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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610412
Report Date: 12/01/2023
Date Signed: 12/01/2023 03:12:58 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
10/24/2023 and conducted by Evaluator Antonia Alvizar
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20231024151628
FACILITY NAME:GRANT SERENITY OF VERDUGO, INC.FACILITY NUMBER:
197610412
ADMINISTRATOR:GEVORKIAN, NVARDFACILITY TYPE:
740
ADDRESS:3214 W. VERDUGO AVETELEPHONE:
(818) 425-6797
CITY:BURBANKSTATE: CAZIP CODE:
91505
CAPACITY:6CENSUS: 3DATE:
12/01/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Resident was sexually abused
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Antonia Alvizar conducted a subsequent complaint investigation visit to the facility. LPA met with House Manager, Ruzanna Sukiassyan and granted entry. House Manager contacted via phone Administrator, Nvard Gevorkian and later joined us. The purpose of the visit was discussed.

It was reported that resident #1 (R1) has bruising, redness and pain in their private area that could have been resulted from possible sexual abuse. (Administrator provided photographic evidence)
During the initial investigation on 10/25/2023 between 2:45p.m. – 3:30p.m. LPA Antonia Alvizar initiated staff interviews. Interviews revealed that staff did not know anything about a resident being sexually abused. Staff also revealed that R1 always scratches their private parts. R1 had a stroke and has limited functions on the left side. To prevent R1 from scratching their private parts, staff put on a glove on their right hand. At the time of initial visit R1 was at the hospital.

On 10/25/23 while LPA was exiting the facility R1’s family member arrived to the facility, due to R1’s
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023
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 2
Control Number 31-AS-20231024151628
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: GRANT SERENITY OF VERDUGO, INC.
FACILITY NUMBER: 197610412
VISIT DATE: 12/01/2023
NARRATIVE
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discharge from the hospital. LPA Alvizar interviewed R1’s family member, who confirmed that R1 scratches vaginal area causing redness and bruises. A family member indicated that has no concerns about R1 being sexually abused and staff does a great job caring for R1. A family member also confirm that R1 is taking over the counter Benadryl as needed for itching.

On 11/30/2023 at 7:45p.m., LPA Alvizar reviewed R1’s physician’s report. Records revealed that R1 has secondary health condition causing dry skin. Records also revealed that R1 has a history of skin condition that causes itching. R1 has a prescription of Benadryl 25MG as needed.

Based on interviews and record review, there is not sufficient information to support this allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No immediate health and safety hazard is noted during this visit.

Exit interview conducted and copy of report was issued Administrator, Gevorkian.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2