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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850091
Report Date: 02/20/2025
Date Signed: 02/20/2025 01:19:20 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/07/2025 and conducted by Evaluator Angela Barutyan
COMPLAINT CONTROL NUMBER: 29-AS-20250207095420
FACILITY NAME:PRESERVE AT WOODLAND HILLS, THEFACILITY NUMBER:
195850091
ADMINISTRATOR:SUSAN WEISBARTHFACILITY TYPE:
740
ADDRESS:6221 FALLBROOK AVENUETELEPHONE:
(747) 226-5834
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY:60CENSUS: 34DATE:
02/20/2025
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Susan WeisbarthTIME COMPLETED:
01:25 PM
ALLEGATION(S):
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Staff retained resident without proper admission procedures
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct an initial complaint investigation for the allegation listed above 01:05PM. Upon arrival, LPA met with Executive Director (ED) Susan Weisbarth. Entrance interview conducted.

During today's visit, LPA delivered final finding for the above allegation. During the initial visit on 02/11/2025, LPA conducted a brief physical plant tour, conducted interviews with five (5) staff members and four (4) residents, reviewed and obtained copies of pertinent documents relevant to the investigation, and discussed allegation with ED and Health and Services Director (HSD) Tony Nunez.

It was alleged that on 07/20/2024, the previous ED Michael Owens retained Resident #1 (R1) without proper admission procedures. ED Owens was in communication with responsible party(ies) of R1 and informally agreed to move R1 to the facility, as evidenced by text messages between ED Owens and responsible party dated 07/19/2024 – 07/26/2024. Continued on LIC 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
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 3
Control Number 29-AS-20250207095420
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: PRESERVE AT WOODLAND HILLS, THE
FACILITY NUMBER: 195850091
VISIT DATE: 02/20/2025
NARRATIVE
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Information obtained confirms that required documents were provided to the facility, such as the resident’s physician’s report and medication list, and that ED Owens spoke with R1’s doctor to create a plan of care. LPA reviewed R1’s file retained at the facility and observed R1’s physician’s report dated 01/17/2024, TB test dated 07/20/2024, COVID/influenza A + B/multiplex NAA nasal test from 07/18/2024, hospital discharge paperwork from 07/18/2024 – 07/20/2024, R1’s medication list dated 07/20/2024, and interim service plans from the facility dated 07/20/2024 and 07/23/2024. R1 moved into the facility on 07/20/2024, however, no admission agreement was provided for review or signature even after prompting from responsible party. No admission agreement, pre-placement appraisal, or care plan/needs and services appraisal was observed in R1’s file. R1 resided at the facility for five (5) days without a contract between 07/20/2024 – 07/25/2024. ED Owens resigned without proper notice end of day on 07/22/2024. R1’s responsible party was informed by corporate management on 07/25/2024 that R1 needs to leave the facility as there is no written contract for R1’s admission. LPA interviewed Staff #1 (S1) and Staff #2 (S2) who were employed during the ED abandonment and confirmed that a resident was improperly admitted to the facility by ED Owens during that time. LPA interviewed current ED Weisbarth, HSD Nunez, and Resident Care Coordinator (RCC) Angelica Caton who were not employed at the facility during the time of the alleged incident. No concerns of the facility’s current admission procedures were noted. Interviews revealed that residents admitted during previous management were not properly assessed, however, the facility has been assessing residents and updating care plans quarterly and organizing resident files to be in compliance. Residents interviewed did not have evidence relevant to the investigation.

LPA conducted previous visits regarding ED Owens and absence of management which were assessed during that time. Based on the facility’s history, interviews, and record review, the allegation “staff retained resident without proper admission procedures” is deemed SUBSTANTIATED at this time. Plan of Correction has been met as current administration is knowledgeable in admission procedures and is properly documenting admissions and assessing residents.



The following deficiency was observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Administrator was informed that failure to correct the deficiency may result in civil penalties.

Exit interview conducted. Appeal rights and a copy of the report was provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20250207095420
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: PRESERVE AT WOODLAND HILLS, THE
FACILITY NUMBER: 195850091
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/27/2025
Section Cited
CCR
87456(a)
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87456 Evaluation of Suitability for Admission
(a) Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8
This requirement is not met as evidenced by:
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Current administration is knowledgeable on proper admission procedures per regulation and provided proof to LPA during the visit of admission procedures. POC has been met.
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Based on record review and interview, the licensee did not comply with the section cited above as Resident #1 (R1) was admitted without an admission agreement and appraisal which posed a potential health, safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3