197602540-2-4-2026-31-AS-MGFS-DY9MUF-20260925095502

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197602540
Report Date: 02/04/2026
Date Signed: 02/04/2026 03:54:50 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/15/2025 and conducted by Evaluator Evelin Rios

COMPLAINT CONTROL NUMBER: 31-AS-20251015081304

FACILITY NAME:	BELLAMAR LANCASTER		FACILITY NUMBER:	197602540
ADMINISTRATOR:	ANALILIA ZARZGOZA		FACILITY TYPE:	740
ADDRESS:	43454 30TH STREET WEST		TELEPHONE:	(661) 949-2177
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	68	CENSUS: 41	DATE:	02/04/2026
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Kortnie Spitznogle - Executive Director		TIME COMPLETED:	04:05 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are mismanaging residents' medication.
Staff did not prevent resident from developing a pressure injury.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 02/04/2026 Licensing Program Analyst (LPA) Evelin Rios conducted a subsequent complaint visit for the above mentioned allegations. LPA met with Kortnie Spitznogle the Executive Director and explained the reason for the visit was to continue the complaint investigation. LPA obtained a copy of the resident roster and staff roster.

LPA Rios conducted an initial unannounced complaint visit on 10/21/2025. At 10:45 a.m., LPA interviewed Jesse Wong the Resident Care Director at the time. LPA obtained a resident roster and Personnel Report (LIC500). At 11:15 a.m., LPA Rios initiated a physical plant tour of the facility to ensure the health and safety of the residents in care. During the tour, LPA made observations of seven (7) resident bedrooms and their bathrooms, the common areas such as the dining area, activity room, and the memory care unit. From approximately 11:30 a.m., to 2:00 p.m while conducting the tour LPA interviewed six (6) residents of which one did not respond to LPA's questions. (Continue to LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

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 3

Control Number 31-AS-20251015081304

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BELLAMAR LANCASTER	FACILITY NUMBER: 197602540
	VISIT DATE: 02/04/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

(Continued form LIC9099) LPA also interviewed five (5) staff members not including the Executive Director, Resident Care Director and a Hospice nurse identified as providing care to a resident in question.

On today's visit LPA obtained copies of Resident #1's (R1's) record such as Physician's Report (LIC602), Assessments and Hospice records. Between 11 a.m., and 1:30 p.m., LPA interviewed Deanna Velasquez the Generations Program Director and two (2) staff from the designated memory care unit. At 2:20 p.m., LPA reviewed centrally stored medication and medication records with the Generations Program Director. LPA obtained copies of four (4) resident medication documents.

Allegation: Staff are mismanaging residents' medication. It was alleged that medications are not being administered properly, with residents at times missing doses, receiving incorrect medications, or being given their medications at the wrong times. LPA's interview with one (1) out of eight (8) staff interviewed confirmed that they heard medication mismanagement was happening in the memory care unit. LPA's interview with seven (7) staff did not corroborate the allegation either denying medication mismanaging or denied witnessing medications mismanagement as described in the allegation. According to the Generations Program Director the facility utilizes a new system and electronically logs medication and Medication Administration Records (MAR). LPA's review of centrally stored medication for four (4) residents found medication was accounted for and medications in bubble pack matched the MAR. LPA's interview with five (5) resident's denied they had issues or concerns involving medication. Based on record review and interviews their was insufficient evidence that staff are miss mismanaging residents' medication. Therefore the allegation is deemed Unsubstantiated at this time.

(Continue to LIC9099-C) Page 2 of 3

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20251015081304

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BELLAMAR LANCASTER	FACILITY NUMBER: 197602540
	VISIT DATE: 02/04/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Allegation: Staff did not prevent resident from developing a pressure injury. It was alleged a resident's wound is infected. Through interviews with staff LPA was able to identify one resident as having a wound. Review of Resident #1’s (R1's) hospice records revealed that R1 began receiving hospice services after admission and had developed at least two (2) wounds over time, with wound care included in the hospice care plan. Hospice records also indicated R1's "prognosis was very poor". On 10/21/2025, LPA attempted to interview R1, but R1 did not respond to LPA's questions. LPA's interview with the Hospice Registered Nurse (RN) on 10/21/2025 confirmed that approximately three weeks ago, R1’s wound was infected. However, the RN emphasized due to the location of the wound, it is difficult to keep clean and would be prone to infection. The RN reported that the wound has been healing with antibiotic treatment and expressed no concerns regarding the facility staff’s ability to meet R1’s needs. In regards to repositioning the RN stated when in bed repositioning should occur every two - three hours. LPA's interview with the Generation Program Director stated that during the day R1 was kept out of bed and would be transferred from bed to wheelchair to a soft couch and R1 was not bed bound. Also stating staff would be responsible for changing R1 every two hours or as needed to keep the area clean and dry. As of today’s visit according to the Generations Program Director, R1's wounds have healed. Interview with three (3) staff working in the memory care unit providing assistance to R1 corroborate they changed R1 routinely and repositioned R1 while in bed.

Based on interviews and record review, there is insufficient evidence that staff did not prevent resident from developing pressure injury. Therefore, this allegation is deemed Unsubstantiated at this time.

No deficiencies were cited. Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3