197609621-7-20-2026-31-AS-TAGD-DXXPD3-20260915111251

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609621
Report Date: 07/18/2026
Date Signed: 07/20/2026 07:40:59 AM

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
03/26/2026 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20260326153038

FACILITY NAME:	GOLDEN ASSISTED LIVING		FACILITY NUMBER:	197609621
ADMINISTRATOR:	LOPEZ, MONIQUE		FACILITY TYPE:	740
ADDRESS:	14060 ASTORIA ST		TELEPHONE:	(818) 367-1947
CITY:	SYLMAR	STATE: CA	ZIP CODE:	91342
CAPACITY:	128	CENSUS: 109	DATE:	07/18/2026
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Amourfino Cruz - Staff		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff did not reposition resident as needed, resulting in multiple unstageable pressure injuries
Staff did not provide adequate incontinence care to resident
Staff did not prevent residents from using narcotics inside of facility.
Staff chemically restrained resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Tan conducted an unannounced subsequent complaint visit to further investigate the above allegations. LPA met with staff Amourfino Cruz and explained the reason for the visit.

LPA conducted a physical plant tour at 8:59 AM, requested copies of facility documents relevant to the investigation at 9:48 AM, reviewed records between 10:00 AM to 11:30 AM and interviewed staff and residents between 11:30 AM to 2:00 PM. Regarding the allegation that Staff did not reposition resident as needed, resulting in multiple unstageable pressure injuries, it was alleged that Resident #1 (R1)'s pressure wound worsened while at the facility. LPA's record review on 03/27/26 revealed that R1 did not have a pressure injury. R1's was admitted at the facility on 01/02/26 with the skin condition that required a licensed medical practitioner to care for. Further review also revealed that R1's skin condition was being taken care of by the facility contracted nurse and being cleaned and treated daily from the time R1 was admitted to the facility. Moreover, record shows that R1 was being changed and checked regularly by the staff, including repositioning every hour or as needed. (continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2026

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-20260326153038

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: GOLDEN ASSISTED LIVING	FACILITY NUMBER: 197609621
	VISIT DATE: 07/18/2026

NARRATIVE

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(continued from LIC 9099)

Regarding the allegation that Staff did not provide adequate incontinence care to residents, it was alleged that R1 was left sitting in feces for long periods of time. LPA's record review today between 10:00 AM to 11:30 AM revealed that R1 was being checked changed regularly by the staff at least three (3) times per shift. LPA's interview with five (5) incontinent residents today between 11:30 AM to 2:00 PM, revealed that five (5) out of five (5) residents interviewed stated that they were being changed by the staff regularly including nights.

Regarding the allegation that Staff did not prevent residents from using narcotics inside of facility, it was alleged that there were multiple residents using crystal meth in the facility and R1 had been offered crystal meth by another resident. LPA's interview with ten (10) residents today or 10% of current census revealed that ten (10) out of ten (10) residents interviewed did not know or witness any residents using and/or selling crystal meth in the facility nor they were offered by any resident any illegal drugs.

Regarding the allegation that Staff chemically restrained resident, it was alleged that R1 was being sedated at the facility. LPA's record review today between 10:00 AM to 11:30 AM revealed that R1 was only given medication as prescribed. R1 however had a psychiatric diagnoses that the Court ordered R1 to take some psychotropic medication, which may have side effect that could cause R1 to feel sedated. LPA's interview with Medication Technician Supervisor on 03/27/26 and today at 1:20 PM revealed that R1 was not given any medication aside from what was prescribed to R1.

Based on the information gathered during this and prior visit, these allegations are 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: 07/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2026

LIC9099 (FAS) - (06/04)

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