Complaint Investigation Report

197609022-10-16-2025-31-AS-MGFS-DVMVGZ-20260703162617

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

WOODLAND HILLS S.RO , 21731 VENTURA BLVD., STE. 250

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

04/22/2025 and conducted by Evaluator Mariana Agban

COMPLAINT CONTROL NUMBER: 31-AS-20250422083808

Staff does not ensure resident’s room is clean.

Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced subsequent complaint visit to include additional interviews for the Substantiated complaint report on 08/27/25 and amended the LIC 9099D. LPA arrived and was greeted by the receptionist, and met with the Executive Director, Tanya Quezada, and explained the reason for the visit. LPA requested copies of LIC 500, the Resident Roster, and other pertinent documents. At 9:45 AM, LPA conducted a physical plan tour to ensure the health and safety of the residents are protected and are in compliance with Title 22 Regulations. During today's visit, LPA interviewed an additional 3 residents, 5 staff members, and the Executive Director. Based on information obtained, the allegation remains Substantiated at this time.

Exit interview conducted, POC is cleared, a copy of this report signed and delivered