197608477-5-13-2024-31-AS-NMAN-DBVW5Z-20241212155959

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608477
Report Date: 05/13/2024
Date Signed: 05/13/2024 03:23:16 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
05/03/2024 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20240503125015

FACILITY NAME:	IVY PARK AT STUDIO CITY		FACILITY NUMBER:	197608477
ADMINISTRATOR:	SHAHIN TAGHIZADEH		FACILITY TYPE:	740
ADDRESS:	4610 COLDWATER CANYON AVE		TELEPHONE:	(818) 505-8484
CITY:	STUDIO CITY	STATE: CA	ZIP CODE:	91604
CAPACITY:	121	CENSUS: 78	DATE:	05/13/2024
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Sean Taghizadeh, Executive Director (ED)		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff member is providing care to residents while intoxicated
Staff member verbally abuses residents in care

INVESTIGATION FINDINGS:

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On 05/13/2024 at 9:50a.m. Licensing Program Analyst, Antonia Alvizar-Ettima conducted an unannounced initial complaint visit to this facility. LPA met with ED and explained the reason for this visit.

At approximately 10:10a.m. LPA request staff schedule, staff contact information, resident and staff roster. At 10:25 a.m., LPA and ED conducted a physical plant tour of the facility including lockers in staff breakroom. Between 10:40a.m. to 11:40a.m. LPA interviewed eight (08) out of seventy-eight (78) residents that have received care from S1. In addition LPA interviewed two (2) other staff. One (1) out of the eight (8) residents refused to be interviewed. At 11:45a.m. LPA received staff schedule, staff contact information, staff and residents roster. Between 11:50a.m. to 2:15p.m. LPA interviewed, ED, Business Office Director (BOD) and staff (S1). LPA, asking questions relevant to the nature of the complaint. LPA reviewed facility documentation related to the allegations above.

Cont. LIC 9099c

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima	TELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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-20240503125015

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: IVY PARK AT STUDIO CITY	FACILITY NUMBER: 197608477
	VISIT DATE: 05/13/2024

NARRATIVE

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1. Staff member is providing care to residents while intoxicated.

It was alleged that S1 is drinking while working at the facility.

Interviews with ED and BOD indicated that they have received a complaint about it approximately a month ago. They indicated that they have conducted an internal investigation but have not found any evidence of S1 being intoxicated while at work. Interview with residents that received care from S1 did not express any concerns. Interview with S1 indicated that has not heard of anything like that on they shift. During physical tour LPA did not observe any alcohol bottles in staff lockers. During to visit, LPA did not smell or observed any alcohol during facility tour.

Based on interviews and observation there is an insufficient information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

2. Staff member verbally abuses residents in care.

It was alleged that when S1 is intoxicated they verbally abuse residents by speaking aggressively and inappropriately.

Interviews with ED and BOD indicated that they have not received any complaint about S1 speaking aggressively and inappropriately. Interview with residents that received care from S1 did not express any concerns. Resident R4 indicated that they get along well. Interview with S1 indicated that has not seen anything like that. During physical tour LPA did not observe any staff verbally abusing residents in care.

Based on interviews and observation there is an insufficient information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Exit interview conducted. Copy of report was provided to ED.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima	TELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

LIC9099 (FAS) - (06/04)

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