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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801876
Report Date: 03/19/2025
Date Signed: 03/19/2025 03:56:51 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
03/13/2025 and conducted by Evaluator Angela Barutyan
COMPLAINT CONTROL NUMBER: 29-AS-20250313114055
FACILITY NAME:ATRIA GRAND OAKSFACILITY NUMBER:
565801876
ADMINISTRATOR:BRIAN LARIOSFACILITY TYPE:
740
ADDRESS:2177 E THOUSAND OAKS BLVDTELEPHONE:
(805) 370-5400
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91362
CAPACITY:140CENSUS: 125DATE:
03/19/2025
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Eden TolentinoTIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Facility staff do not maintain facility walkways free from hazards
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Angela Barutyan and Emily Peraldi arrived at the facility unannounced to conduct an initial complaint investigation for the allegation listed above at 09:50AM. Upon arrival, LPAs met with staff and Executive Director (ED) Eden Tolentino who arrived at 10:15AM. Entrance interview conducted.

During today's visit, LPAs conducted a full physical plant tour between 10:26AM-11:55AM, interviewed seven (7) residents between 11:07AM-11:49AM, three (3) staff members between 11:36AM-02:02PM, and the ED at 02:38PM, and reviewed and obtained copies of pertinent documents relevant to the investigation between 02:50PM-03:30PM.

CONTINUED ON LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025
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 2
Control Number 29-AS-20250313114055
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: ATRIA GRAND OAKS
FACILITY NUMBER: 565801876
VISIT DATE: 03/19/2025
NARRATIVE
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It was alleged that the rug outside of the front entrance of the facility and the outdoor walkways posed safety hazards to residents. Upon entry at 09:50AM, LPAs did not observe a rug by the front door entrance. Interviews conducted with staff and residents confirmed that there used to be a rug at the entrance, but it was removed due to several reports of the rug getting caught on resident walkers. It was further alleged that the outdoor passageways are too narrow and pose concerns for walker usage. LPAs observed the outdoor passageways which were maintained in good repair and not obstructed. Seven (7) out of seven (7) residents interviewed did not report any current safety concerns. At 01:57PM, LPA along with the Maintenance Director, measured the outdoor passageway by the side of the facility to be 37 inches, and at 01:59PM the outdoor passageway leading to the front of the facility to be 60 inches. The average walker measures around 23-28 inches. No concerns of the width of the passageways were noted. Staff interviewed did not have current physical plant safety concerns. LPAs did not observe any immediate safety concerns or deficiencies during the physical plant tour. Minor physical plant concern in the laundry room on the third floor is being addressed by the ED. LPAs had a conversation with the ED to ensure that all rugs in the facility shall have protective devices such as nonslip materials and to ensure that there are no tripping hazards throughout the facility. Based on LPAs’ observation, interviews, and record review, the information obtained during the investigation does not have sufficient evidence to corroborate the allegation. 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 above allegation “Facility staff do not maintain facility walkways free from hazards” is deemed UNSUBSTANTIATED at this time.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2