197608401-9-1-2022-28-AS-MVAO-CHZVF6-20220906162326

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 09/01/2022
Date Signed: 09/01/2022 10:52:15 AM

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
04/29/2021 and conducted by Evaluator Elizabeth Ceniceros

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20210429151909

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:	09/01/2022
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Administrator, Peter Babaian and Asst. Administrator, Alise Nazarian		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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Council is not being allowed to meet without a staff person present.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA)/Retired Annuitant (RA) Elizabeth Ceniceros made an unannounced visit to the facility and was greeted by Asst. Administrator (A2) and was later met by Administrator (A1) Peter Babaian. LPA/RA spoke to A2 prior to entering the facility to conduct a risk assessment. A2 informed LPA/RA that the facility has no COVID cases nor do any of the residents or staff have symptoms.

The purpose of this visit is to conduct a subsequent visit and to deliver the findings pertaining to the above-mentioned allegation. An initial 10-Day virtual visit was conducted by LPA Nicol Wesley on 05/06/21 (via telephone) with Administrator Peter Babaian due to the situation surrounding the Coronavirus Disease 2019 (COVID-19) and to implement mitigation measures.

LPA/RA Ceniceros interviewed (between 8:15 a.m - 9:15 a.m.) three (3) staff members and three (3) residents in care. LPA/RA reviewed pertinent documentation: Admissions Agreement, Emergency I.D. & Information, Appraisal/Needs & Services Plan, Personal Rights for Resident #1; Minutes of Resident Council Meeting.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Araceli Ramirez	TELEPHONE: (323) 980-4925
LICENSING EVALUATOR NAME: Elizabeth Ceniceros	TELEPHONE: (916) 264-1579
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

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-20210429151909

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: 09/01/2022

NARRATIVE

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Regarding Allegation #1: this investigation revealed that the two (2) facility administrators stated that resident council meetings are usually attended by a staff member in order to take notes and pass the concerns along to management. They stated that residents are allowed to meet (without staff) and staff can leave the meeting if asked to do so. Based on interviews conducted with Resident Council Board Members, the majority corroborated that there is not a concern with a facility staff member being present during the meeting; however, it's usually not the case that facility staff member remains for the whole resident council meeting. Due to COVID-19, the formal resident council meetings were not taken place in person; however, they have now resumed to in-person meetings. Resident council meetings require facility staff, but informal meetings take place among residents without facility staff present.

Based on the evidence gathered and interviews conducted and records reviewed, 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 of NEGLECT/LACK OF CARE: Resident sustained multiple pressure injuries while in care is found to be UNSUBSTANTIATED.

An exit interview has been conducted and a copy of the Complaint Report provided to Administrator Administrator (Peter Babaian) and Asst. Administrator (Alise Nazarian).

SUPERVISOR'S NAME: Araceli Ramirez	TELEPHONE: (323) 980-4925
LICENSING EVALUATOR NAME: Elizabeth Ceniceros	TELEPHONE: (916) 264-1579
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC9099 (FAS) - (06/04)

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