, July, and August of 2022. R1's rent is 1231.77 and for the month of June 2022 R1 paid 1,000 dollars, for July 2022 another 1000 dollars, and for August 2022 only 750 dollars was paid. R1 was given a thirty day eviction on 8/10/22 due to non-payment of rent. LPA reviewed a copy of the eviction notice given and after review it is a lawful eviction. R1 has since agreed to pay the balance owed and the eviction notice has been rescinded. Based on the information obtained this allegation is deemed Unsubstantiated at this time. Exit Interview conducted.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell Smith	TELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

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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