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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801598
Report Date: 01/21/2022
Date Signed: 01/24/2022 12:14:17 AM



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. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2021 and conducted by Evaluator Zabel Chochian
COMPLAINT CONTROL NUMBER: 29-AS-20210625092304
FACILITY NAME:ANGELS IIIFACILITY NUMBER:
565801598
ADMINISTRATOR:JOANN TRUPIANOFACILITY TYPE:
740
ADDRESS:3216 YARDLEY PLACETELEPHONE:
(805) 581-9422
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY:0CENSUS: 0DATE:
01/21/2022
UNANNOUNCEDTIME BEGAN:
06:45 PM
MET WITH:Joann TrupianoTIME COMPLETED:
07:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff locked resident(s) in room.
Staff yell at resident(s)
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Zabel Chochian conducted a subsequent telephonic complaint visit to deliver the finding for the above allegation, as the facility was closed effective 11/02/2021. The complaint was initiated on 07/02/2021. LPA Chochian spoke with Administrator, Joann Trupiano and the reason for the call was explained. Following is a summary of the investigation:
Information was received that facility staff yell at residents and have locked a resident in a room. During the initial visit on 07/02/2021 at approximately 2 p.m., LPA Chochian and staff toured the facility and observed all bedrooms. LPA check all bedroom doors and found that all doors have no lock and able to open from the inside and out. Interview was conducted with the two (2) residents and staff at the time of inital visit. One resident briefly communicated with LPA and did not have any issues with staff. The other resident could not answer any basic questions asked by LPA. Staff interviewed denied allegations. No other witnessess available.
Based on observation and interviews conducted, there is not sufficient evidence to support allegations above. Therfore, allegations are deemed unsubstantiated at this time. Exit interview conducted. Copy of report and appeal rights provided to administrator via email.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4337
LICENSING EVALUATOR NAME: Zabel ChochianTELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022
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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