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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610252
Report Date: 11/26/2025
Date Signed: 11/26/2025 12:45:40 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.RO, 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
11/19/2025 and conducted by Evaluator Leslie Ngo-Castaneda
COMPLAINT CONTROL NUMBER: 31-AS-20251119094152
FACILITY NAME:FORBES HOMEFACILITY NUMBER:
197610252
ADMINISTRATOR:LUCKY PANAFACILITY TYPE:
735
ADDRESS:9608 FORBES AVE.TELEPHONE:
(626) 926-7186
CITY:NORTHRIDGESTATE: CAZIP CODE:
91343
CAPACITY:4CENSUS: 4DATE:
11/26/2025
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Lora Pana- Assistant AdministratorTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff do not allow the client to leave the facility.
INVESTIGATION FINDINGS:
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At 9:20 AM, Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced initial complaint visit in response to the above-mentioned allegation. LPA met with Staff #4 (S4), who granted access to the facility.

Today's investigation, LPA requested the resident and staff roster. Between 9:27 AM – 11:45 AM, LPA conducted an interview with the assistance administrator, four (4) staff, three (3) of the four (4) clients, and a third-party who were present at the facility. Between 11:50 AM and 1:15pm, LPA requested and reviewed copies of pertinent information, which included, but were not limited to Physician’s report, Admission Agreement, IPP, and other documents relevant to the investigation.

Allegation: Staff do not allow the client to leave the facility
Continue to LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2025
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 2
Control Number 31-AS-20251119094152
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: FORBES HOME
FACILITY NUMBER: 197610252
VISIT DATE: 11/26/2025
NARRATIVE
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It was alleged that staff #3 (S3) did not allow the client #1 (C1) to leave the facility on 11.19.2025. LPA interview with C1 at 9:27 AM on 11.26.2025, and it was advised to LPA that S3 block C1 pathway with arms wide open for C1 not to leave the facility. LPA interviewed the assistant administrator (S2), four (4) staff, three (3) client, and a third-party, revealed that they would never deny a client to leave the facility. Interview with clients revealed that they are not forbidden from leaving the facility or have witnessed staff not allowing clients to leave the facility. During today visit, LPA witness at 10:28 AM C1 asked permission from S2 to leave the facility by taking the bus to visit family. S3 gave C1 their meds, C1 signed the sign-in/out sheet, and C1 left at 10:35AM happily.


Based on interviews, observation, and record review, this allegation is deemed UNSUBSTANTIATED as C1 left the facility happily today on 11.26.2025.


Exit interview conducted. Copy of this report signed and delivered.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2