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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609060
Report Date: 04/15/2026
Date Signed: 04/15/2026 12:45:08 PM

Substantiated


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
04/06/2026 and conducted by Evaluator Angelica Segovia
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20260406160332
FACILITY NAME:TREASURE HERITAGEFACILITY NUMBER:
197609060
ADMINISTRATOR:OLOWOSAGBA, SUNDAYFACILITY TYPE:
740
ADDRESS:2049 KALLIOPE AVENUETELEPHONE:
(661) 886-8791
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY:6CENSUS: 2DATE:
04/15/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Sunday Olowosagba- AdministratorTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Staff refused to accept the resident back to the facility.
INVESTIGATION FINDINGS:
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On 04/15/2026 at approximately 09:30 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced initial complaint visit to the facility to investigate the above allegation(s). LPA was greeted by the Administrator, Sunday Olowosagba and stated the reason for their visit.

At 09:45 AM, LPA requested census, resident, and staff roster. At approximately 09:50 AM, LPA conducted a physical plant tour, to ensure the health and safety of the residents. At 10:00 AM, LPA requested pertinent documentation pertaining to the investigation such as but not limited to: Admission Agreement, Re-Appraisals and Physician’s Report. In between 10:30 AM – 12:30 PM, LPA attempted interviews with one (1) resident (R1), one (1) staff member (S1) and conducted record review.

(continue to LIC 9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
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 3
Control Number 31-AS-20260406160332
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: TREASURE HERITAGE
FACILITY NUMBER: 197609060
VISIT DATE: 04/15/2026
NARRATIVE
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Regarding the allegation: Staff refused to accept the resident back to the facility. It was alleged that S1 refused to accept R1 back to the facility after being discharged from the hospital. To investigate the allegation, LPA attempted to interview one (1) resident and one (1) staff member. LPA attempted to interview R1, but they no longer reside at the facility and were not present during LPA’s visit. LPA’s interview with S1 revealed on 4/04/2026, R1 was transported to the hospital due to severe pain. S1 stated they refused to allow R1 to return to the facility due to them, “needing a higher level of care”. When questioned as to what higher level of care R1 needed, S1 stated that R1’s chronic pain is too severe, and they do not have nurses such as “LVNs” (Licensed Vocational Nurses) employed at their facility. S1 stated, R1 needs a rehabilitation center.

When questioned if they had provided R1 with a 3-day or 30-day eviction notice, S1 stated, “No”. When questioned if they had submitted R1’s eviction notice to Community Care Licensing Division (CCLD), S1 stated, “No”.

LPA conducted a record review of R1’s file. LPA’s record review of R1’s Admission Agreement revealed that, “…a written notice that includes specific facts concerning the date, place, witnessed, and circumstances for eviction will be provided to the resident”. Further record review of R1’s Pre- Appraisal documented R1 to have episodes of anxiety, but no documentation of the severity of their chronic pain and/or alcohol abuse were notated. LPA’s record review of R1’s Interdisciplinary Discharge Summary paperwork on 6/14/2025, prior to moving into the facility on 6/19/2025 disclosed various diagnosis relating to R1 such as, “…Alcohol abuse with withdrawal with perceptual disturbance…”. Additionally, LPA did not observe there to be any documentation of Re-Appraisals having been done regarding R1’s change in conditions leading to R1’s hospitalization on 4/04/2026. During LPA’s physical plant tour, LPA observed R1’s bedroom to be empty.

Based on interviews, record review and observations, there is enough information to verify the allegation. Therefore, the allegation is SUBSTANTIATED at this time.

Citations issued, please refer to LIC 9099-D.

No other immediate health and safety issues observed during the day of the visit. Exit interview was conducted, appeal rights given, and a copy of this report was provided to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
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 3
Control Number 31-AS-20260406160332
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: TREASURE HERITAGE
FACILITY NUMBER: 197609060
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
87224(a)
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87224 Eviction Procedures (a) The
licensee may evict a resident for one or more of the reasons listed...Thirty (30) days written notice to the resident is required...


This requirement is not met by:
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Licensee/Administrator will ensure to send
Community Care Licensing Division a proper thirty (30) day notice regarding R1.

The POC due date: 04/16/2026
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Based on interviews, the Licensee/administrator failed to ensure Resident 1 (R1) was given the proper 30 (thirty) day notice for eviction. R1 was not allowed back to the facility after hospitalization discharge. This posed an immediate health and safety risk to residents in care.
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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: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
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)
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