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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 405850052
Report Date: 09/03/2025
Date Signed: 09/03/2025 12:55:48 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/27/2025 and conducted by Evaluator Rachael De Leon
COMPLAINT CONTROL NUMBER: 29-AS-20250827130039
FACILITY NAME:PARK PLACE SENIOR ASSISTED LIVINGFACILITY NUMBER:
405850052
ADMINISTRATOR:BARNHILL, DIANAFACILITY TYPE:
740
ADDRESS:7500 PORTOLA RDTELEPHONE:
(805) 591-9855
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY:13CENSUS: 10DATE:
09/03/2025
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Diana Barnhill, Administrator TIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Licensee did not ensure that the facility obtained fire clearance and approval of a delayed egress device on facility door.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) De Leon conducted a 10 day complaint visit to the facility above. LPA met with Administrator/Licensee Diana Barnhill and explained the purpose of the visit.
LPA requested the following records: Staff Roster, Staff Schedule for August 2025, Resident roster and copy of video surveillance of the kitchen area on 08/26/2025.
LPA interviewed staff around 10:30am, toured the kitchen, dining, took photographs of the front exiting doors, and observed the secured perimeter patio to have fencing all around courtyard with a magentic locking mechanicsm on the gates around patio with a magnetic key phobe for opening gates.

On the allegation: Licensee did not ensure that the facility obtained fire clearance and approval of a delayed egress device on facility door. The facility was originally licensed on 03/16/2021 and at that time the front door had key coded exit, and the facility courtyard was a fenced secured perimeter with a magnetic key phobe on gates. The fire clearance was reviewed and this was not indicated as approved. Cont. 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
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 29-AS-20250827130039
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: PARK PLACE SENIOR ASSISTED LIVING
FACILITY NUMBER: 405850052
VISIT DATE: 09/03/2025
NARRATIVE
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LPA De Leon spoke with Administrator and provided the fire department with a updated clearance for approval or denial. The facility had a new company come out to the facility and install delayed egress on the front entry/exiting door and it is not currently working as the Licensee is waiting for the approval from Fire to be able to use the device. On 08/26/2025 Witness 1 (W1) visited the facility and was not able to leave until the staff put the code in the front door to exit. W1 said the front door has a sliding lock located towards the top of the door that is used by sliding it over to lock. The door knob still has a key coded lock on it and it locks from the inside to go outside, the staff would need to come to the door with the code to let someone exit. The fire department has not granted or denied the delayed egress inspection request at this time. LPA has spoken to administrator and let them know the door knobs will need to be removed and a normal locking door knob placed until the fire department can come out to inspect and approve the delayed egress. The front entering door can remain locked at night and overnight for safety but can not have day time locks or delayed egress until it is approved by the fire department and sent to CCL for final approval on the license. Based on the evidence this allegation is deemed Substantiated at this time.

Exit interview conducted, deficiency cited, civil penalty assessed, copy of report and appeal rights printed for Administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
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
CCLD Regional Office, 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
08/27/2025 and conducted by Evaluator Rachael De Leon
COMPLAINT CONTROL NUMBER: 29-AS-20250827130039

FACILITY NAME:PARK PLACE SENIOR ASSISTED LIVINGFACILITY NUMBER:
405850052
ADMINISTRATOR:BARNHILL, DIANAFACILITY TYPE:
740
ADDRESS:7500 PORTOLA RDTELEPHONE:
(805) 591-9855
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY:13CENSUS: 10DATE:
09/03/2025
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Diana Barnhill, Administrator TIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Staff did not keep hazardous items securely stored.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) De Leon conducted a 10 day complaint visit to the facility above. LPA met with Administrator/Licensee Diana Barnhill and explained the purpose of the visit.

LPA requested the following records: Staff Roster, Staff Schedule for August 2025, Resident roster and copy of video surveillance of the kitchen area on 08/26/2025.

LPA interviewed staff around 10:30am, toured the kitchen, dining, took photographs of the front exiting doors, and observed the secured perimeter patio to have fencing all around courtyard with a magentic locking mechanicsm on the gates around patio with a magnetic key phobe for opening gates.

On the allegation: Staff did not keep hazardous items securely stored. LPA De Leon interviewed staff on 09/03/2025 which revealed staff was working that day and a staff person was always in the kicthen/dining area of the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
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 29-AS-20250827130039
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: PARK PLACE SENIOR ASSISTED LIVING
FACILITY NUMBER: 405850052
VISIT DATE: 09/03/2025
NARRATIVE
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 LPA watched the video surveillance on the date of 08/26/2025 around 10:00am and 1 staff was on break sitting at the bar counter between the kitchen and dining room. At no time did a resident enter the kitchen area. According to the staff there was 3 staff on duty, 2 caregivers helping residents and one housekeeper, the housekeeper was on break and if needed would have re-directed any residents that would have tried to go in the kitchen area at this time. Witness 1 (W1) stated the sharps and knives drawer was unlocked and accessible to residents in care. After watching the video surveillance the housekeeper was siting between the kitchen and the dining area and no residents had attempted to go into the kitchen area, the knife drawer was unlocked with a staff in the immediate area making it inaccessible to residents in care. Staff were directed to lock the drawer and did so at that time. Based on the staff being in the immediate area and no residents entering the kitchen area this allegation is Unsubstantiated at this time.

Exit interview conducted and copy of report printed for Administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20250827130039
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: PARK PLACE SENIOR ASSISTED LIVING
FACILITY NUMBER: 405850052
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/04/2025
Section Cited
CCR
87705(f)(2)
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(f) Licensees that lock exterior doors or perimeter fence gates...(2)The licensee shall ensure that the fire clearance includes approval of locked exterior doors or perimeter fence gates...
This requirement was not met as evidenced by:
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Administrator agreed to remove all locks off of the entry/exit door and put a manual knob and lock for overnight until the delayed egress can be approved by the fire department, read and review regulation 87705 and train staff provide proof of training to CCL.
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Based on records review and observation the licesee did not comply with the regulation above the front entry/exit door has an automatic lock when exiting the front door and a sliding lock at the top of the door for locking at night which poses an immediate 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: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5