197609103-3-19-2026-31-AS-NGID-DVML25-20260703082144

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609103
Report Date: 03/19/2026
Date Signed: 03/19/2026 07:15:24 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/24/2025 and conducted by Evaluator Angela Panushkina

COMPLAINT CONTROL NUMBER: 31-AS-20251024095352

FACILITY NAME:	HOLLYWOOD HILLS SENIOR LIVING		FACILITY NUMBER:	197609103
ADMINISTRATOR:	VANESSA JEWELL		FACILITY TYPE:	740
ADDRESS:	1745 N GRAMERCY PLACE		TELEPHONE:	(323) 994-6700
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90028
CAPACITY:	120	CENSUS: 70	DATE:	03/19/2026
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Brittney Buchannan, Executive Director		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff did not ensure residents records were safely secured

INVESTIGATION FINDINGS:

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At 10:00am, Licensing Program Analysts (LPAs) Angela Panushkina and Perchui Milena Khurshudyan conducted an unannounced subsequent visit to deliver final findings. LPAs met with the Executive Director, and explained the reason for the visit.

An initial complaint visit was conducted on 10/30/25 at 9:25am by LPA and Licensing Program Manager (LPM) Nichelle Gillyard. During that visit LPA and LPM requested resident and staff roster. At 09:35am, LPA and LPM requested copies of pertinent information which include, but not limited to Maintenance Log and annual Fire Inspection. Between 09:50am – 12:00pm, LPA and LPM conducted an interview with the Administrator and one (1) resident. Five (5) out of nine (9) allegations were resolved.

Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026

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-20251024095352

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: HOLLYWOOD HILLS SENIOR LIVING	FACILITY NUMBER: 197609103
	VISIT DATE: 03/19/2026

NARRATIVE

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On 11/20/2025 at 9:20am, LPA conducted a subsequent visit and requested additional copies of pertinent information which include, but not limited to Staff Training, Employee Handbook (Workplace Violence, Prohibited Conduct and Procedures for Reporting a Threat) relevant to the investigation. Between 9:35am - 12:00pm, LPA conducted an interview with the (former) Administrator, Concierge, one (1) MedTech and five (5) staff, one (1) witness and ten (10) residents. During the subsequent visit, LPA resolved three (3) out of four (4) “remaining” allegations.

Allegation: Staff did not ensure residents’ records were safely secured

It was alleged that the facility Director shared resident (R1’s) records with hospice staff who are not the attending nurses for the resident(s). To investigate this allegation, LPA conducted an interview with the Director, during the initial visit, who denied the above allegation and informed LPA that hospice resident files must be accessible to assigned hospice employees only, upon request. If the resident’s attending nurse is on vacation or off, another/substitute nurse (from the same hospice agency) may conduct the visit and review the file. LPA was also informed that based on the Health Insurance Portability and Accountability Act (HIPPA) no resident information can be disclosed to other agencies without resident’s consent. Thus, no HIPPA rights were violated by the facility staff. Ten (10) residents interviewed expressed no concern regarding this allegation. Additionally, interview with R1 revealed that he/she is currently receiving hospice services (from the same agency) since October 2025 and had no issues or concerns that his/her information was ever shared with 3rd party company without his/her consent. R1 stated: “This place is very organized.” Lastly, LPA reviewed R1’s hospice file and confirmed that the agency remained the same and no changes have been made since October 2025. Therefore, based on interviews and record reviews this allegation is deemed Unsubstantiated, at this time.

No deficiency issued during today's visit.
Exit interview conducted and copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026

LIC9099 (FAS) - (06/04)

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