197602434-10-23-2024-29-AS-KLOZ-DAJ2RZ-20241029173818

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197602434
Report Date: 10/23/2024
Date Signed: 10/23/2024 03:26:48 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
10/18/2024 and conducted by Evaluator Erica Mosley

COMPLAINT CONTROL NUMBER: 29-AS-20241018133624

FACILITY NAME:	GARDENS AT PARK BALBOA, THE		FACILITY NUMBER:	197602434
ADMINISTRATOR:	DION D GALLARZA		FACILITY TYPE:	740
ADDRESS:	7046 KESTER AVENUE		TELEPHONE:	(818) 787-0462
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91405
CAPACITY:	120	CENSUS: 104	DATE:	10/23/2024
		UNANNOUNCED	TIME BEGAN:	01:07 PM
MET WITH:	Executive Director (ED), Dion Gallarza		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Unlawful eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Erica Mosley conducted an unannounced initial 10-day complaint visit to investigate the above allegation. Upon arrival at 12:30pm LPA Mosley was greeted by front desk staff who called the Executive Director to inform them of the visit. The LPA met with The Executive Director (ED), Dion Gallarza and explained the reason for the visit.

On 10/18/2024, the Department received a complaint regarding the following allegation, Unlawful eviction. LPA toured the physical plant areas inside and outside to ensure there are no immediate health and safety hazards and facility is in compliance with Title 22 Regulations.

Report Continued on LIC9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Erica Mosley	TELEPHONE: (747) 230-3909
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024

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-20241018133624

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: GARDENS AT PARK BALBOA, THE	FACILITY NUMBER: 197602434
	VISIT DATE: 10/23/2024

NARRATIVE

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Report Continued from LIC9099...

On the allegation, unlawful eviction, it is the concern of the Reporting Party (RP) that facility issued an unlawful eviction to Resident #1 (R1). To investigate this complaint, LPA conducted in person interviews with the Administrator and R1 between 12:45 pm – 1:30 pm. LPA also obtained pertinent documents to the investigation and reviewed facility records.

Interviews with R1 revealed that they were involved in an online scheme depleting all financial funds in June of 2024, which has been reporting to local law enforcement. R1 has contacted other agencies to try and obtain funds but has been unsuccessful. R1 states that their Social Security benefits have been temporarily suspended while the investigation is ongoing leaving R1 unable to pay rent. R1 stated they have not made payments to the facility since June 2024 and have not attempted to arrange a payment plan with the facility. Interview with the Executive Director (ED) confirm the statements. Interviews with the ED revealed that the facility has tried to work with R1 in assisting R1 with payment arrangements but R1 has not complied with any arrangements discussed. The facility has made multiple attempts to assist R1 including but not limited to accompanying at the Social Security office but all attempts for assistance have been denied by R1. Records reviewed and obtained revealed that the R1 has not made payments since June 2024 with a total balance of $12,624 as to date.

Based on information obtained, there is insufficient evidence to support the allegation occurred. Therefore, the allegation of unlawful eviction is deemed unsubstantiated at this time. Exit interview conducted. A copy of the report and appeal rights provided.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Erica Mosley	TELEPHONE: (747) 230-3909
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024

LIC9099 (FAS) - (06/04)

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