198603605-4-4-2024-31-AS-RORN-D5SUER-20240531153135

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603605
Report Date: 04/04/2024
Date Signed: 04/04/2024 01:10:37 PM

Unfounded

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
03/28/2024 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20240328102957

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: 86	DATE:	04/04/2024
		UNANNOUNCED	TIME BEGAN:	09:29 AM
MET WITH:	Varsenik Keshishyan		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff mishandled a resident while in care
Staff threw a resident's soiled undergarment at their face while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegations. It was alleged that Staff 1 (S1) was being rough while changing Resident 1 (R1). It was also alleged that S1 threw R1's soiled underwear at them. No injuries were reported and no witnesses identified. LPA met with the administrator, Varsenik Keshisyan, and advised her of the complaint. According to the administrator, this incident occurred at the Skilled Nursing (SN) portion of the campus. The administrator self reported the incident and submitted an SOC 341 to California Department of Public Health (CDPH), Ombudsman, and Law Enforcement (LE) on 03/27/24. CDPH and LE conducted their follow up visit on or around 03/28/24. SNF portion of the campus is overseen by CDPH. Because R1 resides at the SNF portion of the campus and the incident occurred there, and not the RCFE/Assisted Living portion of the campus, based on the information obtained, the above allegations are deemed Unfounded. A finding of unfounded means that the allegation is either false, could not have happened, and/or is without a reasonable basis. Administrator advised, and a copy of this report issued.
*due to technical issues, see hard copy for facility representative's signature

Unfounded

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: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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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