197608401-4-22-2024-31-AS-NMAN-DF4UZX-20250325160214

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 04/22/2024
Date Signed: 04/22/2024 05:20:37 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
04/18/2024 and conducted by Evaluator Rosaura Valenzuela

COMPLAINT CONTROL NUMBER: 31-AS-20240418090205

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:	04/22/2024
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Peter Babaian, Administrator		TIME COMPLETED:	02:54 PM

ALLEGATION(S):

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Staff left resident in soiled diapers for an extended period of time.

Staff are not meeting resident's toileting needs.

INVESTIGATION FINDINGS:

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

It was reported that staff left resident in soiled diapers for an extended period of time. To investigate this allegation on 4/22/2024, between 1:30pm and 2:00pm, staff interviews were initiated. Interviews revealed that Resident #1 (R1) is incontinent and wears more that one diaper at a time due to their large frame. Furthermore, Staff #1 (S1) denies that R1 was left in soiled diapers for an extended period of time. S1 states that R1's diaper is constantly changed throughout the day and that they are given a bath three times per week. R1 is currently out of the community and was recently sent to a skilled nursing facility after a recent hospitalization. While at the hospital R1 was found to have a urinary tract infection (UTI). R1 i able to communicate their needs and they did not notify staff that their their diaper was wet and needed to be changed.
Continue on 9099-C

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: 04/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2024

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-20240418090205

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: 04/22/2024

NARRATIVE

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Between 2:00pm and 2:24pm, facility records were reviewed. Records reviewed confirmed what staff had told Licensing. R1 is incontinent and can communicate their needs.

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

It alleged that Staff are not meeting resident's toileting needs. Between 1:30pm and 2:00pm, staff interviews were initiated. Interviews revealed that R1 is provided assistance with their toileting needs. Staff provide R1 with diapers and change them as needed. In addition, R1 is able to communicate their needs. Further, between 2:00pm and 2:24pm, facility files were reviewed. Records confirm what staff told LPA.

Based on interviews and records review there is not sufficient information to support this allegation. Thus, this allegation is UNSUBSTANTIATED at this time.

No health or safety hazards noted at the time of this visit.

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: 04/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2024

LIC9099 (FAS) - (06/04)

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