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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609662
Report Date: 10/11/2024
Date Signed: 10/15/2024 02:21:44 PM

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
10/03/2024 and conducted by Evaluator Perchui Khurshudyan
COMPLAINT CONTROL NUMBER: 31-AS-20241003155609
FACILITY NAME:TEEN PROJECT INC, THEFACILITY NUMBER:
197609662
ADMINISTRATOR:BURNS, LAURI LYNNEFACILITY TYPE:
772
ADDRESS:8142 SUNLAND BLVDTELEPHONE:
(818) 582-8832
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY:16CENSUS: 4DATE:
10/11/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Melissa Navarrete - Residential Support Lead TIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Unqualified staff administering medications.
INVESTIGATION FINDINGS:
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On 10/11/2024 at 10:00am Licensing Program Analyst (LPA) Perchui Milena Khurshudyan conducted an unannounced ten (10) day initial complaint visit at this facility to investigate the above allegation. Upon arrival, LPA met with Melissa Navarette – Residential Support Lead (RSL), who granted access to the facility. LPA explained the reason for the visit. Entrance interview conducted. Facility Chief Compliance Officer (CCO) Anasheh Safarian and Regional Clinical Director (RCD) Melissa Coons arrived shortly after and gave access to LPA to use the facility computer to review clients’ documents.

During course of the investigation, interviews and records review were made. At 10:45am, LPA with the help of RSL conducted a physical plant tour to ensure health and safety of the clients are protected. Facility is using EXYM system, where all clients’ files including medication administration notes are stored. At 11:15am LPA requested clients and staff rosters. At approximately 11:45am, requested copies of pertinent information which include, but not limited to Personnel Files, Staff Trainings, Incident Reports, and potential documents relevant to the investigation. Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024
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-20241003155609
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: TEEN PROJECT INC, THE
FACILITY NUMBER: 197609662
VISIT DATE: 10/11/2024
NARRATIVE
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Between 12:00pm – 3:10pm, LPA interviewed six (6) out of twenty three (23) staff members, Regional Clinical Director, the Administrator, and two (2) out of four (4) clients in care.

It was reported that staff without the proper Medication Training is administering medication to clients. Staff interviews reveal that untrained staff members never get asked to help with medications or enter to Medication Room. The Facility Administrator and Regional Clinical Director stated that clients go to the Medication Room window to receive their medications and they receive the pills from Residential Aids (RA) or other trained staff only. Later, RAs enter medication log into EXYM system. Interview with clients also verified that medication was dispensed by the RAs. Documents review revealed that medication records are completed and initialed by trained staff only.


Based on observation, interviews and documents review there is an insufficient information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Exit interview conducted and copy of this report signed and delivered.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Perchui Khurshudyan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2