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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197608349
Report Date:
06/06/2022
Date Signed:
06/06/2022 01:00:59 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
06/01/2022
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20220601102454
FACILITY NAME:
ABBEY ROAD VILLA
FACILITY NUMBER:
197608349
ADMINISTRATOR:
MARINE KARAPETIAN
FACILITY TYPE:
740
ADDRESS:
14132 HUBBARD STREET
TELEPHONE:
(818) 837-0077
CITY:
SYLMAR
STATE:
CA
ZIP CODE:
91342
CAPACITY:
78
CENSUS:
56
DATE:
06/06/2022
UNANNOUNCED
TIME BEGAN:
10:00 AM
MET WITH:
Marine Karapetian
TIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
A Resident forced another resident to take nude photos.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
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.
LPA conducted a brief physical plant tour from 10-10:15am to ensure no immediate health and safety issues. No health and safety issues were noted during this visit.
It is alleged that resident # 1(R1) forced resident # 2 (R2) to take nude photos on 4/23/22. LPA conducted interviews with facility staff from regarding the allegation from 10-10:40am. LPA conducted interviews with R1 and R2 regarding the allegation from 10:45-11:45am. LPA reviewed the facility file for R1 and R2 and obtained copies of pertinent information from 11:45-12:30pm. A review of R1 and R2 facility file reveal that R1 and R2 are able to leave the facility independently. Information from interviews reveal that R1 and R2 left the facility together on 4/23/22 with R1 driving and that R1 was assisting R2 with moving items from a storage unit and then both decided to go to motel together. During interviews with both R1 and R2 both denied that anyone was forced to to anything against their will or to do anything they did not want to do. LPA was also notified that Adult Protective Services (APS) was notifed and law enforcement was notified and came and spoke with both residents.
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:
06/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/06/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099
(FAS) - (06/04)
Page:
1
of
2
Control Number
31-AS-20220601102454
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
21731 VENTURA BLVD., STE. 250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
ABBEY ROAD VILLA
FACILITY NUMBER:
197608349
VISIT DATE:
06/06/2022
NARRATIVE
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LPA also obtained copies of written statements from R1 and R2. Based on the information obtained through interviews this allegation is deemed Unsubstantiated at this time. The alleged incident between R1 and R2 did not take place on facility property and both R1 and R2 denied that anything inappropriate was done by either. Exit interview conducted.
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
06/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/06/2022
LIC9099
(FAS) - (06/04)
Page:
2
of
2