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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850240
Report Date: 09/03/2025
Date Signed: 09/03/2025 03:48:05 PM

Unsubstantiated


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
08/29/2025 and conducted by Evaluator Angela Barutyan
COMPLAINT CONTROL NUMBER: 29-AS-20250829112317
FACILITY NAME:VARIEL OF WOODLAND HILLS, THEFACILITY NUMBER:
195850240
ADMINISTRATOR:LOURDES BUSTAMANTEFACILITY TYPE:
740
ADDRESS:6233 VARIEL AVETELEPHONE:
(818) 651-6018
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY:436CENSUS: 366DATE:
09/03/2025
UNANNOUNCEDTIME BEGAN:
11:48 AM
MET WITH:Allison MartyTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff did not clean a resident's room.
Staff are not following a resident's care plan.
Staff are not changing resident's clothing.
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 allegations listed above at 11:48AM. Upon arrival, LPA met with staff and Executive Director (ED) Allison Marty. Entrance interview conducted.

During today's visit, LPA conducted interviews with four (4) staff and one (1) resident between 11:55AM-03:10PM, reviewed and obtained copies of pertinent documents relevant to the investigation between 01:00PM-03:30PM, conducted a brief physical plant tour between 02:52PM-03:15PM, and discussed allegations with ED at 03:30PM.

REPORT CONTINUED ON LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
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-20250829112317
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: VARIEL OF WOODLAND HILLS, THE
FACILITY NUMBER: 195850240
VISIT DATE: 09/03/2025
NARRATIVE
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It was alleged that staff do not clean Resident #1 (R1)’s room as trash is left behind causing ants in the room. LPA reviewed records and observed that the facility was notified on 08/08/2025 by R1’s responsible party that there were ants in R1’s room. Ecolab was contacted and performed a pest control service same day on 08/08/2025. The invoice documents “no ant trails present but ant scouts [were] present” and that the “area was serviced for ants” and “no additional ant activity found after service.” Staff and resident interviews confirmed that trash is taken out daily and housekeeping is done once a week. LPA observed R1’s room to be clean and free of ants and trash. Based on interviews, observation, and record review, the information obtained during the investigation does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the above allegation “Staff did not clean a resident's room.” is deemed UNSUBSTANTIATED at this time.

It was further alleged that staff do not change R1’s clothing as R1 needs dressing assistance and that staff do not check on R1 often enough. LPA reviewed R1’s care plan dated 07/24/2025 which documents that R1 “requires Daily STAND BY assist with dressing” twice a day and “safety checks frequently every 2 hours.” R1’s assessment signed and dated 04/06/2025 documents that R1 “requires standby assistance with dressing and undressing or assistance with seasonal clothes selection.” Record review reveals that R1 is not on a care or service plan to receive full assistance with dressing and that R1 receives frequent checks. Staff and resident interviews confirmed that R1 receives stand by dressing assistance twice a day to monitor R1 and prevent possible injury/falls and that R1 receives frequent checks by staff. The complainant alleged that staff do not assist or encourage R1 to change clothes however, record review and interview did not support the allegation. LPA reviewed logs of R1’s refusals for stand by dressing and interviews confirmed that R1 dresses themselves and is capable to choose their own clothing. Based on interviews and record review, the information obtained during the investigation does not have sufficient evidence to corroborate the allegations. Although the allegations may have happened or are valid, there is not sufficient evidence to prove the alleged violations did or did not occur, therefore the above allegations “Staff are not following a resident's care plan.” and “Staff are not changing resident's clothing.” are deemed UNSUBSTANTIATED at this time.


No deficiencies cited at this time. Exit interview conducted. A copy of the report was provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
LIC9099 (FAS) - (06/04)
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