197608349-3-18-2025-31-AS-EMIR-DJDVG9-20250708162509

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608349
Report Date: 03/18/2025
Date Signed: 03/18/2025 02:56:33 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
03/11/2025 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20250311124016

FACILITY NAME:	ABBEY ROAD VILLA		FACILITY NUMBER:	197608349
ADMINISTRATOR:	MARINE KARAPETIAN		FACILITY TYPE:	740
ADDRESS:	14132 HUBBARD STREET		TELEPHONE:	(818) 837-0077
CITY:	SYLMAR	STATE: CA	ZIP CODE:	91342
CAPACITY:	78	CENSUS: 66	DATE:	03/18/2025
		UNANNOUNCED	TIME BEGAN:	09:11 AM
MET WITH:	Marine Karapetian		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff did not prevent resident from hitting another resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegation. LPA met with the administrator, Marine Karapetian, and advised her of the complaint. It was reported that staff did not prevent Resident 2 (R2) from slapping Resident 1 (R1) in the face. Moreover, staff did not intervene or provide any assistance for R1. Today's investigation consisted of interviews with staff and residents. LPA also conducted a physical plant inspection to insure the health and safety of the residents, and obtained copies of resident records for review.

Interviews with the administrator and staff reveal that the incident occurred at around 8:15am on 03/11/25. Both administrator and staff state that an argument arose between the residents over a dining room chair. Incident occurred early morning, as residents were getting ready for breakfast, therefore no other residents were present yet at the time of the altercaion. Administrator acknowledged both residents were being aggressive towards each other, but deny the lack of supervision by staff, as both residents were redirected

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025

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 31-AS-20250311124016

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: ABBEY ROAD VILLA	FACILITY NUMBER: 197608349
	VISIT DATE: 03/18/2025

NARRATIVE

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immediately. Neither residents sustained an injury during the conflict. This was the first time that R1 and R2 had an altercation. No previous incidents between the two in the past. According to the administrator, R1 has a history of confusion, but is not aggressive. R1 does have a history of making false accusations and doesn't adjust as well socially. R2 is active amongst the community, but has no history of being aggressive towards peers. R2 also does not have a history of confusion or being aggressive. Interviews with ten (10) of ten residents could not confirm the allegation.

In addition to interviews, LPA was able to review surveillance of the incident that occurred at 8:15am, on 03/11/25. LPA observed both R1 and R2 in the dining room together, when the altercation between the two occurred. LPA observed and confirmed that it was R1 that struck R2, but staff was present, and did intervene between the two residents, redirecting both residents.

Although there was an altercation between R1 and R2, that lead to R1 striking R2, there wasn't enough evidence to prove that staff did not prevent resident from hitting another resident in care. as there was staff supervision present to intervene and redirect both residents. Moreover, licensee did submit an Incident Report (IR) to the Licensing agency regarding the incident. Therefore, based on the information obtained the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025

LIC9099 (FAS) - (06/04)

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