197609307-6-11-2021-29-AS-DPEA-C5DMGW-20210729093637

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609307
Report Date: 06/11/2021
Date Signed: 06/11/2021 02:31:51 PM

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
01/07/2021 and conducted by Evaluator Brian Balisi

COMPLAINT CONTROL NUMBER: 29-AS-20210107100951

FACILITY NAME:	WELLBE HOME		FACILITY NUMBER:	197609307
ADMINISTRATOR:	MKRTCHIAN, VAHE		FACILITY TYPE:	740
ADDRESS:	12936 WELBY WAY		TELEPHONE:	(818) 414-0005
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY:	6	CENSUS: 5	DATE:	06/11/2021
		UNANNOUNCED	TIME BEGAN:	02:05 PM
MET WITH:	Vahe Mkrtchian		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff threatned resident while in care

Staff hit a resident while in care

INVESTIGATION FINDINGS:

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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 1/19/2021 as well as interviewed Administrator and reviewed 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 staff members threatened and hit resident while in care, LPAs interview iwth (4) residents and (2) staff revealed that no one has ever witnessed any staff members threaten or hit any residents in care. All residents did not express any concerns for their health and safety while in the care of this facility at this time. Based on the information gathered during this and previous visits, the department does not have sufficient evidence to determine that Staff threatened resident while in care and staff hit a resident while in care. Therefore, the above allegations are UNSUBSTANTIATED at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
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)

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