197607223-1-27-2026-31-AS-NMAN-DQS2JW-20260128162700

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197607223
Report Date: 01/27/2026
Date Signed: 01/27/2026 02:07:12 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
03/13/2025 and conducted by Evaluator Raymond Comer

COMPLAINT CONTROL NUMBER: 31-AS-20250313110749

FACILITY NAME:	ARDENVILLE HOME CARE I		FACILITY NUMBER:	197607223
ADMINISTRATOR:	VICENTE A. ROBLES		FACILITY TYPE:	740
ADDRESS:	7747 SHADYCOVE		TELEPHONE:	(818) 767-6054
CITY:	BURBANK	STATE: CA	ZIP CODE:	91504
CAPACITY:	6	CENSUS: 5	DATE:	01/27/2026
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Rosa Tuason		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff force fed resident(s) in care.
Licensee did not keep residents free from intimidation or actions interfering with daily living functions.
Licensee did not ensure residents were accorded dignity.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On Tuesday, 1/27/26, Licensing Program Analyst, (LPA) Raymond Comer conducted an unannounced subsequent visit to the facility to complete investigation of the allegations noted above. LPA conducted the initial complaint visit on 03/18/25. LPA met with facility DSP, Rosa Tuazon, who connected LPA with Administrator; DSP Rosa Tuazon was approved by Administrator to sign report on her behalf. LPA presented official CDSS badge identification, and reason for the visit was disclosed.

At 1:35pm am, LPA conducted a physical plant tour; no health and safety issues were observed.
To investigate the afformentioned allegations, on 03/18/25 at 12:10 pm, LPA conducted a physical plant tour; no health and safety issues were observed. Between 12:20 pm and 1:15 pm, LPA requested, and received facility residents roster, staff roster, and Residents records including Physician report, need and service plan, and other internal documents. Prior to this visit, on 01/21/26, LPA Comer reviewed facility records previously gathered at the facility. Between 1:25 pm and 2:15 pm, LPA interviewed...
[LIC 9099C] Continued-

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2026

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-20250313110749

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: ARDENVILLE HOME CARE I	FACILITY NUMBER: 197607223
	VISIT DATE: 01/27/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

the Administrator, Residents, and Responsible family members.

Allegation: Facility staff force fed resident(s) in care.
It was alleged that facility staff force-fed residents to eat, or force them to drink, while residents are trying to rest. Staff stated to LPA that residents’ meals are prepared and provided as instructed by the residents’ care plan. Staff are encourage residents to eat. However, no staff would ever force a resident to eat/drink against their will. Residents interviewed by LPA Comer during investigation denied being force-fed or forced to have drinks.
LPA's review of facility records revealed the following: None of the facility's residents are required feeding assistance. Based on interviews, observation and record review, there is not sufficient information to support the allegation. Hence, the allegation is unsubstantiated at this time.

Allegation: License did not keep residents free from intimidation or actions interfering with daily living functions.
Allegation: License did not ensure residents were accorded dignity.
It was reported that facility staff are waking up residents from their sleep, or while they are resting to make sure they eat and drink.
Staff revealed that all residents are assisted before mealtimes for breakfast, lunch and dinner. Staff provide assistance to the residents to ensure they are clean and ready for meals. If residents choose not to get up to eat or drink, staff stated they let residents rest and offer meals at later time. No resident is being forced to get up against their will. Staff indicated that all residents are treated with dignity and respect.
LPA interviews with Residents and Responsible Family Members revealed the following: Residents and Responsible Family Members denied disrespectful treatment or undesired assistance by staff. LPA's review of records did not provide any verifiable information to support the allegation. Therefore, based on interviews and record review, the allegations are unsubstantiated at this time.

No health and safety issues were noted during this visit.

Exit interview was conducted, and copy of report was issued.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 2