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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608401
Report Date: 09/21/2022
Date Signed: 09/21/2022 11:11:19 AM


Document Has Been Signed on 09/21/2022 11:11 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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, LLCFACILITY NUMBER:
197608401
ADMINISTRATOR:PETER BABAIANFACILITY TYPE:
740
ADDRESS:120 E. LAUREL STREETTELEPHONE:
(818) 243-7442
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:60CENSUS: 54DATE:
09/21/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Peter BabaianTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Christine Wong conducted a unannounced case management visit in relation to complaint #28-AS-20220628163253. Upon arrival, LPA met with LVN Amy Smbapuni and explained the purpose of the visit. Shortly after, the administrator Peter Babaian arrived and assisted with the visit.

On today's visit, LPA interviewed administrator, three staff and five residents and all residents report no staff ever hit or pushed any residents in the facility or they never witnessed any staff hit residents in the facility. All residents also indicated staff would never leave them alone in shower or during diaper change. Administrator also reported that there's no way staff would leave resident alone in shower or diaper changing. Administrator stated that he's always on top of these type of work behaviors and he would not allow these things happened in the facility. Administrator also reported he did realize the personnel conflicts between S1 and S2 and other coworkers too. Administrator did try his best to work with them but he cannot please every coworkers. And staff also have their own characters and thoughts.

No deficiencies observed during the visit.

Exit interview conducted and a copy of the report was provided to administrator Peter Babaian.

SUPERVISOR'S NAME: Christine YeeTELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: Christine WongTELEPHONE: (323) 981-3963
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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