197609830-5-21-2021-31-AS-NGID-C4XS9F-20210715134037

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609830
Report Date: 05/21/2021
Date Signed: 05/21/2021 12:28:37 PM

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
12/15/2020 and conducted by Evaluator Naira Margaryan

COMPLAINT CONTROL NUMBER: 31-AS-20201215114640

FACILITY NAME:	MELROSE GARDENS LA, LLC.		FACILITY NUMBER:	197609830
ADMINISTRATOR:	DENISE ROMERO		FACILITY TYPE:	740
ADDRESS:	960 N MARTEL AVE		TELEPHONE:	(323) 876-1746
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	100	CENSUS: 29	DATE:	05/21/2021
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Anita Csukardi		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Unlawful eviction.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Naira Margaryan conducted unannounced subsequent complaint visit to the facility. LPA met the Executive Director (ED) and explained the purpose of this visit.

It was reported that on 12/14/2020 the resident #1 (R1) received 30-day eviction notice due to default of payment. R1’s responsible party was out of job due to Pandemic and was unable to pay R1’s rent.
To investigate the allegation, on 03/16/2020 at 7:30am, LPA Margaryan spoke with ED, who indicated that they had no intention to evict R1. ED stated that since 05/22/2019 R1’s responsible party was either paying partial payment or was not paying at all. ED was trying to communicate with R1’s responsible party and they were not responding. On 11/10/2020 R1 was notified in writing that either R1’s responsible party would pay a 50% of default payments or they will proceed with eviction procedures. On 12/10/2020 R1’s responsible party paid back due payments until November 2020 and requested a new 30-day eviction notice and a copy of the bill to apply for rental assistance for R1.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Naira Margaryan	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021

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-20201215114640

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: MELROSE GARDENS LA, LLC.	FACILITY NUMBER: 197609830
	VISIT DATE: 05/21/2021

NARRATIVE

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On 12/14/2020 ED e-mailed a new copy of eviction notice to R1’s responsible party, so that they could apply for rental assistance.
A review of facility records conducted on 05/17/2021 at 4:00pm, verified the information provided by ED.
Based on the interviews and record review, there is no sufficient information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No immediate health and safety hazard is noted during this visit.
Exit interview was conducted and a copy of report was issued.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Naira Margaryan	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2021

LIC9099 (FAS) - (06/04)

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