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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608595
Report Date: 02/16/2023
Date Signed: 02/16/2023 12:15:07 PM

Unfounded


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
02/09/2023 and conducted by Evaluator Tihesha Smith
COMPLAINT CONTROL NUMBER: 31-AS-20230209161338
FACILITY NAME:NEST, THEFACILITY NUMBER:
197608595
ADMINISTRATOR:MICHELLE WEISMANFACILITY TYPE:
740
ADDRESS:4100 HAYVENHURST AVENUETELEPHONE:
(818) 990-6896
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY:6CENSUS: 6DATE:
02/16/2023
UNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Patty PalaciosTIME COMPLETED:
12:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident sustained injuries while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Tihesha Smith made an unannounced 10-day complaint visit to this facility. LPA Smith met with facility staff and explained the reason for this visit. Staff informed LPA that Resident #1 does not reside at this facility. The administrator was contacted and LPA spoke with Licensee Michelle Weisman who confirmed R1 resides at another facility she operates.

Based upon the information obtained, this agency has investigated the complaint alleging resident sustained injuries while in care. Therefore, the allegation will be deemed Unfounded at this time.

“We have found that the complaint was Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.”

Exit interview conducted. Copy of this report issued.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
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 3