195850184-7-28-2026-29-AS-KHEN-DWHSPJ-20260731140310

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850184
Report Date: 07/28/2026
Date Signed: 07/28/2026 04:07:27 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
06/02/2026 and conducted by Evaluator Quoc Huynh

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20260602080806

FACILITY NAME:	COTTAGES AT THE COLONY OF SHERMAN OAKS #4		FACILITY NUMBER:	195850184
ADMINISTRATOR:	LEE, ANNA B DELROSARIO		FACILITY TYPE:	740
ADDRESS:	5430 TYRONE AVENUE		TELEPHONE:	(818) 855-7021
CITY:	SHERMAN OAKS	STATE: CA	ZIP CODE:	91401
CAPACITY:	6	CENSUS: 6	DATE:	07/28/2026
		UNANNOUNCED	TIME BEGAN:	03:14 PM
MET WITH:	Anna Lee - Administrator		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff speak inappropriately to a resident in care
Staff do not treat a resident with respect

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Quoc Huynh conducted a subsequent visit to deliver findings for the above allegations. The LPA arrived at 3:14PM and met with Administrator Anna Lee. Entrance interview conducted.

On 06/03/2026, LPA Huynh conducted an initial complaint visit. Between 2:01PM and 4PM, the LPA conducted a physical plant tour and interviewed four (4) residents, two (2) staff, and the Administrator. Records were provided via email on 06/04/2026.

During today’s visit, the LPA and Staff toured the physical plant at 3:17PM, and no immediate concerns were observed. The following was then determined:

Report Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

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-20260602080806

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: COTTAGES AT THE COLONY OF SHERMAN OAKS #4	FACILITY NUMBER: 195850184
	VISIT DATE: 07/28/2026

NARRATIVE

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Due to R1’s frequent complaints, the Administrator relocated S1 and S2 to another facility to mitigate ongoing issues. R1 continued to complain about the replacement staff because they did not operate the same way S1 and S2 did. R1 was ultimately relocated to another facility operated by the same Licensee and Administrator, where it was reported that R1 was doing well and happier.

Physician’s Report dated 05/31/2026 documented diagnoses for R1 including schizophrenia, depression, bipolar disorder, and anxiety. Psychiatric visit summaries indicated R1 saw their psychiatrist once a month and experienced “persistent paranoia, anxiety, and inconsistent reporting of incidents involving facility staff.” R1’s paranoid behavior was worsening, and medications were adjusted or discontinued accordingly. Staff were to monitor R1 and maintain a calm, structured environment.

Based on interviews and record review, although the allegations may have happened or are valid, there is insufficient evidence to prove the violations did or did not occur; therefore, the allegations are deemed UNSUBSTANTIATED at this time.

No deficiency cited. Exit interview conducted. A copy of the report was reviewed and provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20260602080806

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: COTTAGES AT THE COLONY OF SHERMAN OAKS #4	FACILITY NUMBER: 195850184
	VISIT DATE: 07/28/2026

NARRATIVE

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Allegations: “Staff speak inappropriately to a resident in care” and “Staff do not treat a resident with respect”

It was reported that Staff #1 (S1), Staff #2 (S2), and the Administrator spoke inappropriately and did not treat Resident #1 (R1) with respect. R1 described S1 as “rude” and “obnoxious,” stating that S1 would often badger R1 after they asked simple questions. R1 did not provide information regarding S2’s conduct and reported that the Administrator was very helpful in resolving concerns. R1 stated that they could no longer tolerate the treatment they received and requested relocation. They further disclosed that they also had conflict with other residents and their families. R1 expressed satisfaction with the facility they were relocated to and stated that the two (2) facilities “were like night and day.”

Interview with S1, S2, and other residents revealed that R1 was frequently disruptive, initiated arguments with staff and residents, and was not satisfied with the accommodations made. Staff reported responding to R1’s behavior by remaining calm and explaining the facility’s rules and expectations, which R1 refused to accept. When staff needed assistance in managing resident behaviors, they communicated with the Administrator for guidance. Residents did not have concerns regarding staff conduct or level of service provided. They stated that S1 and S2 go above and beyond to ensure residents’ needs are met and remain respectful. Residents acknowledged that R1 frequently caused trouble with staff over minor issues and often complained; however, the residents did not agree with R1’s claims. The residents additionally did not observe S1 or S2 act maliciously or treat R1 with disrespect.

The Administrator expressed no concerns regarding staff performance and was confident in staff’s ability to handle all situations appropriately. For more difficult situations, staff maintained open communication with the Administrator and utilized them as a resource. The Administrator stated that due to R1’s mental diagnoses, their perception of reality was severely affected, and R1 frequently attempted to manipulate staff into bending policies for their benefit.

Report Continued on LIC 9099-C

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC9099 (FAS) - (06/04)

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