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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608685
Report Date: 10/30/2025
Date Signed: 10/31/2025 09:22:06 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/22/2025 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20250122155506
FACILITY NAME:ATRIA SANTA CLARITAFACILITY NUMBER:
197608685
ADMINISTRATOR:APRIL PRINCESAFACILITY TYPE:
740
ADDRESS:24431 LYONS AVETELEPHONE:
(661) 254-9933
CITY:SANTA CLARITASTATE: CAZIP CODE:
91321
CAPACITY:160CENSUS: 123DATE:
10/30/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:April PrincessaTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Questionable death
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuesday Cabiness met with Executive Director April Francessa and informed her of the purpose of the visit, which was to deliver the final findings of the complaint investigation.

On January 24, 2025, the Woodland Hills Regional Office (South Adult and Senior Care Program) received a complaint alleging “Questionable Death.” On the same day, the complaint was referred to the Community Care Licensing Division’s (CCLD) Investigations Branch (IB) and assigned to Investigator Sonia Torre.

The initial investigation visit was conducted by LPA Cabiness on February 24, 2025, from 12:45 p.m. to 2:30 p.m. During this visit, the LPA obtained facility and resident documents, including Special Incident Reports (SIRs), the resident agreement, move-in information, fire department records, the physician’s report, and the resident’s assessment. Between January 25, 2025, and April 26, 2025, IB Investigator Torre conducted interviews with residents, staff, and witnesses, and reviewed resident records SIRs, and medical documentation related to Resident #1 (R1).
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025
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 2
Control Number 31-AS-20250122155506
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ATRIA SANTA CLARITA
FACILITY NUMBER: 197608685
VISIT DATE: 10/30/2025
NARRATIVE
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The complaint alleged that R1 expired after sustaining a serious injury due to the fall while in care.
According to the IB investigation, fire department records confirmed that on 12/06/2024, staff called 911 to request medical assistance for R1, who sustained a fall while being assisted in the bathroom. Staff interviews indicated they followed facility protocols for falls, including assessing R1, requesting medical attention, and monitoring R1 until emergency services arrived.

On December 6, 2024, R1 was admitted to the hospital and diagnosed with a displaced distal femur fracture from a mechanical ground-level fall, which required surgery. R1 was discharged from the hospital on December 17, 2024, in stable condition and transferred to a skilled nursing facility (SNF). IB Investigator Torre’s review of R1’s death certificate indicated that R1 expired on January 22, 2025, while under care at the SNF. The immediate cause of death was listed as cardiopulmonary arrest (within minutes), with contributing conditions of Alzheimer’s dementia (within years) and cancer. Based on the investigation conducted by the IB Investigator and review of the medical records, there is insufficient evidence to support the allegation that R1’s death was the result of a serious injury sustained while in care at the facility.

Therefore, the allegation “Questionable Death” is deemed Unsubstantiated at this time.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2