197608401-11-3-2022-28-AS-RORN-CN6VZ6-20230117155211

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 11/03/2022
Date Signed: 11/03/2022 03:01:48 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
10/26/2022 and conducted by Evaluator Ashley Calderon

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20221026113558

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: 49	DATE:	11/03/2022
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Alise Nazarian-Assistant Administrator		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Staff are not providing privacy for when using the phone.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced complaint visit to the above facility. LPA Calderon met with Alise Nazarian, assistant administrator and discussed the purpose of todays visit.

LPA Calderon and Alise toured the physical plant to locate telephones used for residents. Telephones are located in 3 different areas in the facility. One pay phone in the outside patio , second payphone in the cottage located in the 1511 building and a wireless phone located in the front desk area. LPA Calderon collected staff and residents roster, House Rules /Admission Agreement packet regarding telephone policy. LPA conducted interviews for both resident and staff.

Continuation on 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3984
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022

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-20221026113558

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: 11/03/2022

NARRATIVE

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*** This is amended report. ***

Today's investigation revealed the following. In regards to the allegation: Staff are not providing privacy for when using the phone. Interviews conducted with residents showed that 5 out of 5 residents stated that there is no problem with privacy when using phone. 3 out of 3 residents stated they have their own phones and facility provides places for privacy and have had no phone use privacy issues. When interviewing staff 4 out of 5 staff said residents have areas to use phone for privacy within the facility. S3 stated facility has a cordless phone for residents to use in certain areas like resident rooms, patio, and lounge areas to provide privacy while using the phone. During interviews, S3 stated the cordless facility phone is the facility property, resident when using facility phone should remain on facility premises because of safety concerns , and if privacy is needed resident can communicate with staff and staff will provide privacy options. S1 stated in regards to phone privacy, phones within the facility for residents to use are all in locations were privacy is provided .

LPA reviewed the facility House Rules in regards to the phone policy and on page 6 it states: The facility phone is available to residents if they do not have their own phone to making and receiving calls. LPA Calderon with Alisa Nazarian toured facility to locate facility phones that are available for residents. LPA observed phone locations are in areas were privacy is provided.

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.

No deficiencies were cited. A copy of this report provided to Peter Bababian via email, signature on hard copy.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3984
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

LIC9099 (FAS) - (06/04)

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