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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850266
Report Date: 03/10/2026
Date Signed: 03/10/2026 02:28:43 PM

Unsubstantiated


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
11/06/2025 and conducted by Evaluator Brian Balisi
COMPLAINT CONTROL NUMBER: 29-AS-20251106115359
FACILITY NAME:ALTA VISTA SIMI #2 LLCFACILITY NUMBER:
565850266
ADMINISTRATOR:REDLIN, VICTORIA N.FACILITY TYPE:
740
ADDRESS:2942 ROSETTE ST.TELEPHONE:
(805) 208-2345
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY:6CENSUS: 5DATE:
03/10/2026
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Myline ViajeTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility staff did not assist resident with ambulating

Facility staff spoke inappropriately to resident

Staff did not provide adequate food service for residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced subsequent complaint visit to investigation the allegations listed above. Upon arrival LPA met Administrator Emiliano C Siapno and explained the reason for the visit.
On 11/07/2025, LPA conducted an initial 10-day complaint visit to investigate the allegations listed above. At approximately 10:00 a.m. LPA conducted physical plant, interviewed staff, residents, families / responsible parties of residents in care and reviewed and obtained copies of pertinent documentation relevant to the investigation. Today LPA conducted physical plant, interviewed staff, residents, families / responsible parties of residents in care.
It was reported that “Facility staff did not assist resident ambulating” as it was alleged that staff are not assisting Resident #1 (R1) with using the restroom. LPA’s interview with six (6) residents during the investigation reflected that none of the (6) residents reported concerns about staff failing to assist them with toileting or incontinence care. All (6) residents stated they have not been left in soiled diapers or clothing for an extended period of time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
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-20251106115359
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: ALTA VISTA SIMI #2 LLC
FACILITY NUMBER: 565850266
VISIT DATE: 03/10/2026
NARRATIVE
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LPA was unable to effectively communicate with one (1) resident. LPA interviewed four (4) staff members. Staff reported that residents are typically asked if they need to use the restroom or have their diapers checked before each shift, before and after meals, before and after snacks, and before going to bed. Staff stated that R1 is encouraged to request assistance with using the restroom; however, at times when R1 requested assistance they already had urinated or had a bowel movement. LPA also interviewed five (5) residents’ family members or responsible parties. None of the (5) individuals did not report any concerns about staff failing to assist residents with toileting or incontinence care in a timely manner. Based on the information obtained during the investigation, the Department 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 violations did or did not occur, therefore the above allegations "Facility staff did not assist resident with ambulating " has been deemed Unsubstantiated at this time.

It was reported that “Facility staff spoke inappropriately to resident” It was alleged that staff told R1 to “shut up.” LPA’s interview six (6) residents during the investigation revealed one (1) resident stated they were not comfortable ringing a bell to request assistance, however when they do request assistance by other means staff attend to them in a timely manner. All (6) residents also reported they have not observed staff speak inappropriately to residents and did not express any concerns about staff speaking inappropriately or discouraging residents from requesting assistance. LPA was unable to effectively communicate with one (1) resident. LPA’s interview with four (4) staff members revealed all (4) Staff reported they have not observed any staff speak inappropriately to residents and have not observed staff deny assistance to residents when requested. LPA also interviewed five (5) residents’ family members or responsible parties. None of the (5) individuals expressed concerns about staff speaking inappropriately to residents in care. Based on the information obtained during the investigation, the Department 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 violations did or did not occur, therefore the above allegations " Facility staff spoke inappropriately to resident” has been deemed Unsubstantiated at this time.

It was reported that “Meals are not provided in a timely manner” as It was alleged that meals are not provided to residents at typical meal times. LPA interviewed six (6) residents during the investigation. One (1) resident stated they receive their meals "long after" typical meal times, but also indicated they can't recall what time the meals were served or when this occurred.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 29-AS-20251106115359
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: ALTA VISTA SIMI #2 LLC
FACILITY NUMBER: 565850266
VISIT DATE: 03/10/2026
NARRATIVE
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Continued from 809-C

The other (5) residents reported they have not experienced delays in meal service and did not express concerns about meals being provided at inconsistent times. LPA was unable to effectively communicate with one (1) resident. LPA interviewed four (4) staff members. Staff stated that meals are typically served at approximately 7:30 a.m., 12:00 p.m., and 5:30 p.m., with snacks offered between meals. Staff reported that residents are asked if they would like to eat when meals are offered and that some residents occasionally choose to eat later than the scheduled meal time depending on how much they ate during their previous meal time. LPA also interviewed five (5) residents’ family members or responsible parties. None of the (5) individuals expressed concerns regarding residents not receiving meals in a timely manner. Based on the information obtained during the investigation, the Department 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 violations did or did not occur, therefore the above allegations " Meals are not provided in a timely manner”” has been deemed Unsubstantiated at this time.

During the visit Administrator Emiliano C Siapno stated they had leave to attend to an urgent matter, but stated staff can sign in their place.

Exit interview conducted and copy of report issued.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3