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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850206
Report Date: 10/15/2024
Date Signed: 10/15/2024 02:51:10 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
10/07/2024 and conducted by Evaluator Erica Mosley
COMPLAINT CONTROL NUMBER: 29-AS-20241007223014
FACILITY NAME:A'VILLAFACILITY NUMBER:
195850206
ADMINISTRATOR:HAKOBYAN, ANNAFACILITY TYPE:
740
ADDRESS:6532 GLORIA AVE.TELEPHONE:
(310) 435-1445
CITY:LAKE BALBOASTATE: CAZIP CODE:
91406
CAPACITY:6CENSUS: 6DATE:
10/15/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:ANNA HAKOBYAN- Administrator TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Uncleared staff are providing care and supervision.
Staff do not communicate effectively with the residents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Erica Mosley conducted an unannounced initial 10-day complaint visit to investigate the above allegations. Upon arrival at approximately 9:45 am, LPA Mosley were greeted by The Administrator Anna Hakobyan and the reason for the visit was explained.

On 10/07/2024, the Department received a complaint regarding the following allegations, Uncleared staff are providing care and supervision, and staff do not communicate effectively with residents. LPA toured the physical plant areas inside and outside to ensure there are no immediate health and safety hazards and facility is in compliance with Title 22 Regulations.

Report Continued on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Erica Mosley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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 2
Control Number 29-AS-20241007223014
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: A'VILLA
FACILITY NUMBER: 195850206
VISIT DATE: 10/15/2024
NARRATIVE
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On the allegation, Uncleared staff are providing care and supervision it is the concern of the Reporting Party (RP) that staff are not cleared to work at the facility. To investigate this complaint, LPA conducted in person interviews with the Administrator, four (4) Staff, four (4) out of six (6) residents between 10:00 am – 11:45 am. LPA also obtained pertinent documents to the investigation and reviewed facility records.

File review was conducted on all staff. File review revealed that all staff are cleared, and all records are in order. All staff are listed on the LIC 500 personnel report along with the State Agency facility personnel report summary.
Based on information obtained, there is insufficient evidence to support the allegations occurred. Therefore, the allegation uncleared staff are providing care and supervision is deemed unsubstantiated at this time.

On the allegation, staff do not communicate effectively with residents it is the concern of the RP that staff are unable to effectively communicate with residents. To investigate this complaint, LPA conducted interviews with Residents, Staff, and Administrator.
Interviews with four (4) residents currently residing at the facility revealed that the staff can effectively communicate and treat the residents with dignity and respect. Residents noted that one (1) staff needs to be spoken to slower than the other staff to fully comprehend what is being said but is not an issue. Residents stated that the staff are able to effectively understand and communicate the residents needs. Residents also noted that if they are not able to effectively communicate with a specific staff there is always a staff member on duty who can translate for them. In addition, residents stated that they do not have any issues communicating with staff or with their needs being met. Interviews with four (4) staff revealed that English is the primarily spoken language among the residents. All staff were able to communicate with the LPA basic knowledge and procedures in the event of an emergency. Staff noted that there is always one (1) staff who is fluent in English who can assist if needed, however rare. Staff also noted that staff who are not fluent in English are currently enrolled in an online English course to better communicate. Interview with Administrator revealed that staff are knowledgeable in their duties and can effectively communicate with residents. Some staff may require more patience in comprehension however basic conversation and understanding is sufficient. Administrator noted that staff are also enrolled into online English course to gain more English proficiency.
Based on information obtained, there is insufficient evidence to support the allegations occurred. Therefore, the allegation staff do not communicate effectively with residents is deemed unsubstantiated at this time. Exit interview conducted. A copy of the report and appeal rights provided.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Erica Mosley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC9099 (FAS) - (06/04)
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