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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 07:15:01 PM
Substantiated
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:
06/04/2022
UNANNOUNCED
TIME BEGAN:
01:00 PM
MET WITH:
Kara Charchaogalyan
TIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff behavior poses a risk to residents 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.
Regarding the allegation above it is alleged that staff # 1(S1) speaks inappropriately to residents and is sometimes verbally abusive to residents. During today's visit LPA conducted interviews with residents from approximately 1:05-2pm regarding this allegation. LPA had previously conducted an interview with the administrator regarding this allegation. Interviews reveal that S1 was found to speak inappropriately to residents on different occassions and due to that S1 was terminated from their position. Based on the information obtained through interviews this allegation is deemed Substantiated at this time. LPA also investigated this same allegation on a different complaint at this facility (31-AS-20200504144937) on this same date. The allegation was substantiated and a citation was issued regarding the allegation. Due to this allegation already cited on that report. No citation will be issued on this report. Exit Interview conducted.
Substantiated
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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