197609812-3-30-2023-31-AS-NMAN-CUXTLZ-20230822145022

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609812
Report Date: 03/30/2023
Date Signed: 03/30/2023 02:22:38 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
02/17/2023 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20230217165031

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:	03/30/2023
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Roselin Finuliar		TIME COMPLETED:	02:25 PM

ALLEGATION(S):

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Staff did not prevent resident from becoming physical with another resident in care

INVESTIGATION FINDINGS:

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At 12:50 p.m. on 03/30/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced, subsequent complaint visit. LPA met with the Administrator and disclosed the reason for the visit.

Staff did not prevent resident from becoming physical with another resident in care

Regarding the allegation above, it was alleged staff did not prevent Resident #1 (R1) from inappropriately touching Resident #2 (R2). On 02/27/2023 between 10:30 a.m. and 4:00 p.m. LPA interviewed the Administrator, toured the facility, and reviewed records and video footage. On 03/30/2023 between 1:15 p.m. and 2:15 p.m. LPA interviewed residents and staff. Video footage of the facility revealed R1 touching R2 in a friendly manner. R1 pinched R2’s cheek three times and stroked R2’s face using the back of R1’s hand. Staff #1 (S1) intervened to stop the behavior.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

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 31-AS-20230217165031

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: LAND OF PEACE 3	FACILITY NUMBER: 197609812
	VISIT DATE: 03/30/2023

NARRATIVE

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Interviews with the Administrator and staff revealed the behavior exhibited by R1 was normal and meant to be affectionate. Staff #1 (S1) stated they were present and supervising R1 and R2 the entire time. S1 stated an additional staff member was also observing R1 and R2. S1 further stated that both S1 and S2 are not verbally proficient, so they typically interact with others through physical touch. At 1:35 p.m. on 03/30/2023, LPA and S1 observed R1 interact with R2 through physical touch of hands. The interaction was friendly and not physical or violent. Record review of R1 and R2’s service plans confirmed the facility should promote their socialization. Based on video footage review, interviews, observations, and record review, the evidence gathered does not support the allegation. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. Appeal rights discussed. Copy of report provided.

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

LIC9099 (FAS) - (06/04)

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