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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197600430
Report Date: 10/19/2022
Date Signed: 10/19/2022 02:46:23 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
10/14/2022 and conducted by Evaluator Emily Peraldi
COMPLAINT CONTROL NUMBER: 29-AS-20221014155150
FACILITY NAME:VALLEY VIEW RETIREMENT CENTERFACILITY NUMBER:
197600430
ADMINISTRATOR:JUDITH MONTOYAFACILITY TYPE:
740
ADDRESS:7720 WOODMAN AVE.TELEPHONE:
(818) 997-6756
CITY:PANORAMA CITYSTATE: CAZIP CODE:
91402
CAPACITY:116CENSUS: 71DATE:
10/19/2022
UNANNOUNCEDTIME BEGAN:
10:42 AM
MET WITH:Judith Montoya, AdministratorTIME COMPLETED:
02:55 PM
ALLEGATION(S):
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Facility has bed bugs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Emily Peraldi, conducted an unannounced 10-day initial complaint visit to this facility. At 10:42 a.m., the LPA met with the Administrator, Judith Montoya and explained the reason for the visit.

At 10:52 a.m., the LPA conducted an interview with the Administrator. Between 11:10 a.m. and 12:00 p.m., the LPA along with the Administrator, conducted a physical plant tour. The LPA also interviewed seven (7) out of seventy-one (71) residents. At 11:00 a.m., the LPA reviewed records and obtained copies of pertinent documents.

Continued on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 593-4493
LICENSING EVALUATOR NAME: Emily PeraldiTELEPHONE: 818-421-4497
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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-20221014155150
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: VALLEY VIEW RETIREMENT CENTER
FACILITY NUMBER: 197600430
VISIT DATE: 10/19/2022
NARRATIVE
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Regarding the allegation: Facility has bed bugs
On 10/14/2022, the Department received a complaint in which it was alleged that the facility has bed bugs. At 10:52 a.m., the LPA conducted an interview with the Administrator. The Administrator explained that the facility receives monthly pest control maintenance from a company called Western Exterminator Company. The Administrator said if a resident has a bug or insect problem, the Administrator schedules Western Exterminator Company to treat the problem. However, the Administrator said there hasn’t been any recent concerns regarding bugs or insects. The Administrator provided the LPA copies of the most recent invoice from Western Exterminator Company, dated 09/14/2022. During today’s visit, the LPA observed seven (7) resident rooms. The rooms were observed to be furnished appropriately with clean linens. The LPA did not observe bed bugs in the rooms. The interviews with residents revealed that the residents have not observed bed bugs recently. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

Exit interview conducted. A copy of the report was issued via email.
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 593-4493
LICENSING EVALUATOR NAME: Emily PeraldiTELEPHONE: 818-421-4497
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2