197609982-4-15-2025-29-AS-KHEN-DJ5VYD-20250630165057

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609982
Report Date: 04/15/2025
Date Signed: 04/15/2025 07:06:22 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
04/09/2025 and conducted by Evaluator Christine Yee

COMPLAINT CONTROL NUMBER: 29-AS-20250409105136

FACILITY NAME:	PARADISE IN THE VALLEY LLC		FACILITY NUMBER:	197609982
ADMINISTRATOR:	COHEN, YEHUDA		FACILITY TYPE:	740
ADDRESS:	13530 SHERMAN WAY		TELEPHONE:	(818) 902-9501
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91405
CAPACITY:	46	CENSUS: 36	DATE:	04/15/2025
		UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Judah Cohen, Administrator		TIME COMPLETED:	07:15 PM

ALLEGATION(S):

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1. Staff are not meeting resident's dietary needs
2. Staff are not serving residents food of good quality
3. Staff spoke inappropriately to resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christine Yee conducted an unannounced complaint visit to investigate the above allegations and was let into the faciity by Abriiana Thomas, Business Office Manager. Judah Cohen, Administrator, was contacted by telephone and he arrived at 11:13am to conduct the visit. The reason for today's visit was explained

On today's visit, LPA Yee conducted an interview with the Administrator at 11:18am, Staff #1 at 11:45pm, Resident #1 at 12:26pm, Resident #2 at 1:11pm, Resident #3 at 1:55pm, Resident #4 at 2:22pm, Resident #5 at 2:37pm and reviewed this week's menu. LPA Yee also reviewed the food supply at the skilled nursing facility locate next door at 2:05pm.

Per interviews conducted regarding allegation #1, Staff are not meeting resident's dietary needs,

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 29-AS-20250409105136

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: PARADISE IN THE VALLEY LLC	FACILITY NUMBER: 197609982
	VISIT DATE: 04/15/2025

NARRATIVE

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Resident #1 who is diabetic, is supposed to be on special diet consisting of low fat, low carbohydrate and low sugar. Per interview with the Administrator, he has had multiple discussions with Resident #1 about the resident's special diet option but resident #1 has continued to choose the regular meal offered to all residents. Per the Administrator, they had and have offered Resident #1 a special diet option but cannot stop a resident from eating what they want. Per interview with Resident #1, they do no not like some of the food that they serve, especially pasta and won't eat it. Resident #1, who loves fruits, would order a fruit plate as a replacement meal for dinner. Per the Administrator, he will speak with the food director next door about adding more alternatives for those on special diets and those who do not like the featured meal being offered. Per the Administrator, in addition to the 3 meals, the facility also serves 3 snacks to residents. Based on the information received, there is insufficient evidence to support the allegation that staff are not meeting resident's dietary needs, therefore the allegation is deemed to be unsubstantiated at this time.

Regarding allegation #2, staff are not serving residents food of good quality, per information received from interviews conducted, on 4/8/25, the day before the complaint was filed, Resident #1 had requested a plate of fruits for dinner at lunch time since they did not like the featured dinner. Per Resident #1, the fruit tasted old and had no flavor. They ate the cantaloupe and gave away the watermelon to Resident #2. Per Resident #2, they ate the watermelon but it was old. Per interview with Resident #4, who was present at dinner, they stated that the rinds were still on the melon but, it was not juicy and it looked okay to her. The facility meals are prepared in the skilled nursing facility located next door and delivered to the facility for plating. LPA Yee reviewed the food supply at the nursing home at 2:05pm and observed frozen meats, frozen vegetables in the freezer and canned foods in the pantry. Fresh vegetables and fruits were observed stored in the refrigerators. LPA Yee did not observe any spoiled vegetables or fruits during the review of the food supply. Based on interviews conducted and review of the food supply, LPA Yee was not able to obtain sufficient evidence to support the allegation that staff are not serving residents food of good quality. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated at this time.

Per investigation into Allegation #3, staff spoke inappropriately to resident, Staff #1 denies speaking inappropriately or yelling at the Resident 1 to "get out of my kitchen" Per Staff #1, she asked the resident to

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 29-AS-20250409105136

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: PARADISE IN THE VALLEY LLC	FACILITY NUMBER: 197609982
	VISIT DATE: 04/15/2025

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	step out of the kitchen as the resident could slip in the kitchen. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025

LIC9099 (FAS) - (06/04)

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