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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197603012
Report Date: 09/25/2025
Date Signed: 09/25/2025 02:41:58 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/23/2025 and conducted by Evaluator Mariana Agban
COMPLAINT CONTROL NUMBER: 31-AS-20250423104405
FACILITY NAME:NORTHRIDGE RETIREMENT VILLA, LLCFACILITY NUMBER:
197603012
ADMINISTRATOR:STEPHANIE FLORESFACILITY TYPE:
740
ADDRESS:18901 LIGGETT STTELEPHONE:
(818) 203-9411
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY:6CENSUS: 0DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Aida Amante- AdministratorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff financially abused resident
Staff physically abuse resident
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Mariana Agban conducted an unannounced subsquent complaint visit to this facility. LPA met with Administrator Aida Amante and explained the reason for the visit. LPA conducted a physical plant walk-through and observed that there were zero (0) resident at the facility.

On 4/23/25, Complaint 31-AS-20250423104405 was received by the Woodland Hills Adult & Senior Care Regional Office. The complaint was referred to the Community Care Licensing Division’s Investigation Branch (IB) on 04/23/25 and was accepted as an assignment to interview the alleged victim (Case #LA3125-04141)
An initial complaint visit was made, at the facility by LPA Agban and LPA Shahbizian on 04/23/25. LPA met with S1 and conducted a tour of the physical plant to ensure the health and safety of the residents in care; no deficiencies were observed. Relevant documents were gathered, including residents’ roster, Resident 1(R1) Admission agreement, Appraisal Needs and Services Plan, and Physician’s Report.
(Continue on 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
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 31-AS-20250423104405
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: NORTHRIDGE RETIREMENT VILLA, LLC
FACILITY NUMBER: 197603012
VISIT DATE: 09/25/2025
NARRATIVE
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Allegation: Staff physically abused resident.
The complainant alleged that staff physically abused R1 by pushing and shoving, causing R1 to fall and resulting in bruising and the inability to walk independently. On 05/08/25 at approximately 11:30 am, Investigators Christine Ferris and Jorge Rojas conducted an interview with S1 at the facility. At approximately 12:40 pm, the investigators conducted an interview with R1 at the hospital. The interview with R1 included statements that a female staff member had shoved R1’s foot into a pair of small-sized slippers and hit R1 with a wet washcloth. R1 stated that these incidents occurred four to five years ago. R1 refused to disclose the identity of the staff in question. The interview with S1 included statements that R1 was hospitalized for kidney stones. S1 said that R1 had advised S1 that R1 had filed a complaint because S1 had not visited R1 in the hospital. S1 advised that R1 had mild cognitive impairment and that R1’s condition had been progressively deteriorating both mentally and physically. S1 stated that R1 had not suffered any falls while at the facility. On 09/03/25 at approximately 3:00 PM, LPA conducted interviews with six (6) of 6 the residents. Residents' interviews denied the allegations. Interview with Staff#1(S1) and Staff#2(S2) included statements that since R1's admission to the facility, R1 was non-ambulatory and was wheelchair bound. On today's visit at approximately 11:00 AM, LPA conducted a review of R1's Appraisals, and the Physician's Report stated that R1 is unable to walk without assistance and R1 has Motor impairment/Paralysis. The information obtained during interviews conducted by the IB Investigators, as well as interviews and file and document reviews conducted by the LPA, did not corroborate the allegation of physical abuse from facility staff towards Resident 1(R1). Although the allegation may have happened or is valid, there is no corroboration that the alleged violations did or did not occur. The allegation is deemed unsubstantiated per Title 22 Regulations, Division 6, Chapter 8.
Allegation: Staff financially abused resident.
The complainant alleged that staff had asked R1 for money and for R1 to purchase property for the staff. Money belonging to R1 had disappeared. Staff have access to bank accounts belonging to R1, and the accounts are now locked or frozen, preventing R1 access. To investigate this allegation, LPA conducted staff and resident interviews. LPA also obtained a copy of the Admission Agreement, Identification and Emergency Information, Physician Report, and Resident Appraisals. Record Review indicated that the licensee will not be responsible for any cash resources and that R1 was responsible for his/her financial affairs and payments for the facility. Interviews with two residents out of 6 denied the allegation. LPA attempted to interview 4 residents. Interview with 5 out of 5 staff members also denied the allegation. Based on information obtained, the allegation is deemed Unsubstantiated at this time. Exit interview conducted, and a copy of this report signed and delivered.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
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