197609604-1-31-2024-29-AS-KHEN-D2VUY2-20240228145913

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609604
Report Date: 01/31/2024
Date Signed: 01/31/2024 02:11:58 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
01/24/2024 and conducted by Evaluator Christine Yee

COMPLAINT CONTROL NUMBER: 29-AS-20240124115220

FACILITY NAME:	HM SWEET HOME		FACILITY NUMBER:	197609604
ADMINISTRATOR:	NADRIAN, ASMIK		FACILITY TYPE:	740
ADDRESS:	6215 BLUEBELL AVENUE		TELEPHONE:	(818) 903-6302
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY:	6	CENSUS: 3	DATE:	01/31/2024
		UNANNOUNCED	TIME BEGAN:	09:51 AM
MET WITH:	Marine Arshakyan, Staff		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

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Staff did not prevent a resident from being financially abused while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christine Yee conducted an unannounced complaint visit to investigate the above complaint and was let into the home by Emilya Hovsepyan, Staff. Asmik Nadrian was contacted via telephone and she arrived at 10:17am to conduct the visit. The reason for today's visit was explained.

During today's visit, LPA Yee conducted interviews and showed photograph obtained from ATM camera to Resident #2 at 9:52am, facility staff #1 and Staff #2 at 9:55am, Staff #3 at 10:52am, Administrator at 10:55am regarding resident files and photograph. LPA Yee also attempted to interview Witness #1 via telephone at 10:58am. Telephone interview was also conducted with the complainant prior to today's visit and on today's visit.

Per information received from interviews conducted, Resident #1 lived at the facility from the latter part of November 2023 and deceased in mid December of 2023. However, per complainant, on 1/19/24 an

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024

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 29-AS-20240124115220

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: HM SWEET HOME	FACILITY NUMBER: 197609604
	VISIT DATE: 01/31/2024

NARRATIVE

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unknown caller requested information and a credit line increase for Resident #1's credit card. Resident #1 is known to the financial institution and the call for the credit line increase was not the resident's normal pattern. The account was placed on hold on 1/19/24. Per review of the ATM camera images and transactions, Resident #1 was last seen in a branch on 11/7/23 and last contacted the bank on 11/8/23. Per review of ATM camera footage for January 2024, an unidentified female was observed conducting the ATM transactions and not Resident #1. Per review of account activity, ATM and credit card transactions were noted from 1/12/24-1/15/24. Per information provided from the interview with the complainant, the unidentified female also tried to log into Resident #1's online banking on 1/18/24 and was unsuccessful. A call requesting the credit line increase was then requested on 1/19/24. The unidentified female had all the necessary information requested by the banking staff to gain access to Resident #1's accounts.

A copy of the ATM image provided for the unidentified female at the ATM machine and per interviews conducted with Resident #2, Staff #1, Staff #2 Staff #3 and the Administrator, they have never seen the unidentified female at the facility and do not know who she is. She is not a known family member of any of the residents, staff or a facility staff.

Based on the information received on today's visit, there is no evidence to to show that the unidentified female was ever present at the facility and somehow gained access to Resident #1's banking or facility record. Therefore, the above allegation is unsubstantiated.

Exit interview was conducted with Mariam Baghdoyan, Staff

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024

LIC9099 (FAS) - (06/04)

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