<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608129
Report Date: 04/15/2026
Date Signed: 04/15/2026 11:41:08 AM

Substantiated


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
01/07/2026 and conducted by Evaluator Quoc Huynh
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20260107170806
FACILITY NAME:RESIDENCES AT ROYAL BELLINGHAM, THEFACILITY NUMBER:
197608129
ADMINISTRATOR:ANGELITO VITUGFACILITY TYPE:
740
ADDRESS:12229 CHANDLER BOULEVARDTELEPHONE:
(818) 980-2997
CITY:VALLEY VILLAGESTATE: CAZIP CODE:
91607
CAPACITY:96CENSUS: 85DATE:
04/15/2026
UNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Riza Vitug - Assistant Administrator
Lito Vitug - Executive Director		TIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Due to staff neglect resident developed multiple pressure injuries while in care
Facility did not seek timely medical attention for resident with pressure injuries
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Quoc Huynh conducted a subsequent complaint visit to deliver findings for the above allegations. The LPA arrived at 10:05AM and met with Assistant Administrator (AA) Riza Vitug. The Executive Director (ED) Lito Vitug arrived at 11:13AM Entrance interview conducted.

On 01/12/2026, LPA Huynh conducted an initial visit. Beginning at 9:52AM the LPA conducted a physical plant tour and reviewed and obtained pertinent documents. Between 01/14/2026 and 02/27/2026, the Department interviewed residents and staff and obtained and reviewed medical records.

During today’s visit, the LPA and AA conducted a physical plant tour at 10:07AM and no immediate concerns were observed. The following was then determined:

Report Continued on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
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 4
Control Number 29-AS-20260107170806
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: RESIDENCES AT ROYAL BELLINGHAM, THE
FACILITY NUMBER: 197608129
VISIT DATE: 04/15/2026
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
Allegations: “Due to staff neglect resident developed multiple pressure injuries while in care” and “Facility did not seek timely medical attention for resident with pressure injuries”

It was alleged that Resident #1 (R1) developed two (2) Stage II pressure injuries due to staff neglect and that facility staff failed to seek timely medical attention. Physician’s Report dated 05/22/2025 documented that R1 had coronary artery disease and was receiving hospice services at that time. R1 also had mild cognitive impairment but was able to follow instructions and communicate their needs. R1 had a history of skin breakdown, including an open skin impairment on the “butt and sacrum.” Resident Appraisal dated 11/24/2025 indicated R1 was non-ambulatory with a wheelchair and required assistance with transferring, repositioning, and incontinence care.

Interviews with staff and the ED revealed no documented reports or observations of pressure injuries, and staff denied the allegations. Staff stated they provided incontinence care and repositioned R1 every two (2) hours; however, their statements were inconsistent regarding R1’s repositioning schedule and whether R1 was bedbound. Approximately three (3) months prior to the allegations, R1 was discharged from hospice services. While on hospice, R1 received wound care for a wound staff reported had “healed.” Staff further reported that R1 experienced recurring redness and a dry, scabbing blister on the right buttock. Staff stated they applied “cream” and “ointment” to the area during incontinence care. Staff #1 (S1) reported observing an intermittent “small wound” approximately the size of a quarter prior to the allegations but could not recall whether this was reported to Administrators or Med-Techs. Staff #2 (S2) also confirmed that a pressure injury appeared to be developing but stated that lotion was applied and it “went away.”

According to the ED, staff are trained to report skin changes to Management, who then assesses the issue, notifies the resident’s physician and responsible party, and document the occurrence in the resident’s file. S1 stated they did not receive training on identifying pressure injuries. Staff #3 (S3) confirmed being notified of R1’s dry blister but could not recall the location of the blister or timing of the report. S3 stated that no follow up occurred because the blister was “dry.” S3 also reported that skin changes are not documented and that staff notifications are verbal only.

Report Continued on LIC 9099-C
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 29-AS-20260107170806
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: RESIDENCES AT ROYAL BELLINGHAM, THE
FACILITY NUMBER: 197608129
VISIT DATE: 04/15/2026
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
R1 reported that staff do not respond promptly to requests for assistance and that they often wait a long time for help. R1 stated they remain in bed for “too long” and rely on staff for repositioning and transfers, which is sometimes delayed or does not occur. R1 reported being treated well overall and receiving frequent brief changes but could not provide specifics. R1 acknowledged having pressure injuries and stated that staff apply cream “most of the time.”

A review of R1’s Service Log between 11/01/2025 to 01/06/2026 showed that “Incontinent Care” was provided between one (1) to four (4) times a day, with some days showing gaps of more than ten (10) hours between services. Mobility assistance was documented approximately once per day. On 01/06/2026, R1 was admitted to the hospital at 6:44PM with left-sided facial droop. R1 was transferred to a second hospital on 01/07/2026 at 12:44AM, where pressure ulcers were observed during the admission assessment. A wound consult completed on 01/08/2026 confirmed two (2) Stage II pressure injuries on the left and right buttocks.

Based on interview and record review, R1 experienced skin changes that were not addressed in a timely manner, resulting in the development of Stage II pressure injuries. The preponderance of evidence standard has been met; therefore, the allegations are deemed SUBSTANTIATED at this time.

An immediate civil penalty in the amount of $500 was assessed today (Refer to LIC 421M). The ED was informed that additional civil penalties may be assessed based on Health and Safety Code Section 1569.49.

Pursuant to Title 22 CA Code of Regulations and/or the Health and Safety Code, the following deficiencies were cited (Refer to 809-D).

Exit interview conducted. A copy of the appeal rights and report was reviewed and provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 29-AS-20260107170806
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: RESIDENCES AT ROYAL BELLINGHAM, THE
FACILITY NUMBER: 197608129
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/16/2026
Section Cited
CCR
87464(f)(1)
1
2
3
4
5
6
7
(f) basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c)

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The Licensee will provide staff training regarding documentation, reporting, and pressure injuries and will provide proof to CCLD by POC due date.
8
9
10
11
12
13
14
Based on interview and record review, the licensee did not comply with the above cited section in R1 developed 2 Stage II pressure injuries which poses an immediate health, safety, and personal rights risk to persons in care.
8
9
10
11
12
13
14
Type A
04/16/2026
Section Cited
CCR
87631(a)(3)
1
2
3
4
5
6
7
(a)Except as specified in Section 87611(a), the licensee shall be permitted to accept or retain a resident who has a healing wound under the following circumstances: (3) Residents with a stage one or two pressure injury must have the condition diagnosed by a physician or an appropriately skilled professional.

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The Licensee will provide staff training on identifying pressure injuries and reporting to facility management and will provide proof to CCLD by POC due date
8
9
10
11
12
13
14
Based on interview and record review, the licensee did not comply with the above cited section in R1 developed 2 Stage II pressure injuries that were not treated which poses an immediate health, safety, and personal rights risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4