197608401-8-15-2023-28-AS-FFIS-CUT2AG-20230817171329

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 08/15/2023
Date Signed: 08/15/2023 01:03:31 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/18/2022 and conducted by Evaluator Ashley Calderon

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20221118144931

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: 54	DATE:	08/15/2023
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Administrator- Peter Babaian		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Licensee does not maintain facility in good repair
Facility is not allowing residents to use the outdoor telephone comfortably and freely.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Ashley Calderon conducted an unannounced visit to investigate the above allegations. This report supersedes report dated 8-01-23. The purpose of the visit was discussed with Administrator Peter Babaian.

On the initial visit conducted on 11/22/22, the investigation consisted of LPA Calderon obtaining staff and resident roster. Touring physical plant of the facility with Assistant Administrator Alise Nazarian.LPA Calderon alongside with Alise toured common restrooms in main building, common restroom in cottage 1515, residents rooms, outdoor patio/telephone areas. LPA interviewed residents #1-#5 (R1-R5) and interviewed staff: Administrator, Assistant Administrator and Staff #1 (S1) and Staff 2 (S2).

Continuation on 9099-C.

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: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 28-AS-20221118144931

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

FACILITY NAME: VICTOR ROYALE, LLC	FACILITY NUMBER: 197608401
	VISIT DATE: 08/15/2023

NARRATIVE

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On visit 8/1/23, the visit consisted of the following: LPA Calderon obtaining staff and resident roster. LPA Calderon along side with Staff #3 (S3) toured random resident rooms and residents private bathrooms, in main building: Rooms #:12,21, 25, 28, and 29. Main building shower rooms were observed. LPA tested call system. LPA observed cottage 1511 unoccupied by residents. LPA observed cottage 1515 :common restroom, and residents rooms #:2,3,4 and 5. LPA observed kitchen and LPA interviewed handyman worker who was present at the facility during the time of visit.

On 8/15/23 LPA Calderon visit consisted of the following: LPA interviewed Assistant Administrator and Administrator, Staff #1 (S1) and Staff #2 (S2). LPA interview residents #1- resident #4 (R1-R4), Attempt to interview resident #5 (R5). LPA observed the telephone areas.

Regarding allegation: Licensee does not maintain facility in good repair. LPA interviews with staff: Assistant Administrator and Administrator stated facility in good repair when facility requires repairs third party assistance is called and are hired to repair, fix and provide maintenance. Interview with S1 and S2 denied the above allegation and stated that the facility is in good repair. S1 on 11/22/22 interview, stated facility had recent remodels done. Interviews with residents on 11/22/22, revealed the following: 3 out of 5 residents interviewed: R1, R3 and R4 alleged that the cottage room common bathroom toilet has issues flushing at times and stated facility has no other issues regarding disrepair's in the facility. 4 out 5 residents during interview with LPA Calderon stated not aware if call system is operable as they do not use system. On 8/1/23 LPA Calderon interviewed facility handyman that does maintenance for the facility and handyman stated facility communicates with handyman regarding repairs that the facility requires when fixing is needed. Handyman stated working with the facility for about 18-20 years and facility provides on going repairs when needed. LPA Calderon alongside with S3 observed random resident rooms in the main building and observed running hot water, lights being operable, room furniture in good condition, operable toilet with lids, and call light system operable. LPA observed common restroom in cottage 1515 having toilet paper rod holder, toilet lid in place, toilet flushing properly, and running hot water. LPA observed common showers in main building having adequate lighting, running hot water, and operable call system in place. LPA Calderon observed kitchen appliances being operable. LPA observed bathrooms during visits on 11/22/22 and 8/1/22, being operable. However, the investigation did not reveal the licensee does not maintain facility in good repair, there is no evidence to support the above allegation. Therefore, the allegation is deemed unsubstantiated per Title 22 Regulations, Division 6, Chapter 8.
(Continuation 9099-C...)

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3984
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20221118144931

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

FACILITY NAME: VICTOR ROYALE, LLC	FACILITY NUMBER: 197608401
	VISIT DATE: 08/15/2023

NARRATIVE

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Regarding allegation: Facility is not allowing residents to use the outdoor telephone comfortably and freely. LPA Calderon interviewed Assistant Administrator, Administrator, S1 and S2 all who denied the above allegation and stated all three phones are available for the residents use, and phones can be used comfortably and freely and there is privacy upon using the telephones. LPA interviews revealed that R2-R4 all residents have access to a phone and to use the phones comfortably and freely and there is no issues with sandbags located in patio near the outside telephone. R1 during interviewed stated facility provides alternative phones for residents to use comfortable and freely but at times outside telephone may have supply items in the way of reaching the phone. LPA observed location of the phones, 3 phones facility provides for residents in care , 1 phone is in the cottage building hallway, 1 in the patio and another is a wireless phone located in the front desk. LPA observed phones being available to the clients in care and phones can be used comfortable and freely. LPA observed outside phone patio having chairs near the phone for residents comfort and use. However, the investigation did not reveal the licensee does not maintain facility in good repair, there is no evidence to support the above allegation. Therefore, the allegation is deemed unsubstantiated per Title 22 Regulations, Division 6, Chapter 8.

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 was provided to Administrator Peter Babaian.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3984
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC9099 (FAS) - (06/04)

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