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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609001
Report Date: 11/15/2024
Date Signed: 11/15/2024 01:35:16 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
11/08/2023 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20231108105614
FACILITY NAME:ROYALTY ASSISTED LIVINGFACILITY NUMBER:
197609001
ADMINISTRATOR:AVETIAN, LIDUSHFACILITY TYPE:
740
ADDRESS:10940 STRATHERN STREETTELEPHONE:
(818) 436-9088
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY:10CENSUS: 9DATE:
11/15/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Olga RodriguezTIME COMPLETED:
01:35 PM
ALLEGATION(S):
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Staff do not allow residents to call 9-1-1
Staff did not provide proper restroom accomodations to residents in care
INVESTIGATION FINDINGS:
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At 9:30 a.m. on 11/15/24 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with staff and later the administrator and disclosed the reason for the visit.

To investigate the allegations above, LPA Christopher Alemoh conducted an initial visit on 11/16/23 and interviewed one (01) out of three (03) staff and seven (07) out of nine (09) residents and collected and reviewed records including but not limited to physician reports, appraisal needs and service plan, admission agreements, and the Client Roster between 3:00 p.m. and 5:00 p.m. LPA Alemoh conducted a subsequent visit on 01/23/24 and conducted a physical plant tour at 9:35 a.m., requested copies of facility documents relevant to the investigation at 10:20 a.m. and interviewed residents and staff between 10:50 a.m. to 3:00 p.m. Today, LPA Reed interviewed five (05) out of nine (09) residents and one (01) staff between 10:00 a.m. and 11:15 a.m., toured the facility at 10:15 a.m., and reviewed records including but not limited to face sheets and physician reports at 11:30 a.m.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
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-20231108105614
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ROYALTY ASSISTED LIVING
FACILITY NUMBER: 197609001
VISIT DATE: 11/15/2024
NARRATIVE
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Regarding the allegation "Staff do not allow residents to call 9-1-1” it was alleged staff did not call 9-1-1 after Residents #1 (R1) slipped and fell. Additionally, the owner does not want residents calling 9-1-1. Interview with the administrator at 10:15 a.m. today revealed 9-1-1 was not required for R1’s fall as they were not injured. The administrator further stated that residents are allowed to call 9-1-1 from their cell phones or the house phone. The administrator never told residents they were not allowed to call 9-1-1. LPA called the house telephone at 10:30 a.m. today and determined the phone to be operational. Interviews with five (05) out of five (05) residents interviewed revealed they were all allowed to call 9-1-1. Interview with Resident #6 (R6) at 11:15 a.m. revealed staff called 9-1-1 recently for a resident in need. Interview with Resident #4 (R4) at 10:50 a.m. today revealed Staff #2 (S2) has called 9-1-1 for residents in the past. Based on interviews and observations, staff allow residents to call 9-1-1. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Staff did not provide proper restroom accommodations to residents in care" it was alleged that R1 fell in a bathroom due to a wet floor. Additionally, a restroom had a door which did not close. During facility tour today, LPA observed two (02) out of two (02) bathrooms to be sanitary and in good repair. Both doors to the bathrooms closed properly. No floors were wet. Interviews with five (05) out of five (05) residents revealed the bathrooms are clean and safe to their likings. Interview with Staff #1 (S1) at 10:00 a.m. today revealed the bathrooms are cleaned everyday, at least two (02) to three (03) times each day. Based on observations and interviews, the facility restrooms are suitable for residents. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2