197610248-8-8-2023-31-AS-TAGD-CYFPBA-20231212100957

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610248
Report Date: 08/08/2023
Date Signed: 08/08/2023 02:28:49 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
08/02/2023 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20230802101732

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:	08/08/2023
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Naira Paroyan - Administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff calls resident names

Staff does not treat resident with respect

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced initial complaint visit at this facility to investigate the above allegations. LPA met with Administrator Naira Paroyan and explained the reason for the visit.

LPA conducted physical plant tour at 9:18 AM, requested copies of facility record relevant to the investigation at 10:00 AM and interviewed staff and residents between 10:15 AM to 12:45 PM. Regarding the allegation that Staff calls resident names, it was alleged that Resident #1 (R1) was threatened and called name by the staff. LPA's interview with three (3) aware residents today between 10:15 AM to 12:45 PM revealed that no one among them heard or witnessed any staff threaten or calling R1 names or any other resident at the facility. LPA's interview with two (2) staff present also revealed that no one among them threatened and/or called R1 or any client names. All of five (5) person interviewed at the facility however stated that it was the other way around, it was R1 who called the staff names. (continued on LIC 9099)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

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-20230802101732

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: VELVET CARE	FACILITY NUMBER: 197610248
	VISIT DATE: 08/08/2023

NARRATIVE

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(continued from LIC 9099)

Regarding the allegation that Staff does not treat resident with respect, it was alleged that staff was "very rude" and "bullies" R1. LPA's interview with three (3) aware residents today between 10:15 AM to 12:45 PM revealed that they were treated by the staff with dignity and all the staff are very respectful. All three (3) of them did not witness any staff being rude or bullied R1 or anyone at the facility. LPA's interview with the administrator revealed that R1 was being evicted due to non-payment and violation of house rules and denied bullying R1 or disrespected R1. Further, the two (2) staff present also denied being disrespectful or bullied R1 or any resident at the facility.

Based on the information gathered during this visit, the allegations are deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

LIC9099 (FAS) - (06/04)

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