197609312-1-8-2024-31-AS-TAGD-CZMTQB-20240119135541

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609312
Report Date: 01/08/2024
Date Signed: 01/08/2024 10:44:12 AM

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
12/14/2023 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20231214143834

FACILITY NAME:	A PARADISE IN THE VALLEY		FACILITY NUMBER:	197609312
ADMINISTRATOR:	DER-APRAHAMIAN, ARSEN		FACILITY TYPE:	740
ADDRESS:	7754 TEXHOMA AVE		TELEPHONE:	(323) 821-1419
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91325
CAPACITY:	6	CENSUS: 3	DATE:	01/08/2024
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Arsen Der-Aprahamian		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff caused injury to resident in care
Staff did not change resident's clothing for multiple days
Staff restrained residents in care
Staff do not provide adequate supervision to residents in care

INVESTIGATION FINDINGS:

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On 01/08/24, at 9:25am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent, complaint visit and was greeted by housemanager Narine Petikyar (S2). LPA asked for the census, staff, and resident files. Administrator Arsen Der-Aprahamian (S1) arrived about 20 (twenty) minutes later.

Regarding the allegation: Staff caused injury to resident in care. It is being alleged that R1 and R2 sustained an injury to R1’s eye earlier this year because staff hit them.

Based on the resident, staff interviews and LPA record review, staff do no cause injury to residents in care. R3 states, “they treat me like a family member, they went out to eat the other day and brought me some food.” LPA did not observe any injuries to residents in care.

LIC 9099-C continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024

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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Control Number 31-AS-20231214143834

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: A PARADISE IN THE VALLEY	FACILITY NUMBER: 197609312
	VISIT DATE: 01/08/2024

NARRATIVE

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Regarding the allegation: Staff did not change resident's clothing for multiple days. It is being alleged that the residents wear the same clothes for several days and are not changed by staff.

Based on the resident, staff interviews and LPA observation staff change the resident’s clothing often. R1 states, “I can choose what to wear that day.” LPA did not observe the same clothing on the residents during LPA’s subsequent visit.

Regarding the allegation: Staff restrained residents in care. It is being alleged that R1 and R2 are being tied down to their beds and wheelchairs with cloth straps. RP states there is no doctor’s order for the straps.

LPA reviewed the record files and observed that there is a doctor’s order for the straps (postural support) and for the bed rails dated on 05/18/23, 07/21/23 and 09/29/23.

Regarding the allegation: Staff do not provide adequate supervision to residents in care. It is being alleged staff intimidate the residents.

Based on resident, staff interviews and LPA observation adequate supervision is provided. LPA observed R1 spends their time in the kitchen area with staff, R2 and R3 are in their room with a signal alarm button to call staff if they need anything. In addition, R1 states, “my husband is sick.” LPA observed R2 and R3 in their room due to limited mobility. LPA also observed music being played for R2 in their room. LPA did not observe inadequate supervision to residents in care.

Based on the LPA's interviews, observations, and record reviews all four allegations above are unsubstantiated at this time. All copies of record/files were obtained.

An exit interview was conducted, no citations were issued for the four (4) above allegations, and a copy of this report was given to the administrator.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024

LIC9099 (FAS) - (06/04)

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