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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608685
Report Date: 04/24/2026
Date Signed: 04/24/2026 12:55:13 PM

Substantiated


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
03/26/2026 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20260326094951
FACILITY NAME:ATRIA SANTA CLARITAFACILITY NUMBER:
197608685
ADMINISTRATOR:EDEN TOLENTINOFACILITY TYPE:
740
ADDRESS:24431 LYONS AVETELEPHONE:
(661) 254-9933
CITY:SANTA CLARITASTATE: CAZIP CODE:
91321
CAPACITY:160CENSUS: 103DATE:
04/24/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Tracy PaulkTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff deny resident visitor(s)
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuesday Cabiness conducted a subsequent visit to deliver the final findings regarding the above allegation. LPA met with the Administrator Tracy Paulk and explained the purpose of the visit. The following information was obtained during the course of the investigation:

To investigate the complaint, on 03/26/2026, from 9:30 a.m. to 1:00 p.m., LPA conducted interviews with the reporting party (RP), resident #1 (R1), three (3) staff, and seven (7) out of seven (7) residents, and other individuals potentially involved in the allegation. LPA also reviewed relevant documentation. During today’s visit, from 9:30 a.m. to 11:30 a.m., LPA conducted additional interviews with three (3) out three (3) residents, and two (2) staff, including the Administrator.

Based on interviews conducted, R1 was admitted to the facility’s memory care unit. It was alleged that facility staff denied visitation to R1. During an interview, R1 reported that R1’s son was not permitted to
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026
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 3
Control Number 31-AS-20260326094951
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: 04/24/2026
NARRATIVE
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visit at the request of R1’s wife and children. R1 stated that there is a contentious relationship between the wife and the son. R1 further alleged that the wife admitted R1 to the memory care unit in an effort to prevent the son from having access to R1 and for other reasons that R1 did not agree with.

R1 reported that prior to admission, the son communicated with R1 daily; however, since admission, the son had not been able to call or visit. R1 stated that the wife withheld R1’s cellphone, preventing communication. The wife confirmed that R1’s cellphone was not initially provided to R1, which impacted the son’s ability to maintain contact. Although interviews with other residents indicated no general issues with visitation, the wife confirmed during her interview that she requested the facility prohibit visitation between R1 and the son, and that facility staff complied with this request. Based on consistent statements obtained from R1, the RP, and the wife, and interviews by staff, LPA determined that the facility restricted visitation at the request of the wife. Therefore, the allegation that the facility denied visitation to R1 is Substantiated.

Citation issued, appeal rights, exit interview and copy of report provided to Administrator.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20260326094951
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/15/2026
Section Cited
CCR
87468.2(a)(21)
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Additional Personal Rights of Residents in Privately Operated Facilities:(a)In addition to the rights listed in Section 87468.1, Personal Rights...residential care facilities for the elderly shall have all of the following personal rights: (21)To consent to have their relatives
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Administrator has AGREED to conduct an in-service training for all staff on personal rights and the department's PIN 25-04-ASC. LPA requested copies of sign-sheets with subject by POC date.
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 and other individuals of their choosing visit during reasonable hours, privately, and without prior notice. This requirement was not met, evidenced by, based on interviews, R1 was denied vistation by R1's son. This is a potential health and safety risk to resident 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.
SUPERVISOR'S NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2026
LIC9099 (FAS) - (06/04)
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