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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425850219
Report Date: 05/07/2025
Date Signed: 05/07/2025 09:29:21 AM

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
05/01/2025 and conducted by Evaluator Melisa Rankin
COMPLAINT CONTROL NUMBER: 29-AS-20250501143031
FACILITY NAME:VILLA-CARE HOME IVFACILITY NUMBER:
425850219
ADMINISTRATOR:VILLAROS, JENNIFERFACILITY TYPE:
740
ADDRESS:1422 SONYA LANETELEPHONE:
(805) 623-2939
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:6CENSUS: 4DATE:
05/07/2025
UNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Jennifer VillarosTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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Uncleared person present at facility
INVESTIGATION FINDINGS:
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On 05/07/2025 at 7:50 a.m. Licensing Program Analyst’s (LPA) Rankin and Jeffries conducted a 10-day complaint visit to the facility above. LPAs met with Jennifer Villaros, Administrator and explained the purpose of the visit.

During the investigation, LPA Rankin and Jeffries observed the facility, interviewed administrator and staff, and interviewed all residents and collected relevant documentation.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
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 2
Control Number 29-AS-20250501143031
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: VILLA-CARE HOME IV
FACILITY NUMBER: 425850219
VISIT DATE: 05/07/2025
NARRATIVE
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On the allegation: Uncleared person present at facility. It was alleged that an exclude person had resided at the facility. It was discovered through observations, interviews, and documentation, that on 05/07/2025, Licensing Program Analyst (LPA’s) Rankin and Jeffries observed one care giver (S1) and 4 residents. (R1, R2, R3, and R4). On 05/072025 LPA Rankin conducted resident interviews for R1 and R2, who both stated that the care was good, and both stated they had no knowledge of the exclude individual(s) presence at the facility. On 05/07/2025, LPA Jeffries conducted interviews with R3. R3 interview was inconclusive on exclude individuals being present at the facility but feels safe and comfortable in the facility. On 05/07/2025 LPA Rankin interview Care Staff (S1) and Administrator. S1 stated they work morning shifts and are not aware of the excluded individuals present at the facility. On 5/7/2025 LPA Rankin interviewed administrator who stated she was aware that excluded individuals are not to be at the facility. Documents collected were staff and resident rosters. The excluded individuals were not noted on either documents. All rooms occupied were of residents noted on the roster and there are no staff rooms at this facility.

Based on interviews, observation and documentation, there is not sufficient evidence, at this time, to prove the alleged violations did or did not occur therefore the allegations are unsubstantiated.

Exit interview conducted, copy of report given.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2