<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608711
Report Date: 11/04/2025
Date Signed: 11/04/2025 01:55:44 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
10/29/2025 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20251029225310
FACILITY NAME:FOOTHILL RETIREMENT CARE HOMEFACILITY NUMBER:
197608711
ADMINISTRATOR:CABRERA, MARIAFACILITY TYPE:
740
ADDRESS:6720 SAINT ESTEBAN STREETTELEPHONE:
(818) 353-3350
CITY:TUJUNGASTATE: CAZIP CODE:
91042
CAPACITY:72CENSUS: 58DATE:
11/04/2025
UNANNOUNCEDTIME BEGAN:
09:17 AM
MET WITH:Gina Osuna - Wellness DirectorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not prevent a resident from causing harm to another resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jose Tan conducted an unannounced initial complaint visit at this facility to investigate the above allegation. LPA met with Wellness Director Gina Osuna and explained the reason for the visit.

LPA conducted physical plant tour at 9:35 AM, requested copies of facility documents relevant to the investigation at 10:02 AM and interviewed staff and residents between 10:15 AM to 1:00 PM. Regarding the allegation that Staff do not prevent a resident from causing harm to another resident, it was alleged that tenant, who lives above Resident #1 (R1), drilled holes in R1's unit and pumped a toxic substance into R1's unit and R1 believes the perpetrator is in conjunction with the assisted living facility and is working together to harm R1. LPA's interview with the Maintenance Supervisor (MS) today at 12:00 PM revealed that there was no construction being done at the facility since MS joined the facility almost three (3) months ago, R1 was admitted at the facility on 08/21/25. Further interview with MS also revealed if there is any construction or repair being done at the facility, it is done during MS' work hours from 9:00 AM to 4:30 PM.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
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-20251029225310
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: FOOTHILL RETIREMENT CARE HOME
FACILITY NUMBER: 197608711
VISIT DATE: 11/04/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(continued from LIC 9099)

LPA's interview with Resident #2 (R2) and R1's roommate today at 11:25 AM revealed that R2 did not hear or witness any drilling or any kind of construction and/or repair nearby their room at night. LPA's observation also revealed that there is no second floor on the building where R1 & R2's room is located. Further, LPA did not observe any holes and/or ongoing repair anywhere in the facility near R1's room. LPA's interview with the Wellness Director today at 12:46 PM revealed that there was no one in and out of the facility pumped any toxic substance anywhere at the facility.

Based on the information gathered during this visit, the allegation is deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2