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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610298
Report Date: 09/18/2024
Date Signed: 09/18/2024 01:38:12 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.RO, 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
09/16/2024 and conducted by Evaluator Gina Saucedo
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20240916093637
FACILITY NAME:LINDLEY RESIDENTIAL CAREFACILITY NUMBER:
197610298
ADMINISTRATOR:AVETISYAN, ARMENUHIFACILITY TYPE:
740
ADDRESS:18124 VINTAGE STREETTELEPHONE:
(818) 983-2224
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:6CENSUS: 6DATE:
09/18/2024
UNANNOUNCEDTIME BEGAN:
12:59 PM
MET WITH:Armenuhi AvetisyanTIME COMPLETED:
01:55 PM
ALLEGATION(S):
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Staff denied food to residents in care
INVESTIGATION FINDINGS:
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On 09/18/24, at 12:55pm, Licensing Program Analyst (LPAs) Gina Saucedo and Angelica Segovia arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Caregiver, Larisa Bobakova and LPAs disclosed the purpose of the visit. The administator, Armenuhi Avetisyan arrived fifteen (15) minuted later. LPA explained the purpose of this visit was to gather information, conduct staff and resident interviews and deliver findings for this complaint.

The investigation consisted of the following: LPA Saucedo asked for the census, requested the staff and resident roster. At 1:05pm, LPA toured the physical plant. During the tour, LPA's interviewed staff and resient roster.

9099C-continued
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
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-20240916093637
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: LINDLEY RESIDENTIAL CARE
FACILITY NUMBER: 197610298
VISIT DATE: 09/18/2024
NARRATIVE
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Regarding the allegation: Staff denied food to residents in care. It is being alleged that the resident asked for food/snacks and it was denied by staff and therefore they lost a lot of weight. Three (3) residents confirmed that food is not denied to them and they receive snacks anytime they request it. Two (2) witnesses also confirmed that food is not denied to any of the residents and they are given snacks when they request it. One (1) of the witnesses (W1) is resident #1 (R1)'s daughter who confirmed that R1 is given food and snacks when appropriate. W1 also confirmed that R1 lost weight prior to coming to the above facility and has continued to lose weight due to their medical diagnosis and medication which has nothing to do with staff denying food and snacks to R1. W1 also confirmed that they visit R1 weekly and have never heard staff denying any resident's food or/and snacks. Two (2) staff also confirmed that food is not denied to any of the residents and snacks are given to them when they ask for it. LPA's were able to obtain R1's medication and medical diagnosis that confirms the weight loss. Therefore, based on the LPA's record reviews, staff and resident interviews the above allegation(s) above is UNSUBSTANTIATED at this time.

An exit interview was conducted, no citation(s) were issued for the above allegation(s), and a copy of this report was given to the Administrator.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC9099 (FAS) - (06/04)
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