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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610446
Report Date: 06/11/2024
Date Signed: 06/11/2024 01:24:32 PM

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
06/04/2024 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20240604135203
FACILITY NAME:GLOBUS SENIOR LIVING INCFACILITY NUMBER:
197610446
ADMINISTRATOR:ABRAMIAN, RAFAELFACILITY TYPE:
740
ADDRESS:17339 HORACE STTELEPHONE:
(323) 491-0077
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 3DATE:
06/11/2024
UNANNOUNCEDTIME BEGAN:
09:12 AM
MET WITH:Donara AghabalyanTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff did not ensure that resident was adequately dressed
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegation. LPA met with staff, Yegsik Tonikyan, and advised her of the visit. The adminstrator, Donara Aghabalyan was called and joined shortly after. It was reported that on or around 05/12/24, Resident 1 (R1) was observed by a visitor/guest with only a t-shirt, adult diaper and socks on. Today's investigation consisted of interviews with the administrator, facility owner, three (3) of three residents and resident family. Record review was also made.

According to the administrator, R1 was only at the facility for 24 hours. R1 was discharged (d/c) from the hospital on or around 05/12/24. When d/c to this facility, R1 did not have any clothing or personal belongings with them. Family was aware of the d/c from the hospital, and that R1 had no belongings and clothing with them. Family was preparing to bring over some clothing for R1 the next day, but R1 had a behavioral issue, which staff had to call paramedics the same day R1 was admitted into facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2024
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-20240604135203
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: GLOBUS SENIOR LIVING INC
FACILITY NUMBER: 197610446
VISIT DATE: 06/11/2024
NARRATIVE
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Administrator did admit R1 was observed with only t-shirt, socks and an adult diaper on when picked up by the paramedics, and stated R1 was offered spare clothing (sweat pants and sweat shirt) at admission, but R1 declined them. This was also explained to the paramedics.

Interviews with the three residents could not confirm the allegation. These residents did not have any complaints or concerns with the care and supervision provided by the facility staff. They add that their needs are being met. Interview with R1's family confirm that R1 was admitted into the home without any personal belongings and clothing, and that they were preparing to bring some over the next day for R1. Family member also confirmed that they instructed for staff to call paramedics in the evening, of on or around 05/12/24, to address R1's behavior. Family was also aware clothing was provided to R1, in which R1 declined to use.

Based on the information obtained, although R1 had only a t-shirt, socks and an adult diaper on when there was a visitor/guest present, the allegation of staff did not ensure that resident was adequately dressed due to neglect could not be confirmed. Facility staff did offer spare clothing for R1 to wear, which R1 declined to wear. R1's family was also aware that R1 was admitted without any clothing or belongings, which they were preparing to bring in the following day. The allegation is deemed Unsubstantiated at this time.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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