565850555-1-14-2026-29-AS-KHEN-DRP988-20260226220818

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850555
Report Date: 01/14/2026
Date Signed: 01/14/2026 04:18:07 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
01/12/2026 and conducted by Evaluator Kelly Dulek

COMPLAINT CONTROL NUMBER: 29-AS-20260112122927

FACILITY NAME:	CYPRESS PLACE ASSISTED LIVING		FACILITY NUMBER:	565850555
ADMINISTRATOR:	ROZANER, GINA		FACILITY TYPE:	740
ADDRESS:	1200 CYPRESS POINT LANE		TELEPHONE:	(805) 650-6000
CITY:	VENTURA	STATE: CA	ZIP CODE:	93003
CAPACITY:	89	CENSUS: 75	DATE:	01/14/2026
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Gina Rozaner		TIME COMPLETED:	04:25 PM

ALLEGATION(S):

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Staff did not assist resident with medical transportation needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint visit regarding the above noted allegation. LPA was greeted by the front desk staff and met with Executive Director (ED) Gina Rozaner. LPA explained the purpose of the visit. Entrance interview conducted.

During today's visit, LPA interviewed ED and Director of Wellness at 11:40AM, staff at 12:33PM, briefly toured the facility at 12:45PM, conducted two (2) resident interviews from 12:48PM to 03:00PM. LPA also reviewed and obtained copies of pertinent documents. The following was then determined:

The complaint alleges that the facility is not providing transportation for Resident #1 (R1)'s scheduled medical appointment. Interview revealed that the facility does have a vehicle and driver available three (3) days a week to take residents to scheduled medical appointments. Staff stated that typically reservations are made a week in advance to secure a spot on one of the available days. In the event a resident becomes ill
Report Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20260112122927

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: CYPRESS PLACE ASSISTED LIVING	FACILITY NUMBER: 565850555
	VISIT DATE: 01/14/2026

NARRATIVE

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and/or has a last minute appointment, the front desk staff will check for availability and add the resident to the schedule if there is availability. In the case of R1, interview revealed that R1's family member called and left a voice message for the concierge at 07:43AM on 01/12/2026 indicating R1 had an appointment scheduled and required transportation. Concierge attempted to return the call, however, R1's family member did not answer nor did R1 or their family member follow up when they were both in the facility speaking to the staff in person. Later that day, police officers arrived at the facility to check on R1. Police informed concierge that R1 had not been assisted with transportation arrangements. Concierge then reached out to R1 via telephone and gathered details about the appointment. Concierge was able to arrange facility transportation for R1's medical appointment scheduled for the next day. Concierge did receive a call back from R1's family member on the morning of 01/13/2026 and informed them of the transportation arrangements. Interview with R1 confirmed the facility driver did assist R1 in their transportation needs and took R1 to their appointment. 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 violation did or did not occur, therefore the above allegation is deemed UNSUBSTANTIATED at this time.

No citations issued. Exit interview conducted. A copy of today's report was provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026

LIC9099 (FAS) - (06/04)

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