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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850339
Report Date: 02/05/2025
Date Signed: 02/06/2025 03:43:20 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
12/16/2024 and conducted by Evaluator Zabel Chochian
COMPLAINT CONTROL NUMBER: 29-AS-20241216151032
FACILITY NAME:INN AT THE PARK VENTURAFACILITY NUMBER:
195850339
ADMINISTRATOR:ANGUIANO, ROSEFACILITY TYPE:
740
ADDRESS:21200 VENTURA BLVDTELEPHONE:
(818) 884-7100
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91364
CAPACITY:200CENSUS: 168DATE:
02/05/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Rose AnguianoTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not ensuring the facility is free from pests
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to deliver investigation finding. Upon arrival LPA met with Administrator Rose Anguiano.
On 12/16/2024, Community Care Licensing Division received the above allegation. It was reported that resident #1 had bed bugs at one time (unknown date) and bed bug issue continues; no response or improvement was made by staff. On 12/20/2024, Licensing Program Analyst (LPA) Brian Balisi conducted a complaint visit to investigate the allegation listed above. At approx. 10:50 a.m., LPA Balisi conducted physical plant, interviewed staff, reviewed and obtained copies of pertinent documentation relevant to the investigation. On 02/05/2025, LPA Chochian conducted a subsequent visit. From 10am-11am, LPA and Administrator toured the facility and LPA interviewed ten (10) residents. Residents reported no bed bug activity. Resident #1 denied any bed bug activity in room. Administrator provide records and invoices from Hydrogen Pest Control for the last three months confirming general pest and bed bug prevention treatment conducted. Based on the above information gathered, there is insufficient evidence to support the allegation; therefore, allegation is deemed unsubstantiated at this time. Exit interview held copy of report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
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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