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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197609666
Report Date:
06/04/2022
Date Signed:
06/04/2022 07:11:58 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
05/04/2020
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20200504151556
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:
06/04/2022
UNANNOUNCED
TIME BEGAN:
12:00 PM
MET WITH:
Kara Charchaogalyan
TIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff illegally evicted resident
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 resident #1 (R1) was illegally evicted from Royal Assisted Living II and moved to Royalty Assisted Living without their permission. The initial visit was conducted on virtually on 5/14/2020 due to the corona-virus pandemic. Interviews were conducted with facility staff and R1's social worker. R1 was not able to be interviewed regarding the complaint allegation. Later on information was obtained that R1 passed away on 7/8/2020. LPA had previously interviewed the administrator regarding R1 being evicted from the facility. According to the administrator R1 wanted to move to the other facility due to not liking being at this facility and that R1 was not evicted. Based on the information obtained at this time this allegation is deemed Unsubstantiated at this time. Without being able to speak with R1 there is not enough information to state R1 was evicted. 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:
06/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/04/2022
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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