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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197610162
Report Date:
09/17/2021
Date Signed:
09/17/2021 02:01:43 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
07/06/2021
and conducted by Evaluator
Patrick Shanahan
COMPLAINT CONTROL NUMBER:
31-AS-20210706160545
FACILITY NAME:
LOVE & CARE SENIOR LIVING, INC.
FACILITY NUMBER:
197610162
ADMINISTRATOR:
HAKOBYAN, DAVIT
FACILITY TYPE:
740
ADDRESS:
17710 MARTHA STREET
TELEPHONE:
(818) 585-0063
CITY:
ENCINO
STATE:
CA
ZIP CODE:
91315
CAPACITY:
6
CENSUS:
DATE:
09/17/2021
UNANNOUNCED
TIME BEGAN:
10:30 AM
MET WITH:
Davit Hakobyan/ Licensee
TIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unlicensed care is being provided.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPA's) Patrick Shanahan and Wendell Smith arrived at the home in order to conduct a follow up visit in regard to the above mentioned complaint.
LPA conducted the initial complaint visit on 7/16/2021. Interviews were previously conducted with the operator and residents of this location. During the initial visit it was determined there was two residents residing in this location but they did not require care and supervision. During today's visit from approximately 10:45-11:15am interviews were conducted with the two clients. The two clients indicated that they will be moving at the end of the month due to an application for licensure being submitted at this location. From 11:15am-12pm LPA's interviewed the operator regarding the complaint allegation. Based on the information obtained from interviews with clients and what was observed during this and previous visits this allegation is deemed Unsubstantiated at this time. Exit Interview conducted.
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:
09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
09/17/2021
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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