197608401-6-18-2020-31-AS-MVAO-BS7P4W-20200805105950

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 06/18/2020
Date Signed: 06/18/2020 05:13:09 PM

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
03/23/2020 and conducted by Evaluator Alexander Pitz

COMPLAINT CONTROL NUMBER: 31-AS-20200323133550

FACILITY NAME:	VICTOR ROYALE, LLC		FACILITY NUMBER:	197608401
ADMINISTRATOR:	PETER BABAIAN		FACILITY TYPE:	740
ADDRESS:	120 E. LAUREL STREET		TELEPHONE:	(818) 243-7442
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	60	CENSUS: 58	DATE:	06/18/2020
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Peter Babaian		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Resident was inappropriately touched by another resident.
Staff withheld resident's meal.
Resident not provided with an adequate amount of time to consume meals.
Facility furniture is not properly cleaned.
Staff are not allowing resident to use phone

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pitz initiated a complaint investigation for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Administrator Peter Babaian.

LPA Pitz conducted telephone interviews with the administrator, 7 residents, 3 staff on 6/18/20. 2 staff and the administrator were interviewed on 4/30/20 and the administrator was interviewed on 4/1/20.

Allegation #1, that "Resident was inappropriately touched by another resident," has been unsubstantiated due to the interviews conducted. No corroborating evidence was provided by the complainant and 11/11 of those interviews denied the allegation

A telephonic exit interview was conducted with Administrator, and a hard copy was provided via email for signature.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Alexander Pitz	TELEPHONE: (805) 450-1627
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2020

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-20200323133550

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: VICTOR ROYALE, LLC	FACILITY NUMBER: 197608401
	VISIT DATE: 06/18/2020

NARRATIVE

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Allegation #2, that "Staff withheld resident's meal" has been unsubstantiated based on the interviews conducted. No corroborating evidence was provided by the complainant and 11/11 of those interviews denied the allegation.

Allegation #3, that "Resident not provided with an adequate amount of time to consume meals" has been unsubstantiated based on the interviews conducted. No corroborating evidence was provided by the complainant and 11/11 of those interviews denied the allegation.

Allegation #4, that "Facility furniture is not properly cleaned," has been unsubstantiated based on interviews and observations. No corroborating evidence was provided by the complainant, 11/11 of others interviewed denied the allegation, and LPA did not observe the facility to be dirty during video tours on 4/30/20 or 6/18/20.

Allegation #5, that "Staff are not allowing resident to use phone," has been unsubstantiated based on interviews and observations. No corroborating evidence was provided by the complainant, 11/11 of others interviewed denied the allegation, and LPA observed the facility allowing residents access to a telephone repeatedly.

Exit interview conducted, report sent to administrator for signature.

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Alexander Pitz	TELEPHONE: (805) 450-1627
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2020

LIC9099 (FAS) - (06/04)

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