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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608319
Report Date: 12/10/2025
Date Signed: 12/10/2025 12:56:47 PM

Substantiated


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
12/08/2025 and conducted by Evaluator Sandra Urena
COMPLAINT CONTROL NUMBER: 29-AS-20251208125314
FACILITY NAME:CHRISTINE'S RETREATFACILITY NUMBER:
197608319
ADMINISTRATOR:CHRISTINE MKRTCHIANFACILITY TYPE:
735
ADDRESS:17145 WILLARD STTELEPHONE:
(818) 578-8468
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY:6CENSUS: 6DATE:
12/10/2025
UNANNOUNCEDTIME BEGAN:
09:57 AM
MET WITH:Marsha WilliamsTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Facility is in disrepair.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sandra Urena conducted an initial unannounced visit to investigate the allegation listed above. The LPA was greeted by staff and informed them of the reason for the visit. Staff contacted the Licensee via phone and informed them of the visit. The facility’s designated staff Marsha Williams arrived shortly thereafter, and the LPA explained the reason for the visit.

LPA Urena, along with the facility’s designated staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2025
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 29-AS-20251208125314
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: CHRISTINE'S RETREAT
FACILITY NUMBER: 197608319
VISIT DATE: 12/10/2025
NARRATIVE
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Facility is in disrepair
This page is being amended as some information was left out inadvertently. LPA will request from licensee signature via email. On the allegation that the facility is in disrepair; it is the concern of the reporting party that it was observed that the home is in poor physical condition, specifically the following items: 1) broken unused car being stored on the driveway; 2) broken basketball hoop on top of the garage; 3)completely worn-out carpet in the den area; 4)the kitchen cabinets are very dirty and broken, and 5)broken ceiling fan in one of the bedrooms. To investigate the allegation the LPA and the designated staff conducted a physical plant tour to address the observe the physical plant. The designated staff stated that the licensee is in process of making improvements to the facility. The LPA observed the items listed 2, 4, and 5 to be in need of repair/removed. However, the car parked in the driveway does not obstruct passageway for the fire clearance. The carpet in the den does have one spot that appears ripped and needs repair, but mostly the carpet needs to be shampoo. Additional items that need to be replaced, cleaned and repaired are- the bedrooms’ window blinds and kitchen blinds need to be replaced. Bathroom bottom of cabinets, peeling paint needs to be fixed. Wall kitchen area above the stove needs to be cleaned. Sliding door screen needs to be replaced. Side wooden gate needs to be repaired, as the wood is splintered and the wooden slats are falling apart. The LPA spoke with the licensee on the phone and explained the deficiencies and correction date, and the licensee stated that the kitchen cabinets will be repaired, and doors replaced. Top of the kitchen counter will be redone. All deficiencies will be corrected by the end of February 2026.

Based on observation, the allegation that the Facility is in disrepair is deemed Substantiated at this time.

The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations (CCR) Title 22 and/or California Health and Safety Code (HSC). Failure to correct the deficiencies may result in civil penalties.

Exit interview was conducted and a copy of the report and Appeal rights were issued.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20251208125314
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: CHRISTINE'S RETREAT
FACILITY NUMBER: 197608319
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2026
Section Cited
CCR
80087(a)
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80087 (a) Buildings and Grounds. The facility shall be kept clean, sanitary and in good repair at all times.

This requirement is not met as evidenced by:

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Licensee agreed to inform the LPA of the corrections by end of February 2026. LPA will conduct a case management visit after to confirm all corrections
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Based on observation the LPA observed the kitchen cabinets to dirty, have a broken cabinet door, …which poses a potential danger to residents in care.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3