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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 405800577
Report Date: 06/19/2025
Date Signed: 06/19/2025 07:13:59 PM

Unsubstantiated


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
06/16/2025 and conducted by Evaluator Garrett Haner-Tomasko
COMPLAINT CONTROL NUMBER: 29-AS-20250616114812
FACILITY NAME:VILLAGE AT SYDNEY CREEK, THEFACILITY NUMBER:
405800577
ADMINISTRATOR:LIZA HIXFACILITY TYPE:
740
ADDRESS:1234 LAUREL LANETELEPHONE:
(805) 543-2350
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93401
CAPACITY:84CENSUS: 54DATE:
06/19/2025
UNANNOUNCEDTIME BEGAN:
09:43 AM
MET WITH:Administrator - Liza HixTIME COMPLETED:
07:30 PM
ALLEGATION(S):
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Licensee does not ensure that facility faucets used by residents for personal care deliver hot water.
Staff do not ensure that resident's needs are met.
Staff do not ensure that the facility is sanitized.
INVESTIGATION FINDINGS:
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On 6/19/2025 at 09:43am Licensing Program Analyst (LPA) Haner-Tomasko arrived unannounced at the facility to further investigate the allegations to this complaint. LPA met with Administrator Liza Hix and explained the purpose of the visit.

During the visit, from 1:30pm to 3:40pm LPA interviewed staff, clients, administrator, Vice President of Operations, and obtained relevant documents.

On the allegation: Licensee does not ensure that facility faucets used by residents for personal care deliver hot water. It was alleged that off and on for several years the facility has had a problem with the faucets delivering hot water and now it is happening more frequently, resulting in residents needing to take cold showers. LPA noted the facility has a boiler room off the main kitchen.

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
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 3
Control Number 29-AS-20250616114812
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: VILLAGE AT SYDNEY CREEK, THE
FACILITY NUMBER: 405800577
VISIT DATE: 06/19/2025
NARRATIVE
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There are two boilers that supply a large hot water tank and from there the hot water is delivered to the kitchen and through mixers to all other areas of the facility. LPA interviews revealed on 5/1/2025 a plumber repaired a leak in one of the boilers, there was not a hot water issue at this time, the plumber recommended the boiler be replaced but they do not work on boilers. Vice President of Operations Lisa Hulse contacted Wick Boiler Service, Inc to schedule a maintenance visit on 6/2/2025 and they recommended rebuilding the boilers at that visit. On 6/16/2025 Administrator Liza Hix was notified by staff there was no hot water at around 8:00am, she contacted Wick Boilers via text message at 8:21am and they arrived at the facility the same day at around 11:00am. LPA observed during the previous visit to the facility for this complaint on 6/18/2025 a boiler company was working on the boilers. LPA interviews with staff revealed there have been a couple of occasions over the last year or two where the water was not hot enough to shower residents, the issue was resolved within a couple of hours, and staff were instructed to schedule the showers later in their shift. LPA interviews revealed the showers were completed by staff and residents have not had to take cold showers. As of 6/19/2025 the boilers have been fixed and the facility is working to ensure the hot water temperature is within regulation. Based on all interviews conducted and documents obtained, at this time the above allegation was found to be unsubstantiated, meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

On the allegation: Staff do not ensure that resident's needs are met. It was alleged that the facility is understaffed, resulting in residents not receiving incontinence care regularly and residents who go out to the secured patio are alone and fall frequently. LPA interviews with staff revealed 6 of 7 staff feel the facility is staffed to meet the residents needs, there are occasional call offs, and the facility covers the staff call offs. LPA interviews also revealed the staff are not aware of any incontinence issues not being met and they are expected to check the incontinent residents ever 1-2 hours or more often for residents who need. LPA interviews revealed that staff are expected to check the secured patio every 30 minutes – 1 hour and the majority of staff interviewed believe this is being done. LPA noted during file review that three residents have fallen in the secure patio area in the last three months, the facility called 911 and submitted incident reports to Licensing. Based on all interviews conducted and documents obtained, at this time the above allegation was found to be unsubstantiated, meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20250616114812
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: VILLAGE AT SYDNEY CREEK, THE
FACILITY NUMBER: 405800577
VISIT DATE: 06/19/2025
NARRATIVE
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On the allegation: Staff do not ensure that the facility is sanitized. It was alleged that due to the faucets not delivering hot water the kitchen could not be sanitized. LPA interviews with kitchen staff revealed the kitchen wash all kitchen utensils and dishware in a dish sanitizer that utilizes a disinfectant agent and when the sanitizer is not functioning, they have a backup sink with three basins and sanitizing chemical to perform the “three sink sanitization method.” LPA interviews showed that during this week’s hot water issues the kitchen staff were able to follow sanitizing protocols or wait for the hot water supply to be restored between maintenance. LPA observed the kitchen to be clean, organized and free of debris. Based on all interviews conducted and documents obtained, at this time the above allegation was found to be unsubstantiated, meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted, no citation was given at this time and report was provided.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3