197608401-9-16-2024-31-AS-NMAN-D9QRTT-20241004131852

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 09/16/2024
Date Signed: 09/16/2024 06:19:56 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
09/06/2024 and conducted by Evaluator Leizl De La Cerra

COMPLAINT CONTROL NUMBER: 31-AS-20240906090906

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: 55	DATE:	09/16/2024
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Peter Babaian, Administrator		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Facility signal system is not consistently functional.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Leizl de la Cerra conducted an unannounced initial complaint visit to the facility. Upon entry, LPA was met with the Executive Director, Peter Babaian, and explained the reason for the visit.
Facility signal system is not consistently functional..
It was alleged that R1's signal system is not consistently functional. To investigate the allegation, on 09/16/2024 at 11:30AM, LPA conducted a physical plant tour, interviewed two (02) staff members and interviewed one (01) resident between 12:30PM to 2:00PM. Before conducting the physical plant tour, staff member #1, S1 showed LPA how the signal system works within the facility. LPA observed that the front desk of the facility where a staff member is always available/present monitoring the equipment that receives the signal system when activated by a resident of the facility. The screen of the equipment shows the staff member which room the signal system alert is coming from.

CONTINUE to LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Leizl De La Cerra	TELEPHONE: (818) 454-0632
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2024

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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Control Number 31-AS-20240906090906

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: 09/16/2024

NARRATIVE

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During the physical plant tour LPA observed that R1's room is in a cottage that consist of 5 bedrooms. R1 is in bedroom #4. LPA with the assistance of a staff member #2, S2 pushed the switch of the signal system in R1s room (room #4), a staff member #3, S3 who was at the front desk, received the signal and headed over R1's room. LPA took notice that S3 showed up at R1's room within a minute.
Furthermore, LPA sat at the front desk and requested S2 to go back to the cottage and had S2 push the signal system for two other bedrooms that are in cottage #1515. S2 pressed the signal system for bedroom #2 and bedroom #5, LPA observed that both alerts registered on the screen of the equipment. LPA visually observed that the receiving equipment showed that the signal system was alerted from bedroom #2 and bedroom #5.

LPA interviewed staff member #1, S1 and S1 interview revealed that R1 complained about the signal alert problem, R1 was informed by S1 on 9/10/24 that the company that maintains the signal system (HCI Systems, Inc,) was called to check for any problems with the signal system within the cottage #1515. S1 was informed by HCI Systems during a remote maintenance check that there was no record of any disfunction with the call systems. S1 then relayed that information to R1. S1 also requested HCI systems, Inc. to do a physical maintenance system check to ensure R1 that all call systems were functional in cottage #1515,

Based on observation, interview and record reviews, there was not enough supporting information to confirm the allegation. Therefore, the allegation deemed unsubstantiated at this time.
No health and safety issues noted at the time of this visit.

Exit interview conducted and a copy of the report was issued by e-mail to administrator due to technical issues.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Leizl De La Cerra	TELEPHONE: (818) 454-0632
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2024

LIC9099 (FAS) - (06/04)

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