<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610191
Report Date: 09/19/2023
Date Signed: 09/19/2023 12:38:52 PM

Unfounded


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
09/15/2023 and conducted by Evaluator Antonia Alvizar
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20230915090228
FACILITY NAME:GARDENS AT NORTHRIDGE, THEFACILITY NUMBER:
197610191
ADMINISTRATOR:GENA GRUNDEISFACILITY TYPE:
741
ADDRESS:17650 WEST DEVONSHIRE STREETTELEPHONE:
(818) 886-1616
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:135CENSUS: 82DATE:
09/19/2023
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Anne Marie Chan, Business Office ManagerTIME COMPLETED:
12:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Illegal eviction
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At 10:15am, Licensing Program Analyst (LPA’s) Antonia Alvizar and Gina Saucedo arrived at the facility in response to the above mentioned allegation. LPA’s met with Business Office Manager Anne Marie Chan and explained the reason for the visit.

To investigate the allegation, on 09/19/2023 at 10:20am, LPA Alvizar requested a copy of facility records. At 10:30am, LPA’s conducted a tour of the facility, made observations and interviewed the Business Office Manager and Resident Service Director, Cinthia Lara- Vargas. Record review (facility resident roster) did not show that the individual in question is a current resident at this facility. Interviews with the Business Office Manager and Resident Service Director revealed that the individual in question was never a resident of this facility. At 11:40am, LPA’s walked to the back side of the property where Skill Nursing Facility is located.

Continue on LIC9099-C

Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
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 2
Control Number 31-AS-20230915090228
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: GARDENS AT NORTHRIDGE, THE
FACILITY NUMBER: 197610191
VISIT DATE: 09/19/2023
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
Upon arrival LPA’s met with Administrator in Training, Keith Vogal and Jeff Tabor it was confirmed that the individual in question was admitted to the skilled nursing facility of "Aspen" which is not a part of Assisted Living nor Memory Care licensed by Department of Social Services / Community Care Licensing. Keith indicated that individual in question is currently at Northridge Hospital. The department will notify the appropriate agency. The skilled nursing is located on the same property as The Gardens at Northridge. Therefore, based on interviews this allegation is deemed Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.


There were no deficiencies cited. Exit interview conducted. Copy of this report will be emailed.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2