<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565800978
Report Date: 01/06/2025
Date Signed: 01/06/2025 11:12:17 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
01/30/2024 and conducted by Evaluator Erika Miller
COMPLAINT CONTROL NUMBER: 29-AS-20240130123335
FACILITY NAME:UNIVERSITY VILLAGE THOUSAND OAKSFACILITY NUMBER:
565800978
ADMINISTRATOR:DMITRY ESTRINFACILITY TYPE:
741
ADDRESS:3415 CAMPUS DRIVETELEPHONE:
(805) 241-3000
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY:514CENSUS: 486DATE:
01/06/2025
UNANNOUNCEDTIME BEGAN:
10:49 AM
MET WITH:Dmitry Estrin, Executive DirectorTIME COMPLETED:
11:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility retained resident with a higher level of care needs.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Associate Governmental Program Analyst (AGPA) Jennifer Walden (Walden) made an unannounced complaint visit (telephonically) to this facility and spoke with the Executive Director, Dmitry Estrin (Estrin). Licensing Program Analyst (LPA) Erika Miller (Miller) conducted a subsequent complaint visit to the facility above to issue final findings. LPA Miller met with Estrin, and explained the purpose of the visit.

Reporting party (RP) alleges that Resident 1 (R1) was initially healthy then experienced multiple infections. RP alleges that facility did not make a higher level of care available as advertised on their website. RP alleges that family requested assistance in placing R1 in Assisted Living or Skilled Nursing units, but staff advised that space was not available. RP further stated that facility has not helped R1 find a suitable location, despite facility staff stating that R1 requires a higher level of care.
Continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Erika Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025
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-20240130123335
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: UNIVERSITY VILLAGE THOUSAND OAKS
FACILITY NUMBER: 565800978
VISIT DATE: 01/06/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Walden interviewed Estrin, who stated that an admission to skilled nursing requires a written order, which had only recently been received. Estrin met with R1’s family on January 29, 2024, and advised that a transfer of R1 would be made to a sister community’s Skilled Nursing Facility located in Fuller ton, California. The transfer was completed on February 3, 2024. As of February 5, 2024, Estrin stated that R1 was on the priority list for admission and 3rd in line. Estrin further stated that the wait could take a couple of weeks or more for space to become available.

LPA Miller reviewed the August 23, 2010, admission agreement that states in part, “If an assisted living standard studio is not available in the Health Care Center, Continuing Life Communities will arrange for you to receive assisted living at a similar outside facility and will place you on a priority list for admission to an assisted living standard studio in the Health Care Center.”

Based on the documentation reviewed and interviews conducted, the facility complied with the terms of the written agreement. Although, the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

Exit interview conducted, copy of report issued.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Erika Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2