<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609307
Report Date: 06/11/2021
Date Signed: 06/11/2021 02:16:21 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. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/25/2020 and conducted by Evaluator Brian Balisi
COMPLAINT CONTROL NUMBER: 29-AS-20200925084106
FACILITY NAME:WELLBE HOMEFACILITY NUMBER:
197609307
ADMINISTRATOR:MKRTCHIAN, VAHEFACILITY TYPE:
740
ADDRESS:12936 WELBY WAYTELEPHONE:
(818) 414-0005
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY:6CENSUS: 5DATE:
06/11/2021
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Vahe Mkrtchian - AdministratorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff hit resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced subsequent complaint investigation for the allegation listed above. LPA met with Vahe and explained the reason for the visit.

During the course of the investigation, LPA conducted a physical plant tour virtually on 9/29/2020 as well as interviewed Administrator as well as review and obtained copies of documents relevant to the investigation. Today between 11:00am - 3:00pm, LPA conducted physical plant with administrator, conducted interviews with facility staff and residents.

It was alleged that a member of the Staff 1 (S1) hit a Resident. LPA’s interview with (4) residents and staff revealed that no one has ever witnessed S1 hit any resident in care. All residents did not express any concerns for their health and safety in the presence of S1. Based on the information gathered during this and previous visits, the department does not have sufficient evidence to determine that that Staff hit resident. Therefore, the above allegation is UNSUBSTANTIATED at this time.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021
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