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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 03/11/2025
Date Signed: 03/11/2025 04:14:37 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
03/10/2025 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20250310162358
FACILITY NAME:VICTOR ROYALE, LLCFACILITY NUMBER:
197608401
ADMINISTRATOR:PETER BABAIANFACILITY TYPE:
740
ADDRESS:120 E. LAUREL STREETTELEPHONE:
(818) 243-7442
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:60CENSUS: 54DATE:
03/11/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Peter BabaianTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff physically abused a resident
INVESTIGATION FINDINGS:
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At approximately 10:30 a.m. on 03/11/2025 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with the administrator and disclosed the reason for the visit.

To investigate the allegation above, LPA interviewed staff and residents today between 10:40 a.m. and 2:40 p.m., conducted a record review of pertinent records, including but not limited to an admission agreement, medical assessment, care plan, and staff and client rosters at 11:00 a.m., and toured the facility inside and out at 11:15 a.m.

Regarding the allegation "Staff physically abused a resident" it was alleged Staff #1 (S1) struck Resident #1 (R1) in the face twice. Interview with the administrator at 10:40 a.m. today revealed they were aware of the allegation and reported it to the Department. Glendale police investigated the allegation on 03/10/2025.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
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-20250310162358
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: VICTOR ROYALE, LLC
FACILITY NUMBER: 197608401
VISIT DATE: 03/11/2025
NARRATIVE
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The administrator noted that a previous incident occurred between R1 and S1 in January 2025. No injuries were observed on R1 after the incidents, but the administrator issued a warning to S1. Interview with R1 at 12:00 p.m. today revealed S1 “socked [them] in the face”. Interview with Resident #2 (R2) at 12:10 p.m. today revealed they witnessed the alleged abuse. R2 stated S1 was assisting R1 in transferring from their bed to their wheelchair when R1 slipped. S1 then hit R1 and shoved them back onto the bed. Interview with Staff #2 (S2) at 12:25 p.m. today revealed S1 has abused residents in the past. S2 reported the abuse to their supervisors. Interview with Resident #3 (R3) at 12:40 p.m. today revealed S1 is physically and verbally “rough with residents” and has pushed them on two previous occasions. Interview with Resident #4 (R4) around 1:20 p.m. today confirmed S1 is “rough” with residents. Interview with S1 at 2:10 p.m. today revealed they have a difficult time working with R1 because they often resist care. S1 stated they never abused R1 and that R1 and R2 are dramatic. Based on interviews and record review, there is sufficient evidence to confirm that S1 physically abused R1. Therefore, the allegation is deemed SUBSTANTIATED at this time. A deficiency is cited on the LIC 9099-D page. An immediate civil penalty of $500 is issued on the LIC 421IM page for the physical abuse of a resident.

Exit interview conducted. Appeal rights discussed. Copy of report provided.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20250310162358
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: VICTOR ROYALE, LLC
FACILITY NUMBER: 197608401
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/12/2025
Section Cited
CCR
87468.1(a)(3)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents... shall...
(3) ...be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature...
This requirement was not met as evidenced by:
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The licensee has agreed to suspend Staff #1 (S1) until they complete further investigation into the abuse and will ensure S1 does not come into direct contact with residents.
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Based on record review and interview, the licnesee did not comply witht he section cited above in allowing Staff #1 (S1) to hit Resident #1 (R1) which posed an immediate Health, Safety, or Personal Rights to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
LIC9099 (FAS) - (06/04)
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