Complaint Investigation Report, 08/30/2022 — Henrietta's Leven Oaks, Monrovia CA

Complaint Investigation Report

Henrietta's Leven Oaks, Monrovia08/30/2022Licence 198603586

Census28

Date signed08/30/2022 03:38:58 PM

Name of licensing program analystJoe Katrdzhyan

Name of licensing program managerWei Siew Ho

The inspector’s account

198603586-8-30-2022-28-AS-MVAO-CL835J-20221115165648

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1000 CORPORATE CNTR DR. ST 500

This is an official report of an unannounced visit/investigation of a complaint received in our office on

08/29/2022 and conducted by Evaluator Joe Katrdzhyan

COMPLAINT CONTROL NUMBER: 28-AS-20220829152934

Licensing Program Analysts (LPAs) Joe Katrdzhyan, Nune Margaryan and Valeria Maldonado conducted an unannounced complaint visit at 120 S Myrtle Ave. Upon arriving at the property, LPAs met with Director / Lupe Harvey who assisted with the visit. The purpose of the visit was discussed.

The Notice of Operation in Violation of Law was issued during this visit because facility license #198602418 was revoked as of 8/26/22, due to Decision and Order, Stipulation 6120010302E.

An exit interview was conducted and a copy of this report was provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction