197608129-8-26-2026-29-AS-KHEN-DXDVRZ-20260828164047

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608129
Report Date: 08/26/2026
Date Signed: 08/26/2026 03:07:20 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
07/26/2026 and conducted by Evaluator Quoc Huynh

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20260726105225

FACILITY NAME:	RESIDENCES AT ROYAL BELLINGHAM, THE		FACILITY NUMBER:	197608129
ADMINISTRATOR:	ANGELITO VITUG		FACILITY TYPE:	740
ADDRESS:	12229 CHANDLER BOULEVARD		TELEPHONE:	(818) 980-2997
CITY:	VALLEY VILLAGE	STATE: CA	ZIP CODE:	91607
CAPACITY:	96	CENSUS: 93	DATE:	08/26/2026
		UNANNOUNCED	TIME BEGAN:	02:33 PM
MET WITH:	Lito Vitug - Executive Director		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff did not prevent resident from verbally abusing another resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Quoc Huynh conducted a subsequent complaint visit to deliver findings for the above allegation. The LPA arrived at 2:33PM and met with Executive Director (ED) Lito Vitug. Entrance interview conducted.

On 07/30/2026, the LPA conducted an initial visit. Between 10:47AM and 1:30PM, the LPA conducted a physical plant tour, interviewed four (4) residents, five (5) staff, and the ED, and reviewed and obtained pertinent documents.

During today’s visit, the LPA and ED conducted a physical plant tour at 2:39PM, and no immediate concerns were observed. The following was then determined:

Report Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

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-20260726105225

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: RESIDENCES AT ROYAL BELLINGHAM, THE	FACILITY NUMBER: 197608129
	VISIT DATE: 08/26/2026

NARRATIVE

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Allegation: “Staff did not prevent resident from verbally abusing another resident in care”

It was reported that staff did not prevent Resident #1 (R1) from verbally and emotionally abusing their roommate, Resident #2 (R2). Interview with R1 revealed that they do not often speak to each other, do not have arguments, and consider themselves friends. R1 stated that R2 frequently watches TV and uses the restroom, which can be disruptive at times. R2 denied being verbally abused by R1 and reported that, at most, R1 will tell them to pass gas elsewhere.

Interview with staff reflected inconsistent knowledge regarding any conflicts between R1 and R2. Staff reported that R1 previously had a roommate who was relocated due to complaints; however, staff were not familiar with the details of the situation. Staff indicated that R1 and R2 are generally calm and have not previously reported issues regarding their shared room. Staff #1 (S1) reported that R2 confided in them that R1 believes R2 is too loud when using the restroom or watching TV. S1 offered to speak with the Administrators to help resolve any concerns, but R2 declined.

The Facility Manager stated that approximately one (1) week prior to the allegation, R2 approached them requesting a room change due to R1’s complaints about noise. R2 did not report any verbal abuse during this interaction. R2 was informed that the facility would accommodate the room change once a room became available. The Facility Manager further clarified that R1’s previous roommate was relocated due to concerns about incontinence needs, not due to interpersonal conflicts.

Review of R1’s Appraisal/Needs and Services plan dated 01/14/2026 and R2’s plan dated 12/01/2025 documented no history of aggressive behavior for either resident.

Based on interviews and record review, the facility was not made aware of any alleged verbal abuse. Once notified of R2’s concerns, the facility took steps to accommodate R2’s request. Although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur; therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No deficiency cited. Exit interview conducted. A copy of the report was reviewed and provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026

LIC9099 (FAS) - (06/04)

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