195850339-11-13-2025-29-AS-DPEA-DNT28C-20251126161006

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850339
Report Date: 11/12/2025
Date Signed: 11/13/2025 09:10:08 AM

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
10/06/2025 and conducted by Evaluator Zabel Chochian

COMPLAINT CONTROL NUMBER: 29-AS-20251006104545

FACILITY NAME:	INN AT THE PARK VENTURA		FACILITY NUMBER:	195850339
ADMINISTRATOR:	ANGUIANO, ROSE		FACILITY TYPE:	740
ADDRESS:	21200 VENTURA BLVD		TELEPHONE:	(818) 884-7100
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91364
CAPACITY:	200	CENSUS: 139	DATE:	11/12/2025
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Alexander Solorio, Assistant Administrator		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Facility staff did not ensure resident's incontinence care needs were met
Resident was locked in their room

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to this facility today regarding above allegations. Upon arrival LPA met with Resident Care Coordinator Tina Hernandez and Assistant Administrator Alex Solorio. Reason for the visit was explained.

On 10/06/2025, Community Care Licensing Division received the above allegations. Information was received that resident #1 (R1) was locked in their room; and when staff opened the door resident was observed in bed with soiled diaper. On 10/10/2025, LPA conducted the initial complaint visit and toured the facility's memory care unit which consists of 21 resident rooms, and common areas at approximately 11:30 A.M. LPA attempted to interview five (5) random residents in the memory care. One out of five residents was able to communicate and respond to questions asked. LPA also conducted interview with three staff, ED and Assistant Administrator beginning at approximately 11:30 A.M. and from 12:30 P.M - 2:30 P.M.
At the time of the visit memory care resident observed in the activity/dining area. Residents observed dry/not soiled at the time of visit. (Continue to LIC9099c)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:	DATE: 11/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025

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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Control Number 29-AS-20251006104545

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: INN AT THE PARK VENTURA	FACILITY NUMBER: 195850339
	VISIT DATE: 11/12/2025

NARRATIVE

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Random rooms toured in the memory care were odor free at the time of visit. One residents who was able to communicate was interviewed and expressed being satisfied with care service. Resident #1’s (R1) records were reviewed and revealed that R1 is non-ambulatory, nonverbal, requires transfer assistance and is incontinent with folly catheter. R1 observed to be nonverbal and did not understand English. R1 was able to communicate needs and responded through hand movements and facial expressions. R1 was interviewed by LPA with staff assistance. R1 expressed being satisfied with care and staff. R1 was asked how often staff check in on resident (30min, 1hour, not more than 2 hours), and R1 gestured with thumbs up to all. R1 was asked if they are able to transfer out of bed and R1 shook there head from left to right (no). R1 was observed to be following staff command when asked to demonstrate sitting up which R1 is able to do without staff assistance. Staff reported that R1 is assisted with incontinent care according to care needs. Staff also reported that they make sure folly catheter is maintained accordingly as well. According to staff on 10/05/2025 paramedics were called for R1 as a result of R1 pulling out folly catheter. Staff stated that they cleaned R1 and called paramedics. Staff explained that when paramedics arrived R1 had a bowl movement therefore needed to be changed again. Staff reported that all memory care resident are checked at least every 2 hours due to cognitive abilities and incontinent care needs. Staff reported that resident are never left sitting or laying in soiled clothing. Other potential witness interviewed shared that the residents are observed clean and dry.

Regarding allegation "Resident was locked in their room". Staff interviewed reported that the memory care units do not lock. According to staff R1's door was stuck and would not open the day paramedics were called and arrived to the facility for R1. Staff explained that the door was closed and would not open because it was stuck and not because it was locked. Staff reported that the locking mechanism on the door knobs are not functional and you can not lock the doors. Staff stated that they used a random key that day in attempt to unstuck R1's room door. During the tour LPA observed all resident room doors. Door knobs were tested and LPA observed some resident doors to have a key whole on the door knob, however the locking mechanism was tested and observed non-functional. Door knob's observed with a key whole were disabled locks which are unable to be locked. ED reported that all the door knobs that have a key which is non-functional will be replaced with regular door knobs. 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 violations did or did not occur, therefore the above allegations “Resident was locked in their room” is deemed unsubstantiated at this time. Exit interview held. Copy of report provide.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:	DATE: 11/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025

LIC9099 (FAS) - (06/04)

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