Complaint Investigation Report

565801347-2-24-2025-29-AS-KLOZ-DEC3ME-20250228172210

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

WOODLAND HILLS N.ASC , 21731 VENTURA BLVD. #250

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

06/03/2024 and conducted by Evaluator Esther Cortez

COMPLAINT CONTROL NUMBER: 29-AS-20240603091555

Licensing Program Analyst (LPA) Esther Cortes conducted a subsequnet visit to investigate the allegation listed above. The LPA met with Licensee Julia Espena and explained the reason for the visit. Administrator Louisa May Nollan, arrived shortly thereater.

On 06/04/24, LPA Urena interviewed Licensee, Administrator and residents from approximately 11:03 a.m. to 12:20 p.m. During today's visit LPA Cortez conducted a file review and interview two (2) staff, and Client #1. Interviews revealed that on 05/30/24, C1 was lost during an outing around 2:30 p.m., and arrived to the facility on their own three and a half (3.5) hours later. File Review revealed that per C1's Physician Report, dated 07/13/20, C1 is not able to leave the facility unassisted. Based on the information gathered, the allegation is deemed Substantiated at this time.

Pursuant to Title 22, California Code of Regulations, the following deficiency was cited (refer to LIC 9099-D).Exit interview conducted, appeal rights discussed, and a copy of this report issued.