197609103-4-28-2026-31-AS-NMAN-DXDSRW-20260828140701

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609103
Report Date: 04/28/2026
Date Signed: 04/28/2026 02:12:51 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.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
04/07/2026 and conducted by Evaluator Raymond Comer

COMPLAINT CONTROL NUMBER: 31-AS-20260407161012

FACILITY NAME:	HOLLYWOOD HILLS SENIOR LIVING		FACILITY NUMBER:	197609103
ADMINISTRATOR:	BRITTNEY BUCHANNAN		FACILITY TYPE:	740
ADDRESS:	1745 N GRAMERCY PLACE		TELEPHONE:	(323) 994-6700
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90028
CAPACITY:	120	CENSUS: 62	DATE:	04/28/2026
		UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Brittney Buchannan		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff did not follow physician's orders, resulting in hospitalization.
Staff did not adequately monitor resident for change of health condition.
Staff did not seek timely medical attention.

INVESTIGATION FINDINGS:

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On Tuesday, 4/28/26, Licensing Program Analyst (LPA) Raymond Comer conducted unannounced subsequent visit to complete an investigation of the above noted allegation(s).
To investigate the allegation, on 4/14/26, LPA conducted an initial complaint visit. During initial visit, between 9:45 am and 11:30 am, LPA received and reviewed copies of R1's Identification\emergency contact info, physician's report (LIC 602), appraisal, and other relevant documents. At 11:45 am, LPA interviewed two (2) staff. At 1:20 pm, LPA spoke with the Administrator.

During today’s visit, between 9:10 am and 10:40 am, LPA interviewed three (3) additional staff and between 10:50 am, and 12:15pm, LPA interviewed six (6) out of sixty-two (62) total residents.

[LIC9099C] Continued-

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026

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 31-AS-20260407161012

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: HOLLYWOOD HILLS SENIOR LIVING	FACILITY NUMBER: 197609103
	VISIT DATE: 04/28/2026

NARRATIVE

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Allegation: Staff did not follow physician's orders, resulting in hospitalization. It was alleged that staff did not follow physician order to provide adequate hydration assistance to the resident #1 (R1). Staff did not provide R1 access to beverages and Pedialyte liquid nutrition, as per physician's orders.
LPA Interviews with staff revealed the following: Staff were aware of R1's needs and service plans and provided R1 access to water, juices, milk, and Pedialyte drinks. Staff revealed that R1 was encouraged to stay hydrated and beverage refills were provided throughout the day. Observation of R1's liquid consumption/refusals were reported to the Memory Care (MC) director. Interviews with residents revealed that physician orders were followed in timely manner and required assistance is provided to residents on a daily basis; residents did not report any issues.

Based on LPA interviews with Administrator, Staff, and Residents, there is not sufficient information to support this allegation. Thus, this allegation is deemed UNSUBSTANTIATED at this time.

Allegation: Staff did not adequately monitor resident for change of health condition.
Allegation: Staff did not seek timely medical attention.
It was alleged that staff failed to observe R1 showing signs of dehydration. Subsequently on 04/07/26 that resident #1 (R1) was hospitalized due to severe dehydration. In addition, it was reported that due to inadequate hydration assistance, R1’s health conditions were changed and staff did not act in a timely manner to seek medical attention to address noted changes.

LPA interviews with Administrator and staff revealed the following: On 4/2/26, R1 was observed by the Memory Care (MC) Director as refusing to drink liquids and Pedialyte beverage and appeared lethargic. Staff contacted R1's Primary Care Physician (PCP) and R1 was transferred, via ambulance, to the hospital for medical evaluation and treatment. Interviews with staff reveal that changes in R1's health/behavior were monitored and responded to in a timely manner. Review of submitted Incident reports (LIC 624's) verify that staff are documenting, observing changes in R1’s health condition, and provided timely reporting to appropriate medical providers and other parties. Other residents interviewed during investigation did not address any concerns regarding timely attention to their medical care.

Based on LPA interviews, record reviews, and interviews, these allegation(s) are deemed Unsubstantiated at this time.

Exit interview conducted, and a copy of this report was provided to the Administrator.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026

LIC9099 (FAS) - (06/04)

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