197610050-8-13-2021-31-AS-RRAZ-CWP648-20231016202818

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610050
Report Date: 08/13/2021
Date Signed: 08/13/2021 11:00:57 AM

Unfounded

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
08/09/2021 and conducted by Evaluator Patrick Shanahan

COMPLAINT CONTROL NUMBER: 31-AS-20210809154536

FACILITY NAME:	PARADISO RANCH RESIDENTIAL CARE INC		FACILITY NUMBER:	197610050
ADMINISTRATOR:	ANI GABRIELIAN		FACILITY TYPE:	740
ADDRESS:	18960 KESWICK STREET		TELEPHONE:	(818) 371-8233
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	6	CENSUS: 5	DATE:	08/13/2021
		UNANNOUNCED	TIME BEGAN:	09:16 AM
MET WITH:	Ani Gabrielian/ Administrator		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Facility does not provide a safe environment for resident.
Facility food service is not adequate.
Facility food has worms.
Facility staff did not ensure safety of resident's personal belongings.
Facility staff is unable to communicate with resident due to language barrier.
Administrator does not spend an adequate amount of time at the facility.
Staff member inappropriately handled residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Patrick Shanahan, arrived at the facility and was greeted by the facility administrator, Ani Garielian.
At 9:20 AM, LPA requested a copy of the Register of Clients/ Residents Form (LIC 9020). LPA observed the document and noticed that the resident (R1) in question was not on the form and has never been a resident of this facility.
At 9:40 AM, LPA toured the home and conducted a health and safety check on all residents present at the facility. No concerns or deficiencies were observed during todays visit.
Based on information received, LPA has determined that this complaint s unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.
Exit interview conducted and copy of report provided.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Patrick Shanahan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021

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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