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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 IIFACILITY NUMBER:
197609666
ADMINISTRATOR:AVETIAN, LIDUSHFACILITY TYPE:
740
ADDRESS:17326 LOS ALIMOS STTELEPHONE:
(818) 436-9088
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 0DATE:
06/04/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Kara CharchaogalyanTIME 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 HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell SmithTELEPHONE: (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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