197608661-8-25-2025-29-AS-KHEN-DKZUVA-20250829155449

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608661
Report Date: 08/25/2025
Date Signed: 08/25/2025 01:10:59 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
03/28/2025 and conducted by Evaluator Angela Barutyan

COMPLAINT CONTROL NUMBER: 29-AS-20250328154015

FACILITY NAME:	ELWYN NC - KELVIN 1		FACILITY NUMBER:	197608661
ADMINISTRATOR:	CRYSTAL CORTES		FACILITY TYPE:	735
ADDRESS:	5651 KELVIN AVE		TELEPHONE:	(747) 900-6742
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY:	4	CENSUS: 4	DATE:	08/25/2025
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Crystal Cortes		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

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Facility staff sexually assaulted resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angela Barutyan conducted a subsequent complaint visit to deliver final findings for the above allegation. During today’s visit, LPA met with Administrator at 12:50PM and explained the reason for the visit.

On 03/28/2025, the Woodland Hills North Adult and Senior Care Regional Office (RO) received a complaint report regarding a sexual abuse allegation. It was alleged that Client #1 (C1) was sexually assaulted by Staff #1 (S1) and Staff #2 (S2) while in care of the facility. On 04/01/2025, the complaint was referred to the Community Care Licensing Division (CCLD) Investigations Branch (IB), and was assigned to Investigator Darlene Gonzalez as an assignment. On 04/11/2025, the complaint was re-assigned to Investigator Sonia Torre as a full investigation. Subsequently, on 04/19/2025, the RO received an incident report from the facility Administrator Crystal Cortes indicating on 04/18/2025, C1 reported an additional staff, Staff #3 (S3), also sexually assaulted C1. REPORT CONTINUED ON LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025

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-20250328154015

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: ELWYN NC - KELVIN 1	FACILITY NUMBER: 197608661
	VISIT DATE: 08/25/2025

NARRATIVE

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On 04/01/2025 from 09:45AM to 11:35AM, Licensing Program Analyst (LPA) Angela Barutyan conducted an unannounced initial complaint visit to the facility. LPA Barutyan met with the Administrator upon entry and explained the reason for the visit. The LPA informed the Administrator that the complaint was assigned to the CCLD IB Investigator Darlene Gonzalez. From 10AM-11:35AM, the LPA requested and reviewed copies of pertinent documents, and along with the Administrator conducted a physical plant tour. The LPA determined further investigation was required prior to issuing a finding.

On 05/01/2025, Investigator Torre along with Investigator J. Rojas conducted interviews with C1 at approximately 10:11AM and with three (3) staff between 10:37AM-11:20AM. On 06/12/2025, Investigator Torre along with Investigator J. Thomas conducted interviews with two (2) clients at approximately 10AM-10:30AM. On 07/02/2025, at approximately 10:55AM, Investigators Torre and Thomas interviewed S3. On 07/11/2025, Investigators Torre and Thomas interviewed S2 at 06:12AM and S1 at 10:10AM. On 07/17/2025, Investigator Torre conducted a telephonic interview with C1’s responsible party at approximately 03:36PM. In addition, the investigator requested and obtained police reports from the local police dated 03/28/2025 and 04/18/2025 and C1’s medical records.

A review of C1’s Individual Program Plan (IPP), dated 01/10/2024 revealed C1 would like to continue to reside in the facility and that C1 had a history of fabricating allegations about relationship at times, including allegations about the staff and other client/residents. C1’s Annual Report/ISP dated 01/10/2024, noted period from 01/2024 to 01/2025, indicated C1 as ambulatory diagnosed with bordering personality disorder and schizoaffective disorder and able to communicate wants/needs and have in depth conversations. C1’s Physician Report, revealed C1’s medical diagnosis included schizoaffective disorder (primary) and mild intellectual disability (secondary). C1 was noted as being ambulatory, able to complete activities of daily living (ADLs) unassisted which included bathing, dressing and feeding. However, C1 was unable to leave the facility unsupervised, or manage their own cash resources. C1’s admission agreement was signed and dated 11/25/2014.

During the Department’s investigation, the interview with C1’s responsible party revealed that C1 had a history of making similar allegations in the past. C1’s responsible party stated that the facility was a great place and did not think the abuse occurred. During the investigation, it was revealed that there were no witnesses to the abuse.

Report Continued on LIC9099-C.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250328154015

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: ELWYN NC - KELVIN 1	FACILITY NUMBER: 197608661
	VISIT DATE: 08/25/2025

NARRATIVE

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Two (2) Sexual Assault Response Team (SART) examinations were completed on C1, the initial exam on 03/27/2025 at 11PM with S1 as identified assailant and the subsequent exam on 04/18/2025 at 11:35PM with S3 as identified assailant, and both exams yielded no findings. C1 did not identify S2 as an assailant during the examinations. Staff interviews revealed that staff never witnessed any inappropriate interaction between staff and the clients/residents. Staff interviews of the three (3) alleged suspects revealed they all denied inappropriately touching or sexually assaulting C1, were placed on administrative leave during the internal investigation, and eventually cleared to return to work at the facility. The interviews of two (2) clients/residents also maintained never being mistreated by staff or witnessed staff mistreat any of the clients/residents and that they felt safe in the facility. The review of the facility records revealed during the nocturnal shift there were two to three staff scheduled to work and S3 did not work on 04/17/2025. The interview with C1 revealed inconsistencies in C1’s statements and the client was unable to provide specific details about the incident. In addition, C1 denied being inappropriately touched when C1 was awake or witnessing staff inappropriately touching the other clients/residents.

The Department’s investigation concluded that although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation occurred. Therefore, the allegation “Facility staff sexually assaulted resident” is deemed UNSUBSTANTIATED at this time.

Exit interview conducted, copy of this report was issued.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025

LIC9099 (FAS) - (06/04)

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