197609793-11-20-2023-29-AS-KHEN-CYVSWK-20231226131424

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609793
Report Date: 11/16/2023
Date Signed: 11/20/2023 03:15:30 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/14/2023 and conducted by Evaluator Christine Yee

COMPLAINT CONTROL NUMBER: 29-AS-20231114165616

FACILITY NAME:	SAINT CLAIR ASSISTED LIVING		FACILITY NUMBER:	197609793
ADMINISTRATOR:	EMMA ARUTIUNIAN		FACILITY TYPE:	740
ADDRESS:	6608 SAINT CLAIR AVE		TELEPHONE:	(818) 358-3059
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY:	0	CENSUS: 0	DATE:	11/16/2023
		UNANNOUNCED	TIME BEGAN:	12:47 PM
MET WITH:			TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility staff moved resident without authorization.

INVESTIGATION FINDINGS:

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Licensing Program Analyst(LPA) Christine Yee conducted a complaint investigation for the above allegation from the Woodland Hills Regional Office due to the facility being sold. The facility ceased operations and the facility was closed prior to receiving the current complaint. No onsite visit was conducted for this complaint.

On 11/15/23, LPA conducted telephone interviews with the responsible parties for: Resident #1 at 12:35pm, Resident #2 at 3:47pm and Resident #3 at 4:06pm.

As part of the investigation into the above allegation: Facility staff moved resident without authorization, LPA Yee conducted interviews with the former residents' responsible parties and conservators regarding the relocation of the residents on 6/1/23 due to the sale of the facility. Per interviews conducted, Licensee did not provide anyone with written notification of the closure or any eviction notices. The responsible

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Christine Yee	TELEPHONE: (747) 230-3890
LICENSING EVALUATOR SIGNATURE:	DATE: 11/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023

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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Control Number 29-AS-20231114165616

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAINT CLAIR ASSISTED LIVING	FACILITY NUMBER: 197609793
	VISIT DATE: 11/16/2023

NARRATIVE

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representatives for Resident #1 and Resident #2, were both verbally told about the sale of the facility a week before the residents were relocated. Emma Arutiunian, Administrator, advised both of them that the residents would have to be relocated as soon as possible. Per Resident #1's representative, they were told about the sale of the facility around 5/24/23 or 5/25/23. On 6/2/23 the representative for Resident #1 went to visit Resident #1 and was not able to get into the facility. No one answered the facility phone and so they called the Administrator's phone. Emma told Resident #1's representative that the residents had been transferred to Leo's Assisted Living on 6/1/23 but did not have the facility address and would call them back. The address for the relocation site was not provided until 6/5/23. Per Resident #1's responsible representative, they went down to Leo's Assisted Living the same day and gave them a check made out to Saint Clair Assisted Living only to have the check returned to them. The responsible representatives for Resident #1 and Resident #2 both believed that Saint Clair Assisted Living and Leo's Assisted Living were affiliated, only to discover they are not. Responsible Representative for Resident #2 was in close contact with Emma Arutiunian and believed that it was just a change in location since the relocation had been set in motion by Emma Arutiunian. The representative for Resident #2 knew about the resident relocation and was present to assist Resident #2 pack. The representative likes the new facility. It is more organized and clean. Per responsible representative for Resident #3, they were told that the facility was being sold about a month before the re-location and was also in close contact with Emma and had enough time to look for at other home. They decided to go with the facility recommended by Emma - Leo's Assisted living.

Per information obtained from interviews conducted, there is sufficient information to make a substantiated finding for the above allegation.

Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8

A copy of this report will be mailed and emailed to the Licensee to obtain a signature.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Christine Yee	TELEPHONE: (747) 230-3890
LICENSING EVALUATOR SIGNATURE:	DATE: 11/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20231114165616

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAINT CLAIR ASSISTED LIVING	FACILITY NUMBER: 197609793
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/16/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/22/2023 Section Cited CCR 87468.2(a)(20)	1 2 3 4 5 6 7	Additional Personal Rights of Residents in Privately Operated Facilities:n addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:	1 2 3 4 5 6 7	The LIcensee will submit a plan of action that will be implemented to ensure that the rights of the resident and all eviction and relocation protections are adhered to when a resident need to be relocated, including participation of the family in the decision making by 11/22/23
	8 9 10 11 12 13 14	To be protected from involuntary transfers, discharges, and evictions. A licensee shall not involuntarily transfer or evict residents for reasons other than those permitted by state law or regulations and shall comply with all eviction and relocation protections for residents. For purposes of this paragraph, "involuntary" means a transfer, discharge, or eviction that is initiated by the licensee, not by the resident.	8 9 10 11 12 13 14	*Facility has been closed on 11/9/23***
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	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Christine Yee	TELEPHONE: (747) 230-3890
LICENSING EVALUATOR SIGNATURE:	DATE: 11/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023

LIC9099 (FAS) - (06/04)

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