197609001-2-22-2024-31-AS-NGID-D36UYH-20240308150000

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609001
Report Date: 02/22/2024
Date Signed: 02/22/2024 02:17:52 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
02/13/2024 and conducted by Evaluator Lorena Casillas

COMPLAINT CONTROL NUMBER: 31-AS-20240213083051

FACILITY NAME:	ROYALTY ASSISTED LIVING		FACILITY NUMBER:	197609001
ADMINISTRATOR:	AVETIAN, LIDUSH		FACILITY TYPE:	740
ADDRESS:	10940 STRATHERN STREET		TELEPHONE:	(818) 436-9088
CITY:	SUN VALLEY	STATE: CA	ZIP CODE:	91352
CAPACITY:	10	CENSUS: 8	DATE:	02/22/2024
		UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Estela Avetyan		TIME COMPLETED:	02:31 PM

ALLEGATION(S):

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Staff do not allow residents to possess personal belongings
Staff do not maintain facility at a comfortable temperature for residents
Licensee does not communicate with residents regarding their care
Staff do not ensure that resident's dietary needs are met
Staff speak inappropriately to residents
Licensee is preventing resident from obtaining medical care
Staff are not addressing a resident's behavior
Facility is not providing snacks

INVESTIGATION FINDINGS:

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On 02/22/2024 at 09:40 am Licensing Program Analyst (LPA), Lorena Casillas conducted an unannounced complaint visit to investigate the above stated allegations. LPA was granted entry by Staff #1 (S1). LPA met with Administrator Estela Avetyan and explained the reason for the visit.

At 10:00 AM LPA Casillas conducted a physical plant tour. During the investigation, interviews and record reviews were made. LPA requested resident roster, Liability Insurance, Bond and LIC 500. LPA requested copies of pertinent information relevant to the investigation including but not limited to resident records, staff records, and copy of lunch menu.

Continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Lorena Casillas	TELEPHONE: 818-304-2695
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

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 4

Control Number 31-AS-20240213083051

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: ROYALTY ASSISTED LIVING	FACILITY NUMBER: 197609001
	VISIT DATE: 02/22/2024

NARRATIVE

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Allegation #1: Staff do not allow residents to possess personal belongings.

It is alleged staff removed Resident’s #1 (R1) portable heater due to the electricity bill. On 02/22/2024 LPA conducted interviews with the Administrator, three (3) staff, and six (6) out of eight (8) residents. LPA collected R1’s Resident Personal Property and Valuables (LIC 621) which did not list the item mentioned in this allegation. During interviews with staff it was stated that R1 purchased a portable heater but then tried to return it to the store where it was purchased, when R1 returned to the facility the portable heater was not in their possession. LPA observed that there was no portable heater in R1’s room. Interview with R1 revealed that R1 disposed of the portable heater. Interviews with residents confirmed that residents are allowed to have personal belongings that are kept in their rooms. Based on interviews and LPA's observation this allegation is deemed Unsubstantiated at this time.

Allegation #2: Staff do not maintain facility at a comfortable temperature for residents.

It is alleged that staff do not maintain the facility at a comfortable temperature, that facility is cold, and residents are not allowed to turn on the heater. On 02/22/2024 LPA conducted interviews with the Administrator, three (3) staff, and six (6) out of eight (8) residents. LPA conducted a physical plant walk through and checked the facility temperature. When LPA arrived at the facility, the temperature on the thermostat was 68 degrees Fahrenheit. LPA observed the central heater to start up automatically and throughout the visit the temperature was at a comfortable 73 degrees Fahrenheit. During six (6) out of eight (8) resident interviews LPA asked about the facility temperature and residents denied issues regarding the temperature in the facility. Based upon the information obtained and LPA observations this allegation is deemed Unsubstantiated at this time.

Allegation #3: Licensee does not communicate with residents regarding their care.

It is alleged that staff do not communicate with residents regarding their care due to a language barrier. Regarding the allegation, it was reported that a staff speak very limited English and are unable to understand instructions or requests for assistance. Interviews with staff indicated that they do speak English with an accent, but it does not hinder them from taking care of the residents. Various resident interviews indicated that staff can communicate effectively with residents and staff do provide the care that they require. LPA Casillas observed staff assisting residents with their request without any problems. Based on interviews and observation the allegation is deemed Unsubstantiated at this time.

Continued on LIC9099-C

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Lorena Casillas	TELEPHONE: 818-304-2695
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 31-AS-20240213083051

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: ROYALTY ASSISTED LIVING	FACILITY NUMBER: 197609001
	VISIT DATE: 02/22/2024

NARRATIVE

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Allegation #4: Staff do not ensure that resident's dietary needs are met.

It is alleged that staff do not ensure that residents’ dietary needs are met. Regarding this allegation, it was reported that residents are given on the daily, half a peanut butter sandwich for lunch and that for dinner residents are given frozen pizza or a sandwich. It is alleged that staff do not provide a balanced meal for residents and that the only drink offered is water. LPA conducted interviews with the Administrator, three (3) staff, and six (6) out of eight (8) residents. According to staff and menu, breakfast is served between 7:30-9:00 a.m, lunch is served between 11:30 a.m and 01:00 p.m, and dinner is served between 4:30-6:00 p.m. At times residents do not want to eat the food offered and an alternative is offered instead. LPA toured the facility and observed two days of perishable foods and seven days stock of non-perishable foods along with fresh orange juice, milk and water. LPA collected a copy of the menu and confirmed that the food listed is available in facility stock. Based on interviews and observations this allegation is deemed Unsubstantiated at this time.

Allegation #5: Staff speak inappropriately to residents.

It is alleged that staff speak inappropriately to residents. Regarding the allegation, it is reported that staff tell residents to “leave them alone”. LPA conducted interviews with the Administrator, three (3) staff, and six (6) out of eight (8) residents. Interviews with the Administrator and staff revealed that no staff speak inappropriately to any residents, furthermore staff and Administrator deny ever telling residents to “leave them alone”. Interviews with residents revealed that staff do not speak to residents inappropriately, therefore this allegation is deemed Unsubstantiated at this time.

Allegation #6: Licensee is preventing resident from obtaining medical care.

It is alleged that Licensee is preventing residents from obtaining medical care. Regarding this allegation it is reported that staff tell residents to stop calling the ambulance for help. LPA conducted interviews with the Administrator, three (3) staff, and six (6) out of eight (8) residents. Interviews with the Administrator and staff revealed that no staff has told residents to stop calling ambulance services. Interviews with residents also confirmed that staff have not told residents to stop calling anyone for help, that they can leave facility to go to their medical appointment as they please, and they have never been denied seeking any medical attention, therefore this allegation us deemed Unsubstantiated at this time.

Continued on LIC9099-C

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Lorena Casillas	TELEPHONE: 818-304-2695
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 31-AS-20240213083051

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: ROYALTY ASSISTED LIVING	FACILITY NUMBER: 197609001
	VISIT DATE: 02/22/2024

NARRATIVE

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Allegation #7: Staff are not addressing a resident's behavior.

It is alleged that staff are not addressing a resident’s behavior. Regarding this allegation, it was reported that R1 has been subject to outburst of behaviors from R2. R1 alleges that staff have not addressed R2’s behavior causing him to be arrested. On 02/22/2024 LPA conducted interviews with the Administrator, three (3) staff, and six (6) out of eight (8) residents. Interviews with the Administrator and staff revealed that R1 is the one causing the disturbances, with R2. Staff interviews revealed that they intervene by calling the police anytime that there is a need. Interview with residents confirmed that R1 argues with R2 and the police have had to be called often on R1 for their behavior not R2, furthermore R1 admitted to being the aggressor and that staff talk to R1 regarding his behavior, therefore this allegation is deemed Unsubstantiated.

Allegation #8: Facility is not providing snacks.

It is alleged that the facility is not providing snacks for residents. LPA conducted interviews with the Administrator, three (3) staff, and six (6) out of eight (8) residents. According to the staff and menu, breakfast is served between 8:00-8:30 a.m, lunch is served between 11:30 a.m and 12:30 p.m, and dinner is served between 4:30-6:00 p.m., all residents are offered snacks in between meals at 10:00 am, 2:00 pm and 7:00 pm. At times residents do not want to eat the snacks provided and an alternative is offered instead. LPA toured the facility and observed two days of perishable foods and seven days stock of non-perishable foods, the pantry was observed to have a variety of snacks for residents to eat. LPA collected a copy of the menu and confirmed with staff and residents that snacks are available to residents. Based on interviews and observations this allegation is deemed Unsubstantiated at this time.

No citations issued at this time. Exit interview conducted. A copy of this report was given to Administrator.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Lorena Casillas	TELEPHONE: 818-304-2695
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

LIC9099 (FAS) - (06/04)

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