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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609105
Report Date: 08/19/2022
Date Signed: 08/19/2022 01:17:03 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
11/17/2021 and conducted by Evaluator LaQueena Lacy
COMPLAINT CONTROL NUMBER: 31-AS-20211117154132
FACILITY NAME:GRANDVIEW, THEFACILITY NUMBER:
197609105
ADMINISTRATOR:FLORES, YENIFACILITY TYPE:
740
ADDRESS:2211 W 6TH STREETTELEPHONE:
(213) 380-7000
CITY:LOS ANGELESSTATE: CAZIP CODE:
90057
CAPACITY:215CENSUS: 159DATE:
08/19/2022
UNANNOUNCEDTIME BEGAN:
11:49 AM
MET WITH:Yeni FloresTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff did not provide adequate supervision resulting in a resident being abused by another resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) LaQueena Lacy conducted an unannounced subsequent complaint visit to the facility on 8/19/2022 at 11:00am to deliver the investigative findings. Upon arrival LPA Lacy met with Administrator Yeni Flores and explained the purpose of this visit.

It is alleged that Resident #1 (R1) roommate hit R1 over the head with a slipper, slapped her hand, yells, and cusses. To investigate the above allegation, LPA interviewed residents and staff on 11/23/2021 at approximately 1:40pm – 2:39pm and on 04/29/2022 at approximately 12:39- 3:18pm. Interviews with nine(09) out of fourteen (14) residents determined that no one has witnessed any fights/physical altercations between any residents. Eleven (11) out of (14) have not seen or heard of any arguments or abuse between any residents. Interviews with staff revealed that five (5) out (5) staff have not been told by any residents that anyone is being abused or physically assaulted and have not witnessed any physical altercation between any residents.
Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: LaQueena LacyTELEPHONE: (818) 661-0002
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022
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-20211117154132
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: GRANDVIEW, THE
FACILITY NUMBER: 197609105
VISIT DATE: 08/19/2022
NARRATIVE
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During the investigation LPA interviewed R1, when asked specific questions regarding the abuse, R1 could not detail when the abuse occurred or confirm that they informed S1 or other staff of any abuse/physical altercations towards R1.
Based on interviews and observations, there is a not enough corroborating evidence to prove that the alleged violation occurred. Therefore, the allegation is UNSUBSTANTIATED at this time.

No deficiencies cited, Exit interview conducted and a copy of report and appeal rights issued.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: LaQueena LacyTELEPHONE: (818) 661-0002
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2