197610499-5-17-2024-31-AS-TAGD-D9EM2H-20240924091331

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610499
Report Date: 05/17/2024
Date Signed: 05/17/2024 12:03:18 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
05/10/2024 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20240510150051

FACILITY NAME:	LOS ANGELES BOARD AND CARE		FACILITY NUMBER:	197610499
ADMINISTRATOR:	ARZUMANYAN, ANUSH		FACILITY TYPE:	740
ADDRESS:	15214 CHATSWORTH STREET		TELEPHONE:	(424) 666-5666
CITY:	MISSION HILLS	STATE: CA	ZIP CODE:	91345
CAPACITY:	6	CENSUS: 6	DATE:	05/17/2024
		UNANNOUNCED	TIME BEGAN:	08:53 AM
MET WITH:	Anush Arzumanyan - Administrator		TIME COMPLETED:	12:03 PM

ALLEGATION(S):

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Staff served expired food to a resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced complaint visit at this facility to investigate the above allegations. LPA met with Administrator Anush Arzumanyan and explained the reason for the visit.
LPA conducted physical plant tour at 9:03 AM, requested copy of facility documents relevant to the investigation at 9:30 AM and interviewed residents and staff between 9:30 AM to 11:00 AM. It was alleged that staff gave Resident #1 (R1) old strawberries. LPA's interview with three (3) aware residents today between 9:30 AM to 11:00 AM revealed that they were never served rotten fruit or over ripe strawberry and the facility always serve healthy food and fresh fruit. LPA's observation during physical plant tour revealed that the facility has a lot of fresh fruits and vegetable in stock. Based on the information gathered during this visit. The allegation is deemed unsubstantiated at this time.

Exit interview conducted. Cpy of this report issued.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2024

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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