197607711-2-13-2024-31-AS-EMIR-D3GTYH-20240318150848

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197607711
Report Date: 02/13/2024
Date Signed: 02/13/2024 02:22:41 PM

Unsubstantiated

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
02/05/2024 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20240205145009

FACILITY NAME:	OUR SWEET HOME INC		FACILITY NUMBER:	197607711
ADMINISTRATOR:	ARUTYUNYAN, TINA		FACILITY TYPE:	740
ADDRESS:	16518 DEVONSHIRE ST		TELEPHONE:	(818) 970-9586
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 5	DATE:	02/13/2024
		UNANNOUNCED	TIME BEGAN:	09:43 AM
MET WITH:	Norma Alfeche, Manual Soriano		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not assist resident in a timely manner
Staff threatened resident in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit at the facility to investigate the above allegations. LPA met with staff, Norma Alfeche and Manuel Soriano and advised them of the complaint. Staff notified the administrator, Tina Arutyunyan of the complaint over the telephone, and she was advised of the allegations. Today's investigation consisted of interviews with the administrator, staff and residents. LPA also conducted a physical plant inspection of the facility to insure the health and safety of the residents in care, and a record review.

Staff did not assist Resident 1 (R1) in a timely manner:
In regards to the allegation, it was reported that Resident 1 (R1) slipped, fell, and remained on the floor for over thirty minutes. Interviews with the administrator and staff deny the allegation. According to the administrator, R1 only lived at the facility for approximately a month, but never expressed any complaints or concerns regarding the lack of supervision. Interviews with five (5) of five residents also do not corroborate

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024

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 31-AS-20240205145009

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: OUR SWEET HOME INC	FACILITY NUMBER: 197607711
	VISIT DATE: 02/13/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

with the allegation as residents expressed no concerns regarding lack of supervision, or ever witnessing R1's fall. LPA conducted a phone interview with R1, who no longer resides at this facility. Phone call was made to the facility where R1 currently resides at. Per R1, staff never mistreated them and staff was able to meet all their needs. No complaints or concerns regarding the care provided at this facility. R1 did confirm of a fall they experienced while at the facility, but denies ever being left on the floor for a long period of time. R1 added that staff assisted right away after the fall. Furthermore, R1 stated they didn't require an immediate medical attention after the fall. Based on the information received, there was insufficient evidence to prove staff did not assist resident in a timely manner. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff threatened resident in care:
In regards to the allegation, it was reported that because R1 was having trouble paying facility fees, staff confronted R1 by putting their belongings in trash bags and threatened to place the trash bags out on the street. Interviews with the administrator and staff deny the allegation. The administrator did state that R1 could not afford the monthly rent at this facility, but was able to assist R1 in finding a facility more suitable for R1's needs and finances. Interviews with five (5) of five residents at the facility do not corroborate with the allegation. There were no concerns made by these residents that staff had ever threatened them or mistreated them. LPA conducted a phone interview with R1, who no longer resides at this facility. Phone call was made to the facility where R1 currently resides at. R1 denies ever being threatened or being treated inappropriately by facility staff. R1 confirmed that rent was high at this facility, but was provided assistance to locate another facility suitable to their finances. No further concerns were expressed by R1. Furthermore, LPA made a phone interview with placement agency that was able to assist in R1's placement. They confirmed that the place R1 transferred to satisfied their needs, and was more suitable to their finances. They also expressed no concerns from R1. Based on the information received, there was insufficient evidence to prove that staff threatened a resident in care. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2