197608401-3-15-2025-31-AS-NMAN-DF4UGE-20250325153415

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 03/15/2025
Date Signed: 03/15/2025 03:50:19 PM

Unsubstantiated

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
03/05/2024 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20240305113301

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: 53	DATE:	03/15/2025
		UNANNOUNCED	TIME BEGAN:	09:13 AM
MET WITH:	Marisol Borrero		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Staff physically abused resident while in care.
Staff did not treat resident with dignity and respect.
Due to lack of supervision resident wandered away from facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to this facility to further investigate the above allegations. LPA met with administrator, Marisol Borrero, and explained the reason for the visit. LPA Duguma spoke with the Administrator, Peter Babaian, who designated Marisol Borrero to sign and accept the report.

--- Staff physically abused resident while in care.

It was alleged that facility harasses and hits resident. To investigate the allegation, on 03/13/2024 LPA Rosaura Valenzuela interviewed staff from 10:45a.m. to 11:15a.m. and reviewed facility documents from 11:30a.m. to 12:00p.m. On 03/15/2025, LPA Duguma conducted a physical plant tour and requested documents at around 9:30a.m., interviewed three (03) additional staff from 11:00a.m. – 12:30p.m. and six (06) residents from around 1:00p.m. to 2:30p.m.
(CONT. on LIC9099-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: 03/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2025

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-20240305113301

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: 03/15/2025

NARRATIVE

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During the physical plant tour, LPA observed that all residents were clean, well-groomed and did not show signs of physical abuse. Record review revealed that R1 has a history of self-harming behavior. A review of the Department’s Incident Report records did not show that resident had any wandering incidents or physical incidents with staff. During interviews with staff, all staff stated R1 has never had a physical altercation with them or know of any other staff that has harassed or hit R1. During interviews with residents, all residents stated staff do not harass or hit them.

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

---Staff did not treat resident with dignity and respect.

It was alleged that facility staff are evil people. To investigate the allegation, on 03/13/2024 LPA Rosaura Valenzuela interviewed staff from 10:45a.m. to 11:15a.m. and reviewed facility documents from 11:30a.m. to 12:00p.m. On 03/15/2025, LPA interviewed three (03) additional staff from 11:00a.m. – 12:30p.m. and six (06) residents from around 1:00p.m. to 2:30p.m. Records revealed that R1 has a history of multiple psychiatric hospitalizations. During interviews with staff, all staff stated they treat all residents with dignity and respect. During interviews with residents, all residents stated staff treat them with dignity and respect. LPA was unable to interview R1 as they were not in the facility at the time of the visit.

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

--- Due to lack of supervision resident wandered away from facility.

It was alleged that R1 eloped from the facility. To investigate the allegation, on 03/13/2024 LPA Rosaura Valenzuela interviewed staff from 10:45a.m. to 11:15a.m. and reviewed facility documents from 11:30a.m. to 12:00p.m. On 03/15/2025, LPA Duguma conducted a physical plant tour and requested documents at around 9:30a.m., interviewed three (03) additional staff from 11:00a.m. – 12:30p.m. and six (06) residents from around 1:00p.m. to 2:30p.m. A review of the facility logbook shows that R1 left the facility without signing out.
(CONT. on LIC9099-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2025

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20240305113301

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: 03/15/2025

NARRATIVE

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A review of R1’s Physician’s Report revealed that resident is able to leave the facility unassisted. A review of the Department’s Incident Report records did not show that resident had any wandering incidents. During interviews with staff, Staff #1 (S1) stated Residents are free to come and go as they please. S1 added on 2/19/24, R1 left the facility and did not use the sign out book. After 24 hours had passed, S1 contacted the Glendale Police Department and filed a missing person's report. S1 stated R1 returned to the facility on 3/04/24. All other staff stated to their knowledge, R1 is able to leave the facility unassisted. LPA was unable to interview R1 as they were not in the facility at the time of the visit.

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

No health and safety hazards noted during the visit.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2025

LIC9099 (FAS) - (06/04)

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