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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850240
Report Date: 10/30/2025
Date Signed: 10/30/2025 02:44:31 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: 370DATE:
10/30/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Jessica SaksTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Staff did not ensure that resident's medical equipment is operable.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a subsequent complaint investigation for the allegation listed above at 11:28AM. LPA met with staff and Director of Nursing (DN) Jessica Saks upon arrival and Executive Director (ED) Allison Marty who arrived shortly thereafter. Entrance interview conducted.

During today’s visit, LPA interviewed two (2) staff and reviewed and obtained copies of pertinent documents. During the initial visit on 09/03/2025, LPA conducted interviews with four (4) staff and one (1) resident, reviewed and obtained copies of pertinent documents relevant to the investigation, conducted a brief physical plant tour, and discussed allegations with ED.

Report Continued on LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025
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: 10/30/2025
NARRATIVE
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It was alleged that staff did not replace the tennis balls/gliders on Resident #1 (R1)’s walker, making the walker inoperable. Interviews with R1, R1’s responsible party, and staff confirmed that the walker was not provided by the facility. R1’s responsible party purchased the gliders and had them attached to R1’s walker for easier use. Interviews stated that the gliders fell off the walker and were missing for a few days until R1’s responsible party repurchased and installed the gliders. LPA interviewed R1 who confirmed that their walker is operable and is able to be used with some difficulty when the tennis balls are missing. R1 stated that one of the tennis balls got lost in the facility car and R1’s walker was without the ball for a few days, however, R1 was still able to use their walker. LPA observed R1’s walker on 09/03/2025 and observed the walker to be operable. Staff interviews revealed that they had not observed R1’s walker to be inoperable. LPA reviewed records and observed that the facility purchased the glider replacement on 09/05/2025 and issued credit to R1’s responsible party for the glider accessory on 09/05/2025. Based on interviews 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 ensure that resident's medical equipment is operable.” is 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: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3