191222083-1-13-2025-29-AS-KLOZ-DD8VJS-20250124152909

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191222083
Report Date: 01/13/2025
Date Signed: 01/13/2025 11:53:34 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
01/07/2025 and conducted by Evaluator Trevor Byrne

COMPLAINT CONTROL NUMBER: 29-AS-20250107141159

FACILITY NAME:	LIGHTHOUSE, THE		FACILITY NUMBER:	191222083
ADMINISTRATOR:	GABRIELA VISOVAN		FACILITY TYPE:	740
ADDRESS:	10406 MAGNOLIA BLVD.		TELEPHONE:	(818) 766-3764
CITY:	TOLUCA LAKE	STATE: CA	ZIP CODE:	91601
CAPACITY:	49	CENSUS: 25	DATE:	01/13/2025
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Gabriela Visovan		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility does not provide resident with clean and comfortable mattress.

Facility staff has threatened resident with eviction if resident complains to licensing agency.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Trevor Byrne conducted an unannounced complaint investigation visit at the facility at 9:35 AM. LPA met with facility staff who contacted the facility Administrator Gabriela Visovan via phone call. The Administrator arrived to the facility at approximately 09:55 AM. the reason for the visit was explained and entrance interview was conducted.

During today’s visit LPA conducted a physical plant tour, interviewed five (5) residents, and interviewed the facility Administrator between 09:55 AM and 11:30 AM.

Continued on LIC-9099C

Unsubstantiated

Estimated Days of Completion: 7

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025

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-20250107141159

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: LIGHTHOUSE, THE	FACILITY NUMBER: 191222083
	VISIT DATE: 01/13/2025

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

The allegation of “Facility does not provide resident with clean and comfortable mattress” alleges that the facility did not provide a resident with an acceptable mattress. An interview with Resident #1 (R1) revealed that R1 had been sleeping on three (3) sleeping mats for the past six (6) months. R1 stated that they informed the Administrator that their previous mattress was not comfortable so they replaced it with the three (3) sleeping mats. R1 confirmed that the Administrator replaced the mats with a new mattress about 4-5 days ago. The interview with the Administrator revealed that they have replaced the mattress for R1 on five (5) separate occasions. The Administrator stated that R1 had their prior mattress swapped out for the three (3) mats around November 2024. The Administrator stated that the order of the three (3) mats on R1’s bed was, hospital bed mattress, egg crate mattress, gel mattress topper. The Administrator stated that during the time R1 had the three mats they had not informed the front office that they wished for a new mattress. The Administrator stated that when R1 informed them that they did not like the three (3) mats about a week ago they immediately replaced the mats with a new mattress. Interviews with four (4) additional residents did not reveal concerns with the mattresses provided. Although the allegation may have happened or is valid there is insufficient evidence to support the allegation of facility does not provide resident with clean and comfortable mattress. Therefore, the allegation is deemed Unsubstantiated at this time.

The allegation of “Facility staff has threatened resident with eviction if resident complains to licensing agency” alleges that the facility threatened to evict a resident for filing a complaint with Community Care Licensing Division (CCLD). During the interview with R1 they stated, “They didn’t threaten to evict me, that is not true.” During the interview with the Administrator, they recalled the interaction with R1 and stated that the resident approached the Administrator and asked for an orthopedic mattress. The Administrator informed R1 that, “We don’t provide orthopedic mattresses, if you would like one you will have to ask you family to buy you one.” R1 replied, “Well I’m going to complain.” To which the Administrator responded, “Okay, go ahead.” Additionally, interviews with four (4) additional residents did not reveal concerns regarding threats of eviction for reporting complaints to CCLD. Although the allegation may have happened or is valid there is insufficient evidence to support the allegation of facility staff has threatened resident with eviction if resident complains to licensing agency. Therefore, the allegation is deemed Unsubstantiated at this time.

No deficiencies were observed during today’s inspection. A copy of the report was printed and exit interview was conducted.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2