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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610355
Report Date: 12/04/2025
Date Signed: 12/04/2025 12:55:36 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
12/02/2025 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20251202152439
FACILITY NAME:B AND B SENIOR VILLA IIFACILITY NUMBER:
197610355
ADMINISTRATOR:BAINGAN, GLADELYN P.FACILITY TYPE:
740
ADDRESS:22755 FESTIVIDAD DRIVETELEPHONE:
(661) 600-2838
CITY:SANTA CLARITASTATE: CAZIP CODE:
91354
CAPACITY:6CENSUS: 5DATE:
12/04/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Gladelyn BainganTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff caused injury to a resident in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuesday Cabiness conducted an initial complaint visit to investigate the allegation noted above. LPA met with the Administrator and staff and informed them of the purpose of the visit. The following information was determined during the investigation:

Concerns were expressed, staff caused injury to a resident. Prior to the visit, LPA interviewed witnesses involved with the complaint to gather information regarding the allegation. During the visit on today’s date, from 9:15 a.m. to 1:30 p.m., LPA conducted a physical plant inspection and interviewed two (2) staff members, including the Administrator, and four (4) of the five (5) residents.

Based on staff and resident interviews, it was revealed that Resident #1 (R1) became agitated with staff #1 (S1) during a diaper change. S1 stated that R1 attempted to strike S1, and through an incidental contact and defensive reflex, S1’s ring scratched R1. Interviews determined this was an isolated incident. LPA found no evidence of malicious intent to injure R1. Although it was alleged that S1 struck R1, there were no witnesses,
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tuesday Cabiness
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 5
Control Number 31-AS-20251202152439
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: B AND B SENIOR VILLA II
FACILITY NUMBER: 197610355
VISIT DATE: 12/04/2025
NARRATIVE
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and insufficient evidence exists to corroborate that the scratch was intentionally caused. Based on interviews and observations, the allegation is determined to be Unsubstantiated at this time.

Exit interview conducted, and copy of report provided to Administrator.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tuesday Cabiness
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 5
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
12/02/2025 and conducted by Evaluator Tuesday Cabiness
COMPLAINT CONTROL NUMBER: 31-AS-20251202152439

FACILITY NAME:B AND B SENIOR VILLA IIFACILITY NUMBER:
197610355
ADMINISTRATOR:BAINGAN, GLADELYN P.FACILITY TYPE:
740
ADDRESS:22755 FESTIVIDAD DRIVETELEPHONE:
(661) 600-2838
CITY:SANTA CLARITASTATE: CAZIP CODE:
91354
CAPACITY:6CENSUS: 5DATE:
12/04/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Gladelyn BainganTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff are serving expired food to residents in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuesday Cabiness conducted an initial complaint visit to investigate the allegation noted above. LPA met with the Administrator and staff and informed them of the purpose of the visit. The following information was determined during the investigation:

Concerns were expressed that staff were serving expired food to residents. Prior to the visit, LPA interviewed witnesses involved with the complaint to gather information regarding the allegation. During the visit on today’s date, from 9:15 a.m. to 1:30 p.m., LPA conducted a physical plant inspection of the kitchen and food storage areas. At 10:15 a.m., during the physical plant inspection, LPA observed several expired canned and non-perishable food items stored in the facility’s cabinets and freezer. The presence of expired food creates a potential health and safety risk to residents.

Based on LPA’s observations, the allegation is determined to be Substantiated.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tuesday Cabiness
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: 3 of 5
Control Number 31-AS-20251202152439
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: B AND B SENIOR VILLA II
FACILITY NUMBER: 197610355
VISIT DATE: 12/04/2025
NARRATIVE
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At the conclusion of the visit, the Administrator discarded all the expired items, therefore, the plan of correction was cleared during the visit.

Citation issued, appeal rights provided, exit interview conducted and copy of report provided to Administrator with plan of correction letter.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tuesday Cabiness
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: 4 of 5
Control Number 31-AS-20251202152439
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: B AND B SENIOR VILLA II
FACILITY NUMBER: 197610355
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/04/2025
Section Cited
CCR
80076(a)(1)
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Food Services: (a) In facilities providing meals to clients, the following shall apply: (1)All food shall be safe and of the quality and in the quantity necessary to meet the need of the clients...All food shall be selected, stored, prepared and served in a safe and healthful manner.
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POC cleared during visit. All expired items were discarded during the visit.
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This requirement was not met, evidenced by, based on observations, LPA observed expired cans and non-perishable items stored in the facility kitchen cabinet and freezer. This poses a potential heath 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: Naira Margaryan
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5