197600430-12-4-2025-29-AS-KLOZ-DPVP9U-20251231100742

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197600430
Report Date: 12/04/2025
Date Signed: 12/04/2025 04:02:50 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
11/24/2025 and conducted by Evaluator Sandra Urena

COMPLAINT CONTROL NUMBER: 29-AS-20251124085928

FACILITY NAME:	VALLEY VIEW RETIREMENT CENTER		FACILITY NUMBER:	197600430
ADMINISTRATOR:	JUDITH MONTOYA		FACILITY TYPE:	740
ADDRESS:	7720 WOODMAN AVE.		TELEPHONE:	(818) 997-6756
CITY:	PANORAMA CITY	STATE: CA	ZIP CODE:	91402
CAPACITY:	116	CENSUS: 67	DATE:	12/04/2025
		UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Judith Montoya		TIME COMPLETED:	02:17 PM

ALLEGATION(S):

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Resident is not accorded rights to refuse medications.
Staff do not ensure residents health care needs are being met.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sandra Urena conducted an initial unannounced visit to investigate the allegations listed above. The LPA was greeted by the facility staff, and the LPA explained the reason for the visit. The staff contacted the Administrator Judith Montoya on the phone, and the LPA explained the reason for the visit. The Administrator was unable to come to the facility and asked the designated facility staff to provide the LPA with the requested records, and the LPA interviewed the Administrator on the phone.

LPA Urena, along with the staff, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations.
LPA Urena interviewed the Administrator at approximately 11:37 a.m., staff at approximately 11:55 a.m. and requested records pertinent to the investigation. Additionally, the LPA interviewed R1’s Social Worker with the Veteran’s Administration Office at approximately 12:10 p.m.
Continues on LIC 9099C... page 2.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

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-20251124085928

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: VALLEY VIEW RETIREMENT CENTER	FACILITY NUMBER: 197600430
	VISIT DATE: 12/04/2025

NARRATIVE

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Pg.2
Resident is not accorded rights to refuse medications.
On the allegation that the Resident is not accorded rights to refuse medications; the RP’s concern is that the Resident (R1 refuses to take their medication because R1 does not like how it makes them feel. Furthermore, it is alleged that the medication technicians force R1 to take their medications. However, the RP is unsure whether the staff are physically forcing R1 to take the medication or simply verbally pressuring R1 to comply.

To investigate the allegation, LPA Urena conducted record review and interviewed the Administrator, staff, and R1’s assigned Social Worker (SW) with the Veterans’ Administration. R1 was not available for an interview. The record review revealed that R1 has been receiving the prescribed medication as directed by the doctor. No refusal of medication has been recorded. The interview with the Administrator revealed that R1 has been complying with taking their medication. The staff’s interview revealed that R1 has been compliant with the medication. The interview with R1’s SW revealed that R1 has not shared at any time that staff have forced them either physically or verbally pressured them into taking their medication and are aware that R1 is taking their medication as prescribed.

Based on the information obtained through record review and interviews, the staff has not violated the R1’s personal rights based on R1’s intake of the medication. Therefore, the allegation is deemed Unsubstantiated at this time.

Continues on LIC 9099C...page 3.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 29-AS-20251124085928

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: VALLEY VIEW RETIREMENT CENTER	FACILITY NUMBER: 197600430
	VISIT DATE: 12/04/2025

NARRATIVE

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Pg. 3
Staff do not ensure residents health care needs are being met.
On the allegation that Staff do not ensure residents health care needs are being met; the RP’s concern is that the staff are not capable of providing the level of care R1 requires and have resorted to placing R1 in involuntary restraining holds, to stop the behavior displayed by R1. To investigate the allegation, the LPA conducted record review and interviews. Record review of the Incident Reports (LIC 624) sent to the Community Care Licensing (CCL) Office, revealed that the Administrator has followed protocol and regulations by informing the CCL of any incidents involving R1. Record review revealed that R1 has been residing at the facility for about 1.5 years, and during this time R1 has been placed on one involuntary restraining hold. The interview with R1’s SW from the Veteran’s Administration Department (VA) revealed that the facility’s staff proactively communicates with the VA doctors about any changes in R1’s behavior, allowing for VA’s intervention for a positive outcome when R1 becomes combative. Per the SW, there has been one (1) incident of involuntary restraining hold and one (1) voluntary occurrence which occurred on 11/19/2025 when R1 displayed aggressive behavior towards facility staff. The facility Administrator called the VA’s office and the VA’s SW and field support staff arrived at the facility to speak with R1. R1 was advised by the VA staff that R1 needed to be seen by a VA doctor, to which R1 agreed and R1 was transported by car by the VA staff to the VA’s doctor’s office.

Based on information obtained through record review and interviews, facility staff are following regulations and protocol to provide the level of care needed to R1, at this time. Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview was conducted with the facility’s designated staff. A copy of the report was issued.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025

LIC9099 (FAS) - (06/04)

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