374602369-7-28-2020-08-AS-DPOL-BRZMZ3-20200730100229

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602369
Report Date: 07/28/2020
Date Signed: 07/28/2020 11:21:56 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/09/2020 and conducted by Evaluator Jennifer Lott

COMPLAINT CONTROL NUMBER: 08-AS-20200609152340

FACILITY NAME:	GOLDEN LIVING HEALTH MANAGEMENT, INC.		FACILITY NUMBER:	374602369
ADMINISTRATOR:	MNOYAN, MAYA S.		FACILITY TYPE:	740
ADDRESS:	3223 DUKE STREET		TELEPHONE:	(619) 222-1109
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92110
CAPACITY:	113	CENSUS: 70	DATE:	07/28/2020
		UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Administrator, Maya Mnoyan		TIME COMPLETED:	11:20 AM

ALLEGATION(S):

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Faciltiy did not honor admission agreement
Staff lack the ability to communicate with residents to meet their needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jennifer Lott contacted the facility by telephone via face time due to COVID-19, to deliver findings for the above allegations. LPA identified herself, explained the purpose of the call to Administrator, Maya Mnoyan. The Department’s investigation consisted of review of resident records, facility records and interviews with staff and residents.

It is alleged that on or about June 2020, the facility failed to provide transportation for R1, and therefore not honoring the admission agreement. Review of facility files and interviews with staff and residents revealed that twenty-four (24) hours’ notice is required for all transportation needs in order to allow for scheduling of a driver. Residents may either call the front office and speak with someone to make a reservation or a resident may come to the front office and sign the transportation book themselves and make their reservation. Facility records and interviews revealed that R1 did not call nor did they sign the reservation book to make a reservation for transportation.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Tony Girolami	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR NAME: Jennifer Lott	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2020

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 08-AS-20200609152340

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: GOLDEN LIVING HEALTH MANAGEMENT, INC.	FACILITY NUMBER: 374602369
	VISIT DATE: 07/28/2020

NARRATIVE

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It is also alleged that staff lack the ability to communicate with residents to meet their needs. Although the complainant was unable to refer to specific staff that they were unable to communicate with and they were unable to provide names of residents who stated they could not communicate with staff, interviews revealed that staff and residents can communicate without issue.

This agency has investigated the complaint alleging facility did not honor admission agreement and staff lack the ability to communicate with residents to meet their needs. The Department has found that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted and a copy of this report, Appeal and Licensee Rights (LIC 9058 01/16) and Confidential Names (LIC 811) were provided to the Administrator, Maya Mnoyan via email. An electronic email read receipt confirms the documents were received.

SUPERVISOR'S NAME: Tony Girolami	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR NAME: Jennifer Lott	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2020

LIC9099 (FAS) - (06/04)

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