197609823-8-25-2022-31-AS-NMAN-CJ7SC9-20220912134509

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609823
Report Date: 08/25/2022
Date Signed: 08/25/2022 03:03:30 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
08/17/2022 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20220817144512

FACILITY NAME:	ALALIK CARE HOME		FACILITY NUMBER:	197609823
ADMINISTRATOR:	ARZUMANYAN, HARUTYUN		FACILITY TYPE:	740
ADDRESS:	11152 WOODLEY AVE		TELEPHONE:	(818) 818-1808
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS:	DATE:	08/25/2022
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Harutyun Arzumanyan		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff not wearing masks in facility.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Abeye Duguma conducted an unannounced complaint visit to the facility. LPA arrived to the facility at 9:00am. Upon entry, LPA was offered sanitizer, sceened for COVID 19 and signed in. All staff members were observed to be wearing masks. At 9:30 AM LPA conducted a physical plant tour. LPA interviewed three (03) staff and three (03) residents from 10:15 AM - 11:30 AM. Interviews revealed that staff are wearing their masks at all times.

Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards noted during this visit.

Exit interview was conducted and a copy of the report was issued.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

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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