197608401-7-21-2022-28-AS-LHIS-CHBRAM-20220815125123

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 07/21/2022
Date Signed: 07/21/2022 12:07:03 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, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/14/2022 and conducted by Evaluator Jewel Baptiste

COMPLAINT CONTROL NUMBER: 28-AS-20220714083638

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: 55	DATE:	07/21/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator Peter Babaian		TIME COMPLETED:	12:21 PM

ALLEGATION(S):

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Staff are not assisting residents with medical appointments

INVESTIGATION FINDINGS:

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On 7/21/22 at 9:30 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced complaint visit to the facility. Upon arrival, LPA met with S1 and explained the purpose of the visit. At 10:15 Administrator Peter Babaian joined the visit.

The investigation consisted of the following: During today’s visit LPA toured the facility with S1, obtained the resident/ staff roster, and obtained a copy of S1-S6 LIC-602.

The investigation reveals the following: Regarding “staff is not assisting residents with medical appointments”, it is alleged that residents have not received a second booster. 6/6 residents confirmed staff assists residents with medical appointments and COVID vaccinations.

Report Continued on LIC9099c

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel Baptiste	TELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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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Control Number 28-AS-20220714083638

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: VICTOR ROYALE, LLC	FACILITY NUMBER: 197608401
	VISIT DATE: 07/21/2022

NARRATIVE

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2/6 Residents confirmed they do not need assistance with making medical appointments but witnessed residents stating facility assists with medical appointments. Administrator confirmed facility doctor visit the facility once a week and the facility psychiatrist visit the facility once or twice a month. According to administrator, 99% of the residents receive medical care from facility doctor. The residents who have private doctors can make their own appointments, but facility will assist when needed. Administrator confirmed residents has not received 2nd COVID booster but has reached out to LA county care facility/ department of public health to schedule an appointment. The administrator stated the department of public health are backed up and is waiting for them to schedule the appointment. 3/3 staff stated they help make medical, dental, transportation and personal appointments for residents. 3/3/ Staff also confirmed facility doctor visit the facility once a week. File review revealed LIC-602 for residents is up to date and residents can leave the facility unattended.

Based on LPA's interviews, investigation revealed: Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted with Peter Babaian and a copy of this record provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel Baptiste	TELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC9099 (FAS) - (06/04)

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