197609518-8-4-2026-29-AS-KHEN-DXDQFY-20260828120842

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609518
Report Date: 08/04/2026
Date Signed: 08/04/2026 04:39:52 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/24/2026 and conducted by Evaluator Angela Barutyan

COMPLAINT CONTROL NUMBER: 29-AS-20260524171417

FACILITY NAME:	BELMONT VILLAGE CALABASAS		FACILITY NUMBER:	197609518
ADMINISTRATOR:	CYNTHIA DRACHENBERG		FACILITY TYPE:	740
ADDRESS:	24141 VENTURA BLVD		TELEPHONE:	(818) 222-2600
CITY:	CALABASAS	STATE: CA	ZIP CODE:	91302
CAPACITY:	165	CENSUS: 131	DATE:	08/04/2026
		UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Cyntia Drachenberg		TIME COMPLETED:	04:50 PM

ALLEGATION(S):

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Staff did not ensure resident had enough liquids, resulting in dehydration

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a subsequent complaint investigation for the allegation listed above at 11:20AM. LPA was greeted by staff and met with Executive Director (ED) Cyntia Drachenberg. Entrance interview conducted.

During today's visit, LPA conducted a brief physical plant tour and no health and safety concerns were noted. During the initial visit on 05/27/2026, LPA conducted a brief physical plant tour, interviewed five (5) staff and attempted an interview with one (1) resident, reviewed and obtained copies of pertinent documents, and discussed allegation with the ED.

REPORT CONTINUED ON LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026

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 29-AS-20260524171417

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: BELMONT VILLAGE CALABASAS	FACILITY NUMBER: 197609518
	VISIT DATE: 08/04/2026

NARRATIVE

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It was alleged that Resident #1 (R1) was hospitalized for severe dehydration due to staff neglecting to provide liquids to R1. LPA interviewed five (5) staff members, attempted to interview R1, and interviewed two (2) responsible parties of R1 during the course of the investigation. All interviews confirmed that R1 is encouraged to drink liquids by facility staff, but R1 tends to refuse. Per regulation, R1 has the personal right to refuse, and the facility cannot force R1 to consume liquids if R1 declines. Responsible parties stated that they had no concerns regarding staff members’ attempts to encourage liquid consumption and have witnessed staff actively encourage R1. Staff and responsible parties stated that the facility also tries to increase R1’s liquid intake by providing soup, flavored waters, and popsicles. LPA reviewed R1’s care plan dated 05/27/2026 which states that staff shall “encourage fluids throughout the day- offer juice/water.” LPA reviewed R1’s hospital discharge paperwork which documents a diagnosis of hyponatremia. R1 was hospitalized from 05/20/2026-05/25/2026. LPA observed R1 and no immediate health and safety concerns were noted. Based on interview and record review, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation “Staff did not ensure resident had enough liquids, resulting in dehydration” is deemed UNSUBSTANTIATED at this time.

No deficiencies cited. Exit interview conducted. A copy of the report was issued.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026

LIC9099 (FAS) - (06/04)

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