197610248-10-16-2023-31-AS-NMAN-CXEUFY-20231109143332

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610248
Report Date: 10/16/2023
Date Signed: 10/16/2023 03:57:04 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
06/23/2023 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20230623152503

FACILITY NAME:	VELVET CARE		FACILITY NUMBER:	197610248
ADMINISTRATOR:	PAROYAN, NAIRA		FACILITY TYPE:	740
ADDRESS:	15731 LEMARSH ST.		TELEPHONE:	(818) 891-9186
CITY:	NORTH HILLS	STATE: CA	ZIP CODE:	91343
CAPACITY:	6	CENSUS: 6	DATE:	10/16/2023
		UNANNOUNCED	TIME BEGAN:	09:39 AM
MET WITH:	Cynthia Cherriel		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff speaks inappropriately to resident in care
Staff do not provide adequate food service to resident in care
Staff refuse to provide hygiene supplies to resident in care
Resident in care is not provided privacy by facility staff

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to the facility to investigate the above allegation. LPA met with Cynthia Cherriel and explained the reason for the visit. Administrator Naira Paroyan designated Cynthia Cherriel as the responsible person to sign and accept the report.

--- Staff speaks inappropriately to resident in care.

It was alleged that staff verbally abuse residents. To investigate the allegation on 06/26/2023 LPA interviewed one (01) staff and one (01) resident from 9:10 AM to 09:40 AM. On 10/16/2023, LPA interviewed one (01) additional staff and five (05) out of six (06) residents from 12:15 PM – 1:30 PM. During interviews with staff, all staff stated that they do not speak to residents inappropriately and are kind to all residents.

(CONT. LIC812-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 31-AS-20230623152503

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: VELVET CARE	FACILITY NUMBER: 197610248
	VISIT DATE: 10/16/2023

NARRATIVE

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Staff added that Resident #1 (R1) would use foul language towards staff and residents. During interviews with residents, R1 stated that staff are verbally abusive, however, all other residents stated that staff do not speak to them inappropriately.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

--- Staff do not provide adequate food service to resident in care.

It was alleged that facility is not providing meals according to dietary needs. To investigate the allegation on 06/26/2023 LPA interviewed one (01) staff and one (01) resident from 9:10 AM to 09:40 AM. On 10/16/2023, LPA interviewed one (01) additional staff and five (05) out of six (06) residents from 12:15 PM – 1:30 PM. During interviews with staff, all staff stated that they are aware of the residents’ dietary needs, such as no sodium and low sugar diets, and provide meals accordingly. Staff added that resident would grab the saltshaker, add salt and use other ingredients against their advice. During interviews with residents, Resident #1 (R1) stated that staff are not providing no sodium diet meals, however, all other residents stated that staff provide adequate food services according to their diet.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff refuse to provide hygiene supplies to resident in care

It was alleged that facility does not provide residents with toilet paper. To investigate the allegation on 06/26/2023 LPA conducted physical plant tour at around 08:15 AM and interviewed one (01) staff and one (01) resident from 9:10 AM to 09:40 AM. On 10/16/2023, LPA interviewed one (01) additional staff and five (05) out of six (06) residents from 12:15 PM – 1:30 PM. During the physical plant tour, LPA observed toilet paper in each bathroom and that the facility had approximately 30 rolls of toilet paper and 10 rolls of paper towels in storage cabinets. During interviews with staff, all staff stated that toilet paper is always made available to residents. During interviews with residents, Resident #1 (R1) stated that staff are not providing toilet paper, however, all other residents stated that they always have toilet paper available to them.
(CONT. on LIC812-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20230623152503

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: VELVET CARE	FACILITY NUMBER: 197610248
	VISIT DATE: 10/16/2023

NARRATIVE

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Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

--- Resident in care is not provided privacy by facility staff

It was alleged that staff listen to resident’s telephone conversations. To investigate the allegation on 06/26/2023 LPA interviewed one (01) staff and one (01) resident from 9:10 AM to 09:40 AM. On 10/16/2023, LPA interviewed one (01) additional staff and five (05) out of six (06) residents from 12:15 PM – 1:30 PM. During interviews with staff, all staff stated that they do not listen to resident’s conversations and give residents plenty of privacy. During interviews with residents, Resident #1 (R1) stated that staff listen in on their conversation and are always being nosey, however, all other residents stated that they have enough privacy during telephone conversations.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards noted during the visit.

Exit interview conducted and a copy of the report was issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC9099 (FAS) - (06/04)

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