<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608083
Report Date: 06/16/2022
Date Signed: 06/17/2022 09:12:05 AM

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
06/09/2022 and conducted by Evaluator Angela Panushkina
COMPLAINT CONTROL NUMBER: 31-AS-20220609132619
FACILITY NAME:OUR SWEET HOME INC #2FACILITY NUMBER:
197608083
ADMINISTRATOR:ARUTYUNYAN, TINAFACILITY TYPE:
740
ADDRESS:10150 MELVIN AVETELEPHONE:
(818) 970-9586
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY:6CENSUS: 3DATE:
06/16/2022
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Tina Autyunyan, AdministratorTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are mishandling resident's finances
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately, 12:30pm Licensing Program Analysts (LPAs), Angela Panushkina and Joscelyn Martinez arrived at the facility in response to the above mentioned allegations. LPAs met with Tina Arutyunyan, Administrator, and explained the reason for the visit.

LPAs conducted a physical plant walk through to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. LPA did not observe any immediate health and safety issues during the visit.

To investigate the above allegation, LPAs interviewed the Administrator, one (1) out of one (1) staff member, three (3) out of three (3) residents and reviewed the records. A review of records received revealed that licensee was insured and bonded to handle residents P&I funds. In lieu of P&I logs, the Licensee/Administrator provided hand-written receipts (LIC405) with R1’s signature. Licensee/Administrator
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
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-20220609132619
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 #2
FACILITY NUMBER: 197608083
VISIT DATE: 06/16/2022
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
did maintain adequate safeguards and records for residents cash resources. Moreover, records reviews revealed that R1 did receive the full amount of P&I, including the full amount for the month of June 2022. Interview with S1 revealed that receipts are being provided to residents when asked to purchase items, groceries, etc. Interviews with R1 revealed that the P&I money received from the Administrator, for the month of June 2022, was used to make to make small purchases. R1 was also aware of the full amount received and deposited into the account and had a full knowledge of signing the document (LIC405). Based on information obtained through interviews and record reviews this allegation is deemed Unsubstantiated at this time.


Exit interview conducted and copy of the report given to the Administrator.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2