197608401-10-12-2023-31-AS-NMAN-CXRVUJ-20231120154449

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 10/12/2023
Date Signed: 10/12/2023 04:19:06 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/29/2023 and conducted by Evaluator Rosaura Valenzuela

COMPLAINT CONTROL NUMBER: 31-AS-20230829112003

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:	10/12/2023
		UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	PETER BABAIAN, Administrator		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff did not prevent a resident from causing an injury to another resident

Staff yell at the residents while in care

Staff did not ensure a resident was taking prescribed medications

Staff do not provide a comfortable temperature for the residents

Staff speaks inappropriately towards a resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced subsequent visit for the above noted allegations. LPA met with Administrator Peter Babaian and explained the reason for the visit.

It was reported that staff did not prevent a resident from causing an injury to another resident. Resident #1 (R1) accused another resident of purposefully backing into them and causing them to fall and get hurt. To investigate this allegation on 10/12/2023 between 10:50AM and 11:30AM, staff interviews were initiated. Interviews revealed that facility was not aware of Resident #1 (R1) being injured by another resident. It is possible that Resident #2 (R2) got too close to R1 and accidently bumped into them. Between 2:00PM and 2:20PM, LPA attempted to interview R1, but they were unable to identify who backed into them or when the incident occured.

Based on interviews there is not sufficient information to support this allegation. Therefore, this allegation is UNSUBSTANTIATED at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

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 31-AS-20230829112003

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: VICTOR ROYALE, LLC	FACILITY NUMBER: 197608401
	VISIT DATE: 10/12/2023

NARRATIVE

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It was alleged that staff yell at the residents while in care. To investigate this allegation, LPA interviewed facility staff and residents. Staff interviews revealed that staff do not yell at residents. Some residents are hard of hearing and they need to raise their voice in order to be heard. Between 2:20PM and 2:55PM, ten percent of the residents were interviewed. Resident interviews revealed that staff do not yell at them and that they are nice.

Based on interviews there is not sufficient information to verify this allegation. Thus, this allegation is UNSUBSTANTIATED at this time.

It was reported that staff did not ensure a resident was taking prescribed medications. To investigate this allegation, between 10:50AM and 11:30AM, staff interviews were conducted. Interviews revealed that R1 refuses to take this medication as prescribed by their doctor. Staff can not force R1 to take their medications since it is their personal right to refuse. Between 2:00PM and 2:20PM, LPA spoke to R1. R1 stated that they do not like taking too much medication and that sometimes they refuse it.

Based on interviews there is not sufficient information to support this allegation. Therefore, this allegation is UNSUBSTANTIATED at this time.

It was alleged that staff do not provide a comfortable temperature for the residents. To investigate this allegation between 10:50AM and 11:30AM, staff interviews were conducted. Interviews revealed that the air conditioning board burned about a month in a half ago and that it was immediately fixed. Only the right side of the facility was affected by this. The A/C not functioning was reported in the morning and the following day it was fixed. Between 3:00PM and 3:15PM, LPA conducted a facility walk through. The facility temperature measured on the thermometer was 77 degrees. LPA felt fresh air throughout the facility. The facility was not hot and staff told LPA that the AC is functioning once again.

Based on interviews and observation there is not sufficient information to support this allegation. Therefore, this allegation is UNSUBSTANTIATED at this time.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20230829112003

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: VICTOR ROYALE, LLC	FACILITY NUMBER: 197608401
	VISIT DATE: 10/12/2023

NARRATIVE

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It was reported that staff speaks inappropriately towards a resident. To investigate this allegation staff interviews were conducted between 10:50AM and 11:30AM. Staff interviews reveal that staff are professional and respectful towards residents in care. Between 2:00PM and 2:20PM, LPA interviewed R1. Interview revealed that R1 was upset at staff because they thought someone stole their belongings. Staff were trying to calm them down and reassuring them that no one took their belongings. R1 denied that staff spoke to them inappropriately.

Based on interviews there is not sufficient information to verify this allegation. Therefore, this allegation is UNSUBSTANTIATED at this time.

Exit interview conducted and a copy of the report was issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

LIC9099 (FAS) - (06/04)

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