197610124-12-12-2022-31-AS-NGID-CQ7NCR-20230323102107

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610124
Report Date: 12/12/2022
Date Signed: 12/12/2022 01:39:19 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
12/05/2022 and conducted by Evaluator Patrick Shanahan

COMPLAINT CONTROL NUMBER: 31-AS-20221205131242

FACILITY NAME:	CONCORDIA RESIDENTIAL CARE		FACILITY NUMBER:	197610124
ADMINISTRATOR:	YEGEYAN, NAZAR		FACILITY TYPE:	740
ADDRESS:	16706 BLACKHAWK STREET		TELEPHONE:	(818) 403-1803
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 6	DATE:	12/12/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Nazar Yegeyan/ Administrator		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Facility staff physically abused residents.
Facility staff did not assist resident who was being threatened by another resident.
Facility staff did not ensure that timely medical care was provided for residents.
Facility staff did not ensure that residents were regularly observed for changes in functioning.
Resident not accorded dignity in relationships with facility staff.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Patrick Shanahan, arrived at the facility in response to the above mentioned allegations. The LPA explained the reason for the visit and the administrator arrived a short while later.

Allegation 1. Facility staff physically abused residents.
The LPA was able to speak with 6 out of the 6 residents residing at the home. All residents interviewed denied ever being abused or witnessing any type of abuse by any of the residents or the staff. There were 2 facility staff present at the home and both denied ever witnessing any abuse by any of the staff at the home. All residents, confirmed that staff is respectful and treat them well. The Resident in question (R1), stated that this complaint was not intended for this home and that this event took place somewhere else.
Based on interviews conducted with staff and residents, this allegation is deemed UNSUBSTANTIATED.

Continues on LIC-9099D

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Patrick Shanahan	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

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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Control Number 31-AS-20221205131242

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: CONCORDIA RESIDENTIAL CARE	FACILITY NUMBER: 197610124
	VISIT DATE: 12/12/2022

NARRATIVE

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Allegation 2. Facility staff did not assist resident who was being threatened by another resident.
LPA was able to speak with all residents and staff at the facility regarding this allegation. All residents interviewed confirmed that there is not a violent resident at the home. All residents feel safe and have never been threatened by any of the other residents. R1 was interviewed and confirmed that R1 did have issues with R1's roommate, but R1 never felt threatened and staff was always nearby. R1 also confirmed that R1 and R2 had a verbal disagreement and nothing ever became violent or threatening. R2 was also interviewed and confirmed that no threats or violence had ever occurred at the home. R2 confirmed that R2 and R1 had had a disagreement about the volume of the TV, but it has since been resolved. Staff interviewed, confirmed that the residents have never been threatening towards each other and there has never been any violence in the home. Based on interviews conducted with staff and residents,this allegation is deemed UNSUBSTANTIATED.
Allegation 3. Facility staff did not ensure that timely medical care was provided for residents.
The LPA was able to interview all staff and residents regarding this allegation. Staff confirmed that in the event of an emergency, 911 is called before calling anyone else. All 6 residents were interviewed and confirmed that they feel safe at the home and feel that in the event of an emergency, facility staff will seek medical care in a timely manner. Facility staff did state, that if they do need to call 911 and the administrator is not there, they will call the administrator to inform him that the paramedics have been contacted.
Based on interviews conducted with staff and residents, this allegation is deemed UNSUBSTANTIATED.
Allegation 4.Facility staff did not ensure that residents were regularly observed for changes in functioning.
The LPA was able to speak with staff and all 6 residents regarding this allegation. Residents interviewed confirmed that the staff are very good at their jobs and feel that the staff do take note of any changes in their condition. R3 was interviewed and confirmed that recently R3 needed to be sent to the hospital and that it was a staff member who noticed the change in R3. R3, stated that the staff was able to get R3 to the hospital in a timely manner. Staff interviewed confirmed that they do look for changes in residents conditions daily. Staff state that if a change is observed they will notify the administrator and make notes in the residents file. Based on interviews conducted with staff and residents, this allegation is deemed UNSUBSTANTIATED
Allegation 5. Resident not accorded dignity in relationships with facility staff.
All six residents were interviewed regarding this allegation. All residents confirmed that staff treat them with dignity and respect. R1 also confirmed that all staff have been helpful and that R1 has no complaints regarding the treatment of any of the residents. Based on interviews conducted with staff and residents, this allegation is deemed UNSUBSTANTIATED
Exit Interview Conducted and Report Issued.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Patrick Shanahan	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

LIC9099 (FAS) - (06/04)

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