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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608646
Report Date: 02/07/2023
Date Signed: 02/07/2023 11:42:51 AM

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
01/30/2023 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20230130122231
FACILITY NAME:PARADISE ADULT DAY TREATMENT CENTER, INC.FACILITY NUMBER:
197608646
ADMINISTRATOR:SIMA HAKOBYANFACILITY TYPE:
775
ADDRESS:7133-7135 OWENSMOUTH AVENUETELEPHONE:
(818) 312-1118
CITY:CANOGA PARKSTATE: CAZIP CODE:
91303
CAPACITY:45CENSUS: 23DATE:
02/07/2023
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Tigran NersesyanTIME COMPLETED:
11:55 AM
ALLEGATION(S):
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Client sustained injuries on more than one occasion while in care.
INVESTIGATION FINDINGS:
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At 9:45 a.m. on 02/07/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced subsequent complaint visit. LPA met with the Administrator and disclosed the reason for the visit. LPA and Administrator toured the facility inside and out. No immediate health and safety concerns were observed.

Regarding the allegation above, it was alleged Client #1 (C1) sustained minor injuries on their hand and nose while in care. LPA interviewed the Administrator at 10:54 a.m. and the bus company at 3:31 p.m. on 01/30/2023. LPA interviewed care providers from 12:35 p.m. to 1:45 p.m., conducted a record review at approximately 1:30 p.m., and observed clients boarding the bus home at 2:20 p.m. on 02/01/2023. LPA conducted more interviews and observations with staff and C1 on 02/07/2023 from 9:50 a.m. to 10:25 a.m. From record review, C1 had a scratch on their left hand and a mark on their nose. Photographs taken at the day program on 01/30/2023 showed no marks. From interviews, care providers first observed C1’s injuries around 3:45 p.m. om 01/27/2023 when they got off the bus.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
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 2
Control Number 31-AS-20230130122231
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: PARADISE ADULT DAY TREATMENT CENTER, INC.
FACILITY NUMBER: 197608646
VISIT DATE: 02/07/2023
NARRATIVE
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The driver did not observe any injuries on C1. When care providers asked C1 about the injuries. C1 stated they had fallen. Day program staff typically screen clients before they leave. They did not observe any marks on C1. Staff did not observe C1 have any falls or injuries while in care. C1 did not mention any pain on 02/07/2023. From observations, LPA did not see any marks or injuries on C1. Based on observations, record review, and interviews, although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. Appeal rights discussed. Copy of report provided.
SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2