197609666-3-19-2024-31-AS-MVAO-D3YRPW-20240403131236

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609666
Report Date: 03/19/2024
Date Signed: 03/19/2024 01:46:10 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 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
11/19/2021 and conducted by Evaluator Evelin Rios

COMPLAINT CONTROL NUMBER: 31-AS-20211119095903

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:	0	CENSUS: 0	DATE:	03/19/2024
		UNANNOUNCED	TIME BEGAN:	10:46 AM
MET WITH:	Estela Avetyan		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff left residents alone at the facility.
Staff were yelling at the residents.
Illegal eviction.
Facility yard is cluttered.
Facility freezer is not working.
There are no P & I logs.
Facility is closing with no closure plan.

INVESTIGATION FINDINGS:

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At 10:46 a.m. Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced complaint visit to ROYALTY ASSISTED LIVING facility number 197609001 to deliver determination on the allegations mentioned above. Upon arrival LPA met with staff #1 (S1). S1 contacted the Administrator designee, Estela Avetyan by telephone and LPA explained the purpose of the visit was regarding a complaint for the facility that is now closed. Estela met LPA later.

On 11/24/2021 LPA Melissa Ruiz conducted an initial complaint visit, conducted a physical plant tour at approximately 9:40 a.m., conducted interviews with the director at the time Estella Avetyan, and attempted to interview four out of four residents in care. Residents were unable or unwilling to communicate with LPA. On 3/3/2022 LPA Ruiz conducted an interview with a former resident at time of the initial visit, resident #1 (R1). On 03/19/2024 LPA Rios attempted to contact a former resident #2 (R2) from before the initial unannounced complaint visit on 11/24/2021. LPA did not receive a return call from R2.
(Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2024

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 3

Control Number 31-AS-20211119095903

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ROYALTY ASSISTED LIVING II	FACILITY NUMBER: 197609666
	VISIT DATE: 03/19/2024

NARRATIVE

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On 03/19/2024 LPA Rios conducted an interview with Estala over the phone prior to her arrival at the facility. On 03/19/2024 at approximately 1:00 p.m. LPA Rios conducted an interview with resident #3 (R3) who lived at the facility prior to it closure.

Allegation #1: Staff left residents alone at the facility. To investigate this allegation on 11/24/2021, LPA Ruiz attempted to interview four (4) out of four (4) residents in care. 4 out of 4 residents were unable or unwilling to communicate with LPA. LPA Ruiz interviewed R1 on 3/03/2022, interview with R1 revealed staff would leave residents alone at night and facility did not find a replacement when a staff permanently left. Interview with Estela on 03/19/2024 denies the allegation. Interview with R3 on 03/19/2024 denies the allegation. Based on the information obtained, there was insufficient evidence to corroborate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation #2: Staff were yelling at the residents. It was alleged the Licensee was yelling at resident #1 (R1). To investigate this allegation on 11/24/2021, LPA Ruiz attempted to interview four (4) out of four (4) residents in care. 4 out of 4 residents were unable or unwilling to communicate with LPA. LPA Ruiz interviewed R1 on 3/03/2022, interview with R1 revealed they had gotten "into it" with a caregiver and later the director at the time was yelling at R1 over the phone. LPA Ruiz and LPA Rios attempted to contact R2 on 03/03/2022 and on 03/19/2024, R2 was living in the facility when the alleged incident in question occurred. LPAs were unsuccessful. Interview with Estela on 03/19/2024 denies the allegation. On 03/19/2024 LPA Rios interviewed R3 a resident living at the facility during the alleged incident, R3 revealed they recall the incident in question and consider the interaction at the time as yelling. Based on the interviews, there was insufficient evidence to corroborate the allegation as the incident is described differently in interviews. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation #3: Illegal eviction. It was alleged resident #1 (R1) was told to leave the facility without a proper eviction notification. To investigate the allegation on 11/24/2021 LPA Ruiz questioned the director at the time Estela Avetyan, if they had recently evicted anyone, to which she responded, "no". No documentation was found for an eviction. Interview with individual with knowledge on R1's placement explained R1 wanted to leave the facility and was relocated by placement agency. Based on the information obtained, there was insufficient evidence to corroborate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.
(Continued on LIC9099-C) Page 2 of 3

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20211119095903

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ROYALTY ASSISTED LIVING II	FACILITY NUMBER: 197609666
	VISIT DATE: 03/19/2024

NARRATIVE

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Allegation #4: Facility yard is cluttered. It was alleged the trash cans were full on the street and there were other furniture items in the lawn outside the facility. To investigate the allegation on 11/24/2021 LPA Ruiz at approximately 9:20 a.m. observed the front yard to be clean, tidy, and free from obstructions. No visible trash or junk. LPA also toured the backyard, and no clutter was visible. Based on the observation made by LPA Ruiz on 11/24/2021 and LPA Rios unable to conduct a physical plant tour of the facility on 3/19/2024 due to it's closure, there was insufficient evidence to corroborate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation #5: Facility freezer is not working. To investigate the allegation on 11/24/2022 at 9:50 a.m., LPA Ruiz toured the kitchen and observed the refrigerator to be functioning. LPA opened the freezer and it appeared to be functioning properly. No other freezer was observed. Based on the observation made by LPA Ruiz on 11/24/2021 and LPA Rios unable to conduct a physical plant tour of the facility on 3/19/2024 due to it's closure, there was insufficient evidence to corroborate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation #6: There are no P & I logs. It was alleged resident(s) Personal and Incidental (P&I) logs were not on file at the facility. To investigate the allegation on 11/24/2021 at approximately 10:00 a.m. LPA Ruiz conducted recorded review. LPA Ruiz reviewed four (4) out of four (4) P&I logs for four (4) residents. LPA Ruiz asked for copies, however due to the printer not working, LPA took pictures of the logs. Based on the observation made by LPA Ruiz on 11/24/2021, there was insufficient evidence to corroborate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation #7: Facility is closing with no closure plan. It was alleged the Licensee said they would close the facility. To investigate the allegation, LPA Ruiz interviewed director at the time Estela on 11/24/2021. LPA asked Estela if facility was closing to which she responded, "no". LPA asked if they had told any residents they would be closing to which she responded, "no". Based on observations and interview made by LPA Ruiz on 11/24/2021, there was insufficient evidence to corroborate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. Copy of report provided to facility ROYALTY ASSISTED LIVING facility number 197609001.
Page 3 of 3

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 3