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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609749
Report Date: 06/14/2022
Date Signed: 06/14/2022 02:39:30 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
05/18/2022 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20220518141925
FACILITY NAME:ENCINO GARDENSFACILITY NUMBER:
197609749
ADMINISTRATOR:ARUTUNYAN, ALEXFACILITY TYPE:
740
ADDRESS:4930 NOELINE AVETELEPHONE:
(818) 983-5598
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY:6CENSUS: 4DATE:
06/14/2022
UNANNOUNCEDTIME BEGAN:
12:47 PM
MET WITH:Zoey GevorkianTIME COMPLETED:
02:48 PM
ALLEGATION(S):
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Insufficient staff.
Lack of supervision.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to the facility. Upon entry, LPA met with Zoey Gevorkian and explained the reason for the visit.

--- Insufficient staff.

It was alleged that there is only one staff member working all day and all night. To investigate this allegation, on 05/23/2022, LPA made observations and interviewed staff and residents from 10:30 AM - 12:20 PM. Interviews and observations revealed that although staff work day and night shifts, the facility is providing the necessary care effectively and are meeting all needs. Based on interviews and observations, there is not enough information to verify the allegation, therefore, the allegation is UNSUBSTANTIATED at this time.

(cont. on LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022
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-20220518141925
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ENCINO GARDENS
FACILITY NUMBER: 197609749
VISIT DATE: 06/14/2022
NARRATIVE
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--- Lack of supervision.

It was alleged that staff leave the residents alone. To investigate this allegation, on 05/23/2022, LPA made observations and interviewed staff and residents from 10:30 AM - 12:20 PM. Interviews and observations revealed that staff were present, and that staff do not leave residents alone. Based on interviews and observations, there is not enough information to verify the allegation, therefore, the allegation is UNSUBSTANTIATED at this time.

An exit interview was conducted, and a copy of this report was provided, whose signature on this
form confirm receipt of these documents.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3