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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850143
Report Date: 11/05/2025
Date Signed: 11/05/2025 01:16:39 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
01/08/2025 and conducted by Evaluator Quoc Huynh
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20250108085232
FACILITY NAME:A COMPASSION VALLEYFACILITY NUMBER:
195850143
ADMINISTRATOR:KUYUMCHYAN, BREANNAFACILITY TYPE:
740
ADDRESS:7460 MAMMOTH AVE.TELEPHONE:
(818) 983-9165
CITY:VAN NUYSSTATE: CAZIP CODE:
91405
CAPACITY:6CENSUS: 0DATE:
11/05/2025
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Eva Elizalde - Staff
Fraulem Villasor - CHOW Staff		TIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Staff mismanaged resident's medications
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Quoc Huynh conducted an unannounced subsequent complaint visit to deliver findings for the above allegations. LPA arrived at 11:50AM and made contact with Staff Eva Elizalde at 12:12PM via telephone. Entrance interview conducted.

On 1/13/2025, LPA Christine Yee conducted an initial complaint visit at 10:20AM. Between 11:15AM and 5:25PM, LPA Yee interviewed one (1) resident and one (1) staff, reviewed and obtained pertinent documents, and conducted a medication review.

Report Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
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-20250108085232
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: A COMPASSION VALLEY
FACILITY NUMBER: 195850143
VISIT DATE: 11/05/2025
NARRATIVE
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During today’s visit, The Licensee and Staff were unavailable for the visit and stated they would contact the Change of Ownership Applicants to allow LPA entry into the facility. Fraulem Villasor arrived at 1PM. LPA Huynh and Fraulem Villasor conducted a brief safety tour of the facility at 1:03PM, and no immediate concerns were observed. The following was then determined:

Allegation: “Staff mismanaged resident's medications”

Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed UNSUBSTANTIATED at this time.

The LPA delivered findings to the Licensee’s designee Eva Elizalde via telephone. The LPA emailed a copy of the report to the Licensee and Staff, who agreed to return the report with signatures via email.

No deficiency cited. Exit interview conducted. A copy of today’s report was reviewed and provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2