197608401-1-3-2024-31-AS-NMAN-CZBQCS-20240109110338

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 01/03/2024
Date Signed: 01/03/2024 03:45:14 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
12/29/2023 and conducted by Evaluator Rosaura Valenzuela

COMPLAINT CONTROL NUMBER: 31-AS-20231229095833

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: 56	DATE:	01/03/2024
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Peter Babaian, Administrator		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff are not assisting residents with getting COVID vaccinations

INVESTIGATION FINDINGS:

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

It was reported that staff are not assisting residents with getting COVID vaccinations. To investigate this allegation, on 1/03/2024, between 1:00pm and 1:15pm, staff interviews were initiated; Interviews revealed that all residents have been vaccinated for COVID. Between 1:15pm and 1:30pm, LPA requested and reviewed facility records. Records confirmed what staff had told LPA. Moreover facility records showed that Resident #1 (R1) received four COVID vaccines. Currently there are only four COVID vaccines available. The third and fourth vaccines are optional. Between 1:30pm and 2:00pm, resident interviews were conduted. Interviews revealed that they received the COVID vaccine.

Based on interviews and records review there is sufficient information to not support the allegation. Thus, this allegation is UNSUBSTANTIATED at this time.
EXit interview conducted and a copy of the report was issued.

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: 01/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024

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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