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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609077
Report Date: 10/02/2020
Date Signed: 05/16/2021 10:28:40 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
08/13/2020 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20200813082358
FACILITY NAME:ALL ABOARD!FACILITY NUMBER:
197609077
ADMINISTRATOR:AVETISYAN, HEGHINEFACILITY TYPE:
740
ADDRESS:10629 COLLETT AVETELEPHONE:
(818) 636-8985
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 4DATE:
10/02/2020
UNANNOUNCEDTIME BEGAN:
09:03 AM
MET WITH:Andy Ter-nersesian - AdministratorTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Illegal Eviction
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Gary Tan conducted a subsequent complaint investigation for the allegation listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Administrator Andy Terner.

On 08/18/20, LPA Tan conducted initial virtual visit at this facility, LPA obtained relevant documents and interviewed the administrator. On 08/17/20 LPA interviewed Resident #1 (R1)'s case worker and on 10/01/20, LPA interviewed the family member of R1. On 02//07/21 and 05/16/21, LPA attempted to interview R1 but R1 is still at the Skilled Nursing Facility (SNF). LPA interview with the family member of R1 revealed that R1 was not evicted and was aware that R1 was the one who did not want to go back to the facility. LPA interview with R1's case worker confirmed that it was R1 who decided not to come back at the facility. Based on the information gathered during this visit the allegation is deemed unsubstantiated at this time. A telephonic exit interview was conducted with Administrator Andy Terner and a hard copy was provided via email for signature.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2020
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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