197608083-2-29-2024-31-AS-EMIR-D3QS5G-20240326133419

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608083
Report Date: 02/02/2024
Date Signed: 02/29/2024 10:35:56 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 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
01/26/2024 and conducted by Evaluator Mariana Agban

COMPLAINT CONTROL NUMBER: 31-AS-20240126125534

FACILITY NAME:	OUR SWEET HOME INC #2		FACILITY NUMBER:	197608083
ADMINISTRATOR:	ARUTYUNYAN, TINA		FACILITY TYPE:	740
ADDRESS:	10150 MELVIN AVE		TELEPHONE:	(818) 970-9586
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY:	6	CENSUS:	DATE:	02/02/2024
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Hermon Ledesma- Administrator Designee		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff did not assist resident in a timely manner
Staff threatened resident in care

INVESTIGATION FINDINGS:

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This is an amended report of the prior investigation report delivered on 02/02/24. Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced visit to this facility. LPA met with Administrator Designee Hermon Ledesma and explained the reason for the visit. Based on the information LPA gathered LPA determined that the allegations are unfounded. R1 doesn’t live at the address stated on the complaint report. A finding of unfounded means that the allegation is either false, could not have happened, and/or is without a reasonable basis.

This agency has investigated the complaint alleging (Staff did not assist resident in a timely manner and Staff threatened resident in care). We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened, and/or is without a reasonable basis. We have therefore dismissed the complaint. Exit interview conducted and copy of this report issued

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Mariana Agban	TELEPHONE: 818-738-4525
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

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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