197608401-3-16-2025-31-AS-NMAN-DF4UZW-20250325160213

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608401
Report Date: 03/16/2025
Date Signed: 03/16/2025 03:33:58 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
04/18/2024 and conducted by Evaluator Abeye Duguma

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: 53	DATE:	03/16/2025
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:			TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff left resident is 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) Abeye Duguma conducted an unannounced subsequent complaint visit to this facility to further investigate the above allegations. LPA met with Administrator, Peter Babaian, and explained the reason for the visit.

--- Staff left resident is soiled diapers for an extended period of time.
--- Staff are not meeting resident's toileting needs.

It was alleged that staff left Resident #1 (R1) in soiled diapers for an extended period of time and are not meeting R1’s toileting needs. To investigate the allegation, on 04/22/2024 LPA Rosaura Valenzuela interviewed staff from 1:30p.m. to 2:00p.m. and reviewed records from 2:00p.m. to 2:24p.m. On 03/16/2025, LPA Duguma conducted a physical plant tour 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: 03/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2025

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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: VICTOR ROYALE, LLC	FACILITY NUMBER: 197608401
	VISIT DATE: 03/16/2025

NARRATIVE

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During the physical plant tour, LPA observed that all residents were clean, well-groomed and did not experience any malodor. A review of R1’s Physician’s Report revealed that R1 is incontinent and can communicate their needs. During interviews with staff, all staff stated residents are not left soiled for an extended time and all incontinent residents are checked on every two hours and changed as needed. Staff #1 (S1) added R1 wears more than one diaper at a time due to their large frame. S1 states that R1's diaper is constantly changed throughout the day and that they are given a bath three (03) times per week. While at the hospital R1 was found to have a urinary tract infection (UTI). R1 is able to communicate their needs and they did not notify staff that their diaper was wet and needed to be changed. During interviews with residents, all residents stated they are not left soiled for an extended time and that staff check on them on average every two (02) hours. LPA was unable to interview R1 at the time of the visit.

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.

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: 03/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2025

LIC9099 (FAS) - (06/04)

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