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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197606676
Report Date: 01/29/2025
Date Signed: 01/29/2025 03:09:13 PM

Document Has Been Signed on 01/29/2025 03:09 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:BROOKDALE GARDENS OF TARZANAFACILITY NUMBER:
197606676
ADMINISTRATOR/
DIRECTOR:
HELEN LEEFACILITY TYPE:
740
ADDRESS:18700 BURBANK BLVDTELEPHONE:
(818) 342-0003
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY: 90TOTAL ENROLLED CHILDREN: 0CENSUS: 75DATE:
01/29/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Amanda MonroyTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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At approximately 1:00 p.m. on 01/29/25 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced case management visit. LPA met with the administrator and disclosed the reason for the visit.

Today’s case management was conducted after the Woodland Hills-South Regional Office received two (02) suspected abuse reports from the facility. The first report alleged that during the evening of 01/25/25, Staff #1 (S1) handled Resident #1 (R1) in a rough manner. The second report alleged that Staff #2 (S2) “performed inappropriately” when caring for Resident #2 (R2) around the morning of 01/25/25.

To investigate the allegations above, LPA interviewed the administrator and staff between 1:10 p.m. and 3:00 p.m. today, conducted a record review of pertinent records, including but not limited to medical assessments, and staff and client rosters at 1:30 p.m., and toured the facility inside and out at 1:50 p.m.

Interview with R1 today at 2:40 p.m. revealed they were pushed and handled roughly by S1. Interview with the administrator at 1:10 p.m. today revealed they investigated the allegations and suspended S1 and S2 as a safety measure. The administrator stated S1 and S2 had good relationships with facility staff and residents and had no previous allegations involving them. Interviews with Staff #3 (S3) at 1:45 p.m. and Staff #4 (S4) at 2:20 p.m. today confirmed both S1 and S2 were nice and had no previous incidents or allegations. Telephonic interview with S1 today at 1:55 p.m. today revealed that they had a good relationship with R1 and never abused them. The administrator also stated that S2 was not at work during the time that the abuse was alleged. Record review of S2’s time card confirmed they were not working during the time and date the abuse was alleged. Since R2 was relocated to another facility on 01/28/25, S2 returned to work today. Interview with S2 at 1:30 p.m. today confirmed they were not at work between 01/23/25 and 01/25/25 and they had never abused any residents. Since R2 could not be contacted, the allegations need further investigation. LPA to follow up with additional investigation at a future date.

No immediate health or safety concerns were observed during today’s visit. Exit interview conducted. Copy of report provided.

Naira MargaryanTELEPHONE: (818) 596-4368
Nicholas ReedTELEPHONE: (818) 669-8178
DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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