197610223-4-23-2024-31-AS-EMIR-D8HT3J-20240826142225

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610223
Report Date: 04/23/2024
Date Signed: 04/23/2024 02:23:43 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
04/21/2024 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20240421225937

FACILITY NAME:	NVM COMFORT HOMES		FACILITY NUMBER:	197610223
ADMINISTRATOR:	AGARONYAN, RIMA		FACILITY TYPE:	740
ADDRESS:	16473 MCKEEVER ST		TELEPHONE:	(818) 300-8393
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 5	DATE:	04/23/2024
		UNANNOUNCED	TIME BEGAN:	09:11 AM
MET WITH:	Rima Agaronyan		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff did not allow a resident to leave their bed
Staff inappropriately pushed a resident while in care
Staff unlawfully evicted a resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPA met with the administrator, Rima Agaronyan, and advised her of the complaint. Today's investigation consisted of a physical plant inspection, interviews and record review. At approximately 09:11am to 10:11am, LPA made a physical plant inspection to insure the health and safety of the residents in care. Between 10:11am to 11:30am, interviews administrator, staff (S1) and five (5) of five residents were made. Between 11:30am to 12:00pm, a record review conducted.

Staff did not allow resident to leave their bed/Staff inappropriately pushed resident while in care:
In regards to the allegations, it was reported that Resident 1 (R1) was just left in bed. While attempting to get up to walk out of the facility and try and stretch to ease their back pain, facility staff demanded that R1 stay in bed, pushing them back into bed. No date and time provided to when this incident occurred. Moreover, there were no witnesses identified by the reporting party to corroborate the allegations.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024

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-20240421225937

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: NVM COMFORT HOMES	FACILITY NUMBER: 197610223
	VISIT DATE: 04/23/2024

NARRATIVE

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Interviews with both the administrator and S1 deny the allegations. R1 is never forced to stay in their room or in bed. R1 was always given the right to walk around the home during their brief stay at the facility. Administrator and S1 also confirmed that R1 would get staff supervision while walking outside of the home, as R1 cannot be left outside the home without supervision. Both administrator and staff also deny R1 ever being pushed in bed, or ever being aggressive to R1. Interviews with them reveal that it was R1, who was being aggressive towards staff on or around 04/18/24. Interviews with five (5) of the five residents at the facility also confirm that on or around 04/18/24, R1 was being aggressive towards staff, attempting to hit staff, and strike one of the caregivers (S1). Paramedics were called, and R1 was taken and admitted to the hospital for observation. Based on the information obtained, there wasn't enough evidence to prove that R1 was not allowed to leave their bed, or that staff inappropriately pushed R1. Therefore, the allegations are deemed Unsubstantiated at this time.

Staff unlawfully evicted a resident:
In regards to the allegation, it was reported that the licensee refused to take R1 back into facility, after R1 was cleared for discharge from the hospital. Interview with the administrator deny the allegation. Administrator stated R1 was sent to the hospital for back pain and agitation on or around 04/18/24. Administrator stated she needed to make a proper assessment of R1 first, before readmitting back to the facility, as R1 was previously aggressive towards her staff and the other residents, but she never issued an eviction. Interview made with R1's family and responsible person confirms that R1 was never evicted. R1's family indicated that they are in discussion with R1's case manager to place R1 at a more appropriate setting to address their aggressive behavior. R1's family also confirms that they decided to keep R1 at the hospital at this time and work with the case manager until they can place R1 at a more proper facility to better address their need. Based on the information obtained, there was insufficient evidence to corroborate the allegation of R1 being unlawfully evicted. Therefore, the allegations is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024

LIC9099 (FAS) - (06/04)

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