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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850339
Report Date: 08/18/2025
Date Signed: 08/19/2025 09:51:01 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/03/2025 and conducted by Evaluator Zabel Chochian
COMPLAINT CONTROL NUMBER: 29-AS-20250703114209
FACILITY NAME:INN AT THE PARK VENTURAFACILITY NUMBER:
195850339
ADMINISTRATOR:ANGUIANO, ROSEFACILITY TYPE:
740
ADDRESS:21200 VENTURA BLVDTELEPHONE:
(818) 884-7100
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91364
CAPACITY:200CENSUS: 149DATE:
08/18/2025
UNANNOUNCEDTIME BEGAN:
06:13 PM
MET WITH:Rose AnguianoTIME COMPLETED:
06:45 PM
ALLEGATION(S):
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Staff did not prevent resident from attacking another resident in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to deliver investigation finding. Upon arrival LPA met with Rose Anguiano. The reason for the visit was explained.

On 07/30/2025, Community Care Licensing Division received the above allegation. On 07/09/2025, LPA conducted the initial complaint visit and allegation was discussed with Administrator. LPA toured the facility and met with approximately seven (7) residents. Pertinent documents relevant to the investigation was obtained. On 7/30/2025 during a subsequent complaint visit LPA attempted to interview resident #1 (R1). Interview was conducted with five (5) staff members.

Following is a summary of the allegation and investigation finding:

Allegation “Staff did not prevent resident from attacking another resident in care”: Information was provided that R1 was attacked by another resident on Sunday June 15, 2025 (time unknown). (Continue to LIC9099c)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2025
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 2
Control Number 29-AS-20250703114209
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: INN AT THE PARK VENTURA
FACILITY NUMBER: 195850339
VISIT DATE: 08/18/2025
NARRATIVE
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It was also reported that the alleged physical abuse was not reported to facility staff. Staff interviewed did not observe any incident involving R1. Staff stated that R1 did not report any physical abuse.

Records reviewed revealed that R1 was admitted to the facility on 2/23/2024; medical assessment dated 2/03/2025 indicates R1’s cognitive abilities is limited; R1 lived in the facility memory unit.
Staff interviewed reported that R1 is currently in rehab for post fall treatment. R1 was unable to be interviewed. Information was received that R1 requires a higher level of care and will not be returning to the facility.

Random residents interviewed in the assisted living units expressed satisfaction with the staff. Residents reported that anytime there is a physical or verbal altercation staff are present and either redirect or contact law enforcement. LPA attempted to interview residents in the memory care unit however it was unsuccessful.

Based on the above information gathered although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the allegation “Staff did not prevent resident from attacking another resident in care” is deemed unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2