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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609105
Report Date: 10/14/2022
Date Signed: 10/14/2022 11:53:24 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
06/22/2022 and conducted by Evaluator LaQueena Lacy
COMPLAINT CONTROL NUMBER: 31-AS-20220622154854
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: 157DATE:
10/14/2022
UNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Yeni FloresTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility did not safeguard resident's cash resources.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) LaQueena Lacy conducted a subsequent visit on 10/14/2022 at 11:02am to deliver investigative findings for the above allegation. LPA met with Administrator Yeni Flores and explained the purpose of the visit.

It is alleged that March and April checks are missing. To investigate the above allegation, LPA interviewed resident #1 (R1) on 06/27/2022 at 11:03am and administrator on 06/29/2022 at 11:13am. During the investigation R1 informed LPA Lacy that the social security administration had confirmed two (02) of R1 monthly checks had been cashed by a person that R1 did not know. At the time of the investigation the Administrator confirmed that she did not know the person named by R1 or do not have any staff or residents by that name. The administrator informed LPA Lacy that R1 receives (2) checks a month and that the facility was the payee and she had returned March and April checks to the Social Security Administration. Upon document review LPA observed four (04) receipts from the Social Security Administration for returning R1
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: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022
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-20220622154854
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: 10/14/2022
NARRATIVE
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checks for the month of March (02) and April (02). Based on interviews, observations, and record review, 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. 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: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2