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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608325
Report Date: 07/11/2022
Date Signed: 07/11/2022 03:31:43 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
02/03/2022 and conducted by Evaluator Tihesha Smith
COMPLAINT CONTROL NUMBER: 31-AS-20220203090149
FACILITY NAME:ZANN DAILY CAREFACILITY NUMBER:
197608325
ADMINISTRATOR:ANN SOLAKYANFACILITY TYPE:
740
ADDRESS:11500 BAIRD AVENUETELEPHONE:
(818) 635-9471
CITY:NORTHRIDGESTATE: CAZIP CODE:
91326
CAPACITY:6CENSUS: DATE:
07/11/2022
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:TIME COMPLETED:
03:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff leaves residents unattended.
INVESTIGATION FINDINGS:
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5
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9
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13
Licensing Program Analyst (LPA) Tihesha “Lynn” Smith conducted an unannounced complaint investigation visit at 9:45 am at this facility. LPA met with Administrator Ann Solakyan at 10:35 am. Administrator states census is five (5). Administrator provided LPA with resident files and revealed she had to return to the hospital for client #5 status (C5) and to take(C5) to other medical appointments if not under hospital observation.

Concerns were that staff leaves residents unattended.
During investigation on 07/08/2022 between 12:15pm - 12:45pm, LPA Smith interviewed facility staff. Interviews revealed that there is a live-in caregiver onsite, and administrator coordinates coverage with on call staff to provide additional coverage as needed.
During todays visit LPA reviewed facility files at 10:40 am and obtained copies of pertinent documents at 1:55 pm. LPA interviewed three (3) of the five (5) clients present in the facility starting at 12:40 pm. Interviews revealed that all three (3) clients are enjoying their residency at the facility.
(Cont to 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022
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-20220203090149
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: ZANN DAILY CARE
FACILITY NUMBER: 197608325
VISIT DATE: 07/11/2022
NARRATIVE
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(Cont from 9099)

The clients revealed the staff are pleasant and are always available when they need assistance or have questions. C1 revealed that Staff # 1 (S1) is always in facility and very busy assisting everyone and it’s five (5) of them and one (1) of her at times. LPA observed (S1) making snacks, lunch, providing assistance, and answering clients’ questions during this visit.

Based on interviews and information obtain during the course of the investigation the allegation is deemed
UNSUBSTANTIATED at this time.

Exit interview conducted. Copy of report printed.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2