198603605-3-29-2023-28-AS-MVAO-D27SU8-20240206131044

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603605
Report Date: 03/29/2023
Date Signed: 03/29/2023 03:19:06 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/23/2023 and conducted by Evaluator Troy Agard

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230323162150

FACILITY NAME:	ARARAT GARDENS		FACILITY NUMBER:	198603605
ADMINISTRATOR:	KESHISHYAN, VARSENIK		FACILITY TYPE:	741
ADDRESS:	1230 EAST WINDSOR ROAD		TELEPHONE:	(818) 244-7219
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	175	CENSUS: 96	DATE:	03/29/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Varsenik Keshishyan, Administrator		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility has infestation of rodents

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 03/29/2023 Licensing Program Analyst (LPA) Troy Agard initiated a complaint investigation at the above facility to address the following allegation(s). LPA Agard was met by Varsenik Keshishyan, Administrator. LPA explained the purpose of this visit was to gather information, conduct interviews and deliver findings for this complaint.

The investigation consisted of the following: On 03/29/2023 LPA Agard initiated a complaint investigation. LPA toured the facility kitchen, neighboring closets and requested records. The following records were requested: 1) staff roster, 2) resident roster, 3) any invoices from pest control, 4) any documentation pertaining to the complaint. All records were received at the time of visit.

Cont. on 9099C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

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 4

Control Number 28-AS-20230323162150

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: ARARAT GARDENS	FACILITY NUMBER: 198603605
	VISIT DATE: 03/29/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The investigation revealed the following: Regarding the allegation… Facility has infestation of rodents. It’s being alleged the facility was observed to have rodent droppings during an inspection with the Department of Public Health. LPA interviewed 8 out of 80 staff in total. 1 out of 8 confirmed the allegation. S1 states, “an inspector came in for a visit. They opened a closet and it had rodent droppings. They had the maintenance team unscrew a metal cabinet in the kitchen and there were droppings behind there and behind the oven. Our food license got suspended for 48 hours. They came back 2 days later. We did a deep cleaning and outsourced our food. We put a new cleaning program in place. We fumigated and sprayed. We’ve had traps placed as an extra precaution. The kitchen team is doing another deep cleaning this week and next to make sure we get rid of whatever was present.” S2-S8 all denied observing any evidence of rodents. S2 states, “I’ve been working here for years and I never seen anything like that.”

During interviews with residents, LPA interviewed 9 out of 96. 1 out of 9 confirmed the allegation. R5 states, “we did have a rodent in the heater when we moved in. You could tell because of the smell coming from the heater. When they came to open it up, they removed a dead mouse.” Residents 1-4 and 6-9 all denied the allegation. Citing, the facility is generally clean and not having any issues with rodents. R1 states, “I’ve been here 20 years. I have not seen any rodents. I spoke to a former member of the church behind us and they have a rat infestation problem. That’s probably where they may come from but it’s generally not here.” R9 states, “Never observed rodents or bugs, just me. This place is clean. It was one of the reasons I came here.”
During a record review, LPA reviewed the following documents: Per an inspections report conducted by the Los Angeles Department of Public Health (LADPH) on 03/17/2022, rodent droppings was observed in the kitchen area and nearby storage closet. LPA reviewed invoices from Ecolab Pest Elimination Division dated for 03/17/2023, 03/18/2023, 03/19/2023 which show services were rendered, inspections were completed, deep cleaning was performed, rodent traps were placed and no rodent activity was noted during all 3 dates listed. LPA reviewed invoices from Property Care Building Services dated 03/18/2023 which details the facility’s main kitchen appliances, walls, and floors have been deep cleaned. On 03/19/2023, LADPH returned for a reinspection. At the time of inspection, it was noted that there was no longer a presence of rodents. The facility was cleared to resume operations in their kitchen. LPA reviewed invoices dated 03/22/2023 which indicates the facility conducted an emergency deep cleaning of the facility kitchen. Per the report, all food and beverage areas were treated, and traps were set.

Cont. on 9099C

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 28-AS-20230323162150

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: ARARAT GARDENS	FACILITY NUMBER: 198603605
	VISIT DATE: 03/29/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on the interviews with staff, residents and a record review, the preponderance of evidence standard has been met, therefore the above allegation(s) is (are) found to be Substantiated. California Code of Regulations, Title 22 Division (6) and Chapter (8) are being cited on the attached LIC9099-D.

An exit interview was conducted, and a hard copy was provided with appeal rights.
See LIC 9009-D on the next page

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 28-AS-20230323162150

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: ARARAT GARDENS	FACILITY NUMBER: 198603605
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/29/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/29/2023 Section Cited CCR 87303(a)	1 2 3 4 5 6 7	87303 Maintenance and Operation The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Facility is currently addressing this deficiency. Facility has rendered several services to address the deficiency surrounding a rodent infestation and has contract services that will continue to monitor. The facility has already implemented a plan of correction therefore the POC is cleared as of today.
	8 9 10 11 12 13 14	Based on interviews and record review, rodent droppings were observed within the facility.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 4