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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197609666
Report Date:
06/27/2022
Date Signed:
06/27/2022 01:37:31 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., STE. 250
WOODLAND HILLS
,
CA
91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/29/2021
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20210129154117
FACILITY NAME:
ROYALTY ASSISTED LIVING II
FACILITY NUMBER:
197609666
ADMINISTRATOR:
AVETIAN, LIDUSH
FACILITY TYPE:
740
ADDRESS:
17326 LOS ALIMOS ST
TELEPHONE:
(818) 436-9088
CITY:
GRANADA HILLS
STATE:
CA
ZIP CODE:
91344
CAPACITY:
6
CENSUS:
0
DATE:
06/27/2022
UNANNOUNCED
TIME BEGAN:
11:00 AM
MET WITH:
Kara Charchaogalyan
TIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Residents are not properly fed while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced subsequent visit to finish investigation into the allegation above. LPA conducted the visit at ROYALTY ASSISTED LIVING-197609001 due to this location being closed and no residents residing at this location. Five of the residents that resided at Royalty Assisted Living II moved over to this location.
It is alleged that the food the residents were served was not prepared properly and that the food service was poor. Initial visits regarding this allegation was conducted on 2/8/21. LPA conducted interviews with residents regarding this allegation from 11:30-12:15pm. Information obtained from interviews revealed that the residents did not have an issue with the food that was served at the facility. There was no mention of the food being prepared unproperly or that the food was not in good condition. Based on the information obtained through interviews this allegation is deemed Unsubstantiated at this time.
Exit Interview conducted.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/27/2022
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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