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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197609812
Report Date:
05/06/2022
Date Signed:
05/06/2022 02:30:31 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
05/06/2022
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20220506125935
FACILITY NAME:
LAND OF PEACE 3
FACILITY NUMBER:
197609812
ADMINISTRATOR:
SONA MURADYAN
FACILITY TYPE:
740
ADDRESS:
22600 KITTRIDGE STREET
TELEPHONE:
(818) 704-7733
CITY:
WEST HILLS
STATE:
CA
ZIP CODE:
91307
CAPACITY:
6
CENSUS:
5
DATE:
05/06/2022
UNANNOUNCED
TIME BEGAN:
01:05 PM
MET WITH:
Sona Muradyan
TIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff unlawfully evicted a resident 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 complaint visit to investigate the allegation above. LPA met with the administrator and explained the reason for this visit.
It is alleged that the facility is refusing to accept resident #1 (R1) back into the facility after being hospitalized.
Regarding the allegation LPA conducted interviews with the administrator and facility staff regarding this allegation from 1:10-1:45pm. Information from interviews reveal that R1 was admitted to the facility on 4/29/22. On 5/3/22 R1 went to the hospital due to having a wound. After being hospitalized it was found that R1 has a prohibited health condition to which R1 could not be accepted back without being on hospice care. While at the facility LPA spoke with R1's responsible party who confirmed that R1 just secured hospice services. LPA spoke with administrator who confirmed they are accepting R1 back into the facility and was just awaiting for R1 to retain hospice services to treat R1's wounds. LPA also spoke with staff at the hospital R1 is staying at and confirmed that R1 had a prohibited health condition and is being discharged back to the facility with hospice services. Based on the information obtained through interviews this allegation is deemed Unsubstantiated at this time. 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:
05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
05/06/2022
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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