197608401-9-27-2023-31-AS-NMAN-CYMV6U-20231218151003

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 09/27/2023
Date Signed: 09/27/2023 03:12:36 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/25/2023 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20230925155857

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:	09/27/2023
		UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Peter Babaian		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility phone is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to the facility. Upon entry, LPA met with the Executive Director, Peter Babaian, and explained the reason for the visit.

--- Facility phone is in disrepair.

It was alleged that one of facility’s phones is in disrepair and phone wire was cut. To investigate the allegation, on 09/27/2023 at 10:00 AM, LPA conducted a physical plant tour, interviewed one (01) staff at around 11:30 AM and interviewed one (01) resident at 12:30 PM. During the physical plant tour LPA observed that resident pay phone in cottage #2 was in disrepair, however, the resident phone near reception area was in working condition.

(CONT. on LIC9099-C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

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 4

Control Number 31-AS-20230925155857

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: VICTOR ROYALE, LLC	FACILITY NUMBER: 197608401
	VISIT DATE: 09/27/2023

NARRATIVE

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During interviews with Staff #1 (S1), they stated that pay phone in cottage #2 is temporarily not working because it was recently renovated, and they are waiting for the company that manages the phones to come and reconnect them. S1 also added that residents have easy access to a portable phone located near the lobby. During interview with Resident #1 (R1), they stated phone was in working order, noticed telephone wire was exposed and confirmed that phone does not work.

Based on observations and interviews, there is enough information to verify the allegation. Therefore, the allegation is SUBSTANTIATED at this time. However, although one phone was found to be in disrepair, there is a working portable phone located near the lobby that residents have reasonable access to, to both make and receive confidential calls. Therefore, a citation will not be issued at this time.

No health and safety hazards were noted during the visit.

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

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/25/2023 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20230925155857

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:	09/27/2023
		UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Peter Babaian		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Resident's dresser drawer is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to the facility. Upon entry, LPA met with the Executive Director, Peter Babaian, and explained the reason for the visit.

--- Resident's dresser drawer is in disrepair.

It was alleged that Resident #1 (R1) has broken chest drawers. To investigate the allegation, on 09/27/2023 at 10:00 AM, LPA conducted a physical plant tour, interviewed one (01) staff at around 11:30 AM and interviewed one (01) resident at 12:30 PM. During the physical plant tour, LPA observed that R1’s has a vertical closet organizer for personal belongings which is in good condition, a nightstand by the bed with drawer in good condition and a desk that is dilapidated.

(CONT on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

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

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 31-AS-20230925155857

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: VICTOR ROYALE, LLC	FACILITY NUMBER: 197608401
	VISIT DATE: 09/27/2023

NARRATIVE

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During interviews with Staff #1 (S1), they stated resident has sufficient storage space and a closet. S1 added that R1 does not allow staff to enter their room which poses a challenge to maintain it. S1 believes R1 is referring to a desk which is not the facility’s responsibility to replace. S1 stated that R1 is free to purchase a new desk at any time, but due to the desk’s current poor condition, it should be removed as it poses a potential safety hazard to R1 and staff. During interview with Resident #1 (R1), they stated a request for replacements of the desk was made but nothing came of it.

Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards were noted during the visit.

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

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 4