195850317-10-8-2024-29-AS-KLOZ-DAHTLW-20241029145012

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850317
Report Date: 10/08/2024
Date Signed: 10/08/2024 04:22:12 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
10/01/2024 and conducted by Evaluator Erica Mosley

COMPLAINT CONTROL NUMBER: 29-AS-20241001091309

FACILITY NAME:	STARLIGHT FACILITY INC.		FACILITY NUMBER:	195850317
ADMINISTRATOR:	TADEVOSYAN, NELLI		FACILITY TYPE:	740
ADDRESS:	7647 TUJUNGA AVE.		TELEPHONE:	(818) 378-7069
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91605
CAPACITY:	6	CENSUS: 5	DATE:	10/08/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator Nelli Tadevosyan		TIME COMPLETED:	04:35 PM

ALLEGATION(S):

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Staff yelled at resident while in care.
Staff are physically aggressive with residnets.
Staff are unable to communicate with residents due to language barrier.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Erica Mosley conducted an unannounced initial 10-day complaint visit to investigate the above allegation. Upon arrival at approximately 9:30 am, LPA Mosley was greeted by caregiver, Ruzanna Melikyan who called the Administrator to inform them of the visit. The Administrator Nelli Tadevosyan arrived shortly after and the reason for the visit was explained.

On 09/27/2024, the Department received a complaint regarding the following allegations, Staff yelled at resident while in care, Staff are physically aggressive with residents, and Staff are unable to communicate with residents due to language barrier. 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: 10/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

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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Control Number 29-AS-20241001091309

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: STARLIGHT FACILITY INC.	FACILITY NUMBER: 195850317
	VISIT DATE: 10/08/2024

NARRATIVE

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Report continued from LIC9099...
On the allegation, Staff yelled at resident and are physically aggressive with residents in care it is the concern of the Reporting Party 1 (RP1) and Reporting Party 2 (RP2) that Staff 1 (S1) is yelling at the residents on a regular basis and and that staff are physically aggressive with residents. To investigate this complaint, LPA conducted telephonic interviews with RP 1, RP 2, and a former resident. In person interviews were conducted with the Administrator, Staff, three (3) out of five (5) residents, two (2) home health CNA Shower nurses, and one (1) family member / visitor at the time of the visit between 10:00 am – 12:30pm. LPA also obtained pertinent documents to the investigation and reviewed facility records.
Interviews with three residents currently residing at the facility revealed that the staff treat the residents with dignity and respect. Residents noted that two (2) out of three (3) residents are hard of hearing and require others to be louder when speaking to them. However, there is a difference between yelling and projecting the voice. Residents noted that staff project at times but do not yell at them. In addition, staff are also not physically aggressive with them. Residents stated they are handled with care and stability to ensure their safety, but not aggressively. Interviews with home health CNA shower nurses revealed that staff are attentive and caring. CNA 1 and CNA 2 are at the facility two (2) to three (3) times a week and have not witnessed or heard staff yelling at residents. CNA’s were asked if they have seen any unexplained markings on residents that would be from aggressive behavior such as pulling or pushing. CNA’s both stated they have not witnessed any unexplained marking or anything concerning. Interviews with family member / visitor revealed that they are at the facility three (3) to four (4) times a week, unannounced and have not seen staff yell at residents or any type of aggressive behavior. Family member / visitor stated that the staff have been wonderful and love it at the facility and the quality of care is exceptional. Interview with S1 revealed that residents are not yelled at or mistreated in anyway. S1 stated they have never yelled at a resident, however, must project the voice to be heard by residents who have trouble hearing. Interview with Administrator revealed that no complaints of staff yelling have been made or witnessed. Administrator has no issues with S1s performance. File review was conducted and support that no disciplinary action has been noted on any staff.
Report Continued on LIC9099C...

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Erica Mosley
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20241001091309

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: STARLIGHT FACILITY INC.	FACILITY NUMBER: 195850317
	VISIT DATE: 10/08/2024

NARRATIVE

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Report continued from LIC9099-C...

Based on information obtained, there is insufficient evidence to support the allegations occurred. Therefore, the allegations of Staff yelled at resident while in care and Staff are physically aggressive with residents are deemed unsubstantiated at this time.

On the allegation, Staff are unable to communicate with residents due to language barrier it is the concern of the RP2 that S1 is unable to communicate with residents due to limited understanding of English. To investigate this complaint, LPA conducted interviews with Residents, S1, and Administrator.

Interviews with residents revealed that they can communicate with S1 regarding their basic needs and had no concerns regarding communication. However, if further understanding or a complex conversation is needed, the Administrator is able to translate or the use of a translator application on the phone of S1. Interview with S1 revealed they are able to assist the residents with their needs and that they are knowledgeable in the basic process of emergency procedures and able to assist paramedics in English if needed. Administrator is also readily available and able to translate and assist when and if needed. Administrator noted that S1 is in the process of learning more English.

Based on information obtained, there is insufficient evidence to support the allegation occurred. Therefore, the allegation of Staff are unable to communicate with residents due to language barrier 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: 10/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

LIC9099 (FAS) - (06/04)

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