197608129-8-26-2026-29-AS-KHEN-DXDVY5-20260828165036

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608129
Report Date: 08/26/2026
Date Signed: 08/26/2026 03:08:36 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
07/29/2026 and conducted by Evaluator Quoc Huynh

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20260729083754

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 do not ensure call signal alerts are answered in a timely manner
Staff does not ensure residents food is kept free of contaminants
Staff do not ensure resident’s room is clean, safe and sanitary

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Quoc Huynh conducted a subsequent complaint visit to deliver findings for the above allegations. 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)

Page: 1 of 5

Control Number 29-AS-20260729083754

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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Allegations: “Staff do not ensure call signal alerts are answered in a timely manner,” “Staff does not ensure residents food is kept free of contaminants,” and “Staff do not ensure resident’s room is clean, safe and sanitary”

It was reported that staff do not respond when Resident #1 (R1) uses their call light, that meals delivered to R1’s room contain pests, and that R1’s room is cluttered, uncomfortable in temperature, and malodorous. Interview with R1 revealed that staff do not respond when they attempt to use their call light. During the interview, R1 tested the call light, and it was determined that R1 was not pulling the cord with significant force to activate the system. R1 stated that they stop pulling the cord after the initial clock and do not continue pulling until the alert triggers.

R1 denied that cockroaches were present on meals at the time food is delivered. R1 reported that meals arrive covered in plastic wrap and that pests appear only if food is left uncovered in the room for an extended period. R1 also noted that the facility has been conducting pest control treatment in their room due to the presence of pests.

Regarding room conditions, R1 stated they do not have concerns about the room being too hot and are able to adjust the in-unit air conditioning as needed. R1 expressed more concern about the room being too cold at times, but that staff provide them with extra blankets. R1 denied any clutter that would create a hazard or prevent them from safely entering or exiting the room with their wheelchair. During the visit, the LPA observed R1’s room to be clean and sanitary. A mild odor was present due to R1’s indwelling catheter.

Interviews with staff disputed all allegations. Staff reported that R1 does not typically use their call light and instead goes to the front desk when needing assistance. Staff stated they have not observed pests in R1’s room and explained that routine pest control services are performed as a preventative measure. Staff also reported that R1 frequently empties their own catheter bag, which sometimes results in spillage and associated odor. Staff stated they assist when permitted and ensure the room is cleaned and organized. Staff added that R1 often removes clothing items from storage and places them on the floor shortly after the room is cleaned.

Report Continued on LIC 9099-C

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)

Page: 2 of 5

Control Number 29-AS-20260729083754

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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Staff reported that R1’s room is not typically hot and that they offer to adjust the temperature when needed; R1 occasionally declines such assistance. Staff further noted that R1 frequently leaves their window open despite high outdoor temperatures.

On 07/27/2026, the Department received an incident report indicating that on 07/26/2026 an individual notified the facility of concerns regarding the condition of R1’s room. The facility conducted an internal investigation and addressed each concern. The facility also contacted R1’s family who reported no concern and stated they observed no conditions consistent with the allegations during prior visits.

Based on interviews and record review, although the allegations may have happened or are valid, there is insufficient evidence to prove the alleged violations did or did not occur; therefore, the allegations are deemed UNSUBSTANTIATED at this time.

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)

Page: 3 of 5

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
07/29/2026 and conducted by Evaluator Quoc Huynh

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20260729083754

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 handled resident in a rough manner
Staff does not ensure resident receives adequate incontinence care due to neglect
Staff do not ensure resident is accorded personal privacy in their room

INVESTIGATION FINDINGS:

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Unfounded

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)

Page: 4 of 5

Control Number 29-AS-20260729083754

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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Allegations: “Staff handled resident in a rough manner,” “Staff does not ensure resident receives adequate incontinence care due to neglect,” and “Staff do not ensure resident is accorded personal privacy in their room”

It was reported that staff twisted Resident #1’s (R1) arms behind their back while performing catheter care, failed to provide adequate incontinence care, and that R1’s door remained open, resulting in other residents entering their room. Interview with R1 revealed disorganized thoughts and a primary recollection of their recent hospital stay. R1 stated that while at the hospital, staff were not attentive to their needs, and several hospital patients entered their room and used their restroom. R1 reported that the hospital staff apologized and stated that the hospital did not have enough restrooms. R1 did not provide clear details regarding whether hospital staff handled them roughly but indicated that they had been treated in a rough manner. R1 described the hospital as “like a prison.”

In contrast, R1 reported that the facility staff are respectful and do “everything they need to.” R1 stated they can empty their own catheter bag and that staff also assist appropriately when needed. R1 also stated that their door remains open and confirmed that they prefer it to be cracked open.

Interview with facility staff revealed no concerns, mistreatment, or neglect. Staff confirmed that R1 preferred to keep their door open and noted that they offer to close it when exiting the room, but R1 declines. Staff reported that when they assist with emptying R1’s catheter bag, the procedure does not require staff to place their hands on R1’s body.

Based on the information obtained, the allegations are deemed UNFOUNDED at this time. A finding of unfounded means that the allegations are either false, could not have happened, and/or are without a reasonable basis.

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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