197610318-1-30-2024-31-AS-EMIR-D2VP5R-20240228100108

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610318
Report Date: 01/30/2024
Date Signed: 01/30/2024 02:27:05 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
01/25/2024 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20240125085213

FACILITY NAME:	EMERALD SENIOR CARE,INC.		FACILITY NUMBER:	197610318
ADMINISTRATOR:	HAYRAPETYAN, ELEN		FACILITY TYPE:	740
ADDRESS:	10401 ENCINO AVE.		TELEPHONE:	(747) 300-2232
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 6	DATE:	01/30/2024
		UNANNOUNCED	TIME BEGAN:	09:04 AM
MET WITH:	Hovhannes Papazyan		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff do not assist resident with obtaining therapy services
Staff do not provide adequate food service to resident
Staff are not allowing resident to move out of the facility
Staff prevent resident from having visitors

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, Hovhannes Papazyan, and advised him of the complaint. Today's investigation consisted of a physical plant inspection to insure the health and safety of the residents, which was made approximately 9:15am to 10:00am, interviews with the administrator, staff and residents, held at approximately 10:00am to 12:00pm, and record review, held between 12:00pm to 1:00pm.

Staff do not assist resident with obtaining therapy services:
In regards to the allegation, it was reported that the licensee has failed to assist Resident 1 (R1) with obtaining physical therapy (PT) for their legs. According to the administrator, PT was never ordered by R1's primary physician or R1's hospice services. Interview with R1 was made, and R1 deny that they require PT. Interview with the hospice agency also do not corroborate with the alegation of R1 not getting PT. The hospice nurse stated, PT was never ordered by their agency, nor R1's primary physician. PT is not part of

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: 01/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024

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-20240125085213

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: EMERALD SENIOR CARE,INC.	FACILITY NUMBER: 197610318
	VISIT DATE: 01/30/2024

NARRATIVE

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R1's hospice care plan. Based on the information obtained, there was insufficient evidence to prove that Staff do not assist resident with obtaining therapy services. Therefore the allegation is deemed Unsubstantiated at this time.

Staff do not provide adequate food service to resident:
In regards to the allegation, it was reported that R1 is not being fed regular food, but always given Ensure. R1 does have problems swallowing at times, but does not require a special diet. Interview with R1 deny the allegation. R1 states they are provided a variety of food, aside from Ensure. Interviews with the other five residents also deny the allegation of not being provided an adequate food service. Administrator stated R1 is given regular food, chopped at times, to satisfy instructions from R1's physician's report. Ensure is only given as an alternative, if R1 only prefers to have it. LPA was also able to witness food preparation at the time of the visit, and observed R1's food being prepared, chopped and blended to fit their need. Based on the information obtained, there was insufficient evidence to prove that staff do not provide adequate food service to R1. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff are not allowing resident to move out of the facility:
In regards to the allegation, it was reported that staff member are refusing to let R1 out. Interviews with the administrator deny the allegation, stating, R1 was asked if they want to move out. LPA interviewed R1, who stated they like living here, and prefer to live here. R1 further stated they are responsible for themselves at this time. Based on the information obtained there was insufficient evidence to corroborate the allegation of staff not allowing R1 to move out of the facility. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff prevent resident from having visitors:
Regarding the allegation, interviews were made and all individuals interviewed deny the allegation. According to the administrator, visiting hours are 10am-7pm every day, or the guest can call ahead of time, and accommodations outside of visiting hours will be made. Interviews with R1 deny the allegation, stating they get visitation rights. Interviews with the other five residents do not corroborate with the allegation. Based on the information obtained, there was insufficient evidence to prove staff prevented R1 from having visitors. Therefore, the allegation 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: 01/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024

LIC9099 (FAS) - (06/04)

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