197609621-5-14-2026-31-AS-TAGD-DUXNF9-20260611102509

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609621
Report Date: 05/14/2026
Date Signed: 05/14/2026 01:54:45 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
02/02/2026 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20260202101633

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: 111	DATE:	05/14/2026
		UNANNOUNCED	TIME BEGAN:	09:18 AM
MET WITH:	Monique Lopez - Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff are not providing adequate supervision to a resident

Staff are not meeting the hygienic needs of residents

Staff do not ensure resident is properly clothed

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Tan conducted an unannounced subsequent complaint visit to this facility to further investigate the above allegations. LPA met with Administrator Monique Lopez 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, reviewed records between 10:15 to 11:15 AM and interviewed staff and residents between 11:15 to 1:00 PM. Regarding the allegation that Staff are not providing adequate supervision to a resident, it was alleged that Resident #1 (R1) is “constantly outside, struggling to move own self. LPA's record review today and on prior visit revealed that there is no resident by the name that the reporting party (RP) reported is residing at the facility. LPA called the RP multiple times to clarify the report and if the RP could provide any physical description of the reported resident to no avail. LPA was not able to communicate with the RP as the Voicemail Messaging system on RP's phone was not set up nor replied to LPA's text messages. (continued on LIC 9099)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026

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-20260202101633

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: 05/14/2026

NARRATIVE

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(continued from LIC 9099)

LPA's interview with staff and Administrator on prior visit on 02/10/26 also confirmed that there is no resident by the name that the RP provided. LPA however found that there is a resident with almost similar name as the RP provided but was observed to be always at the facility on own room otherwise goes out with friend/family and not lingering outside of the facility. LPA's interview with the facility resident with almost similar name RP provided today at 11:49 AM, confirmed that the resident always goes out with friend/family almost every day and just stay at own room when at the facility. LPA's interview with the Administrator at 12:10 PM confirmed what the facility resident stated.

Regarding the allegation that Staff are not meeting the hygienic needs of residents, it was alleged that R1' feet have black discoloration, toenails are overgrown and curving inward. LPA's observation on the resident with almost similar name during this and prior visit revealed that the resident is very well kept and clean from head to toe. LPA observed the toenails had no discoloration, not overgrown and/or had ingrown but was polished with dark pink color instead. LPA's interview with the facility resident with almost similar name revealed that the resident is very independent and able to do own self-care including but not limited to showering, toileting and grooming.

Regarding the allegation that Staff do not ensure resident is properly clothed, it was alleged that R1's pants were halfway down and no shoes. LPA's observation on the resident with almost similar name during this and prior visit revealed that the resident is very well kept and clean from head to toe. Further, the resident is an amputee and had only one foot and fully clothed with leggings and shoe during visits. LPA's interview with the facility resident with almost similar name revealed that the resident is very independent and able to do own self-care including but not limited to showering, toileting and grooming.

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: 05/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026

LIC9099 (FAS) - (06/04)

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