197610309-3-10-2026-31-AS-TAGD-DT7NQ3-20260416103917

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610309
Report Date: 03/10/2026
Date Signed: 03/10/2026 01:56:36 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
10/10/2025 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20251010120401

FACILITY NAME:	VALLEY STAR OLIVE VIEW UCLA CRT		FACILITY NUMBER:	197610309
ADMINISTRATOR:	SOWUNMI, GBENGA		FACILITY TYPE:	772
ADDRESS:	14119 BUCHER AVE		TELEPHONE:	(818) 290-5307
CITY:	SYLMAR	STATE: CA	ZIP CODE:	91342
CAPACITY:	16	CENSUS: 15	DATE:	03/10/2026
		UNANNOUNCED	TIME BEGAN:	08:48 AM
MET WITH:	Gbenga Sonwunmi - Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff does not keep facility free from pests

Staff not following resident’s dietary needs

Staff does not treat resident with respect

Staff denied resident access to medical records

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 Gbenga Sonwunmi and explained the reason for the visit.

LPA conducted physical plant tour at 9:02 AM, requested copies of facility documents relevant to the investigation at 9:30 AM, reviewed records between 9:30 AM to 10:30 AM and interviewed staff and residents between 10:30 AM to 1:00 PM. Regarding the allegation that Staff does not keep facility free from pests, it was alleged that there are ants at the facility crawling on the table, in residents’ rooms, bathrooms, sink, and toilet. LPA record review revealed that the facility had a contracted pest control that visits the facility once a month and comes when needed. LPA's observation during this and prior visit revealed that there were no ants crawling or roaming inside the facility during visits. LPA's interview with three (3) residents or more than 10% of the current census on 10/17/25 between 10:30 AM to 12:30 PM revealed that three (3) out of three (3) residents stated that they did not see any ants inside the facility. (continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026

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-20251010120401

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: VALLEY STAR OLIVE VIEW UCLA CRT	FACILITY NUMBER: 197610309
	VISIT DATE: 03/10/2026

NARRATIVE

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(continued from LIC 9099)

Regarding the allegation that Staff not following resident’s dietary needs, it was alleged that Resident #1 (R1) requires a special diet for R1's meals. LPA's record review today from 9:30 AM to 10:30 AM revealed that R1 had pork and beef allergy. LPA's observation during tour revealed that R1's and other residents' allergy was clearly displayed on the refrigerator and on their catered meals clearly stated R1's name on Vegan food kept on the refrigerator, breakfast, lunch and dinner. LPA's interview with kitchen staff on 10/17/25 also confirmed that they ordered Vegan food for R1 to their caterer since R1's admission as per R1's request.

Regarding the allegation that Staff does not treat residents with respect, it was alleged that Staff #1 (S1) gives R1 an attitude and doesn’t treat R1 with respect. LPA's interview with S1 today at 11:50 AM revealed that S1 almost never had an interaction with R1 only during R1's admission where R1 signed all the admission documents and one interaction wherein R1 complained about R1's dietary restriction, which S1 ordered from their caterer. S1 did not recall any interaction with R1 that might be construed as being rude to R1. LPA's interview with Administrator confirmed that the Administrator did not receive any complaint from anyone about S1 being rude. LPA's interview with three (3) residents or more than 10% of the current census on 10/17/25 between 10:30 AM to 12:30 PM revealed that three (3) out of three (3) residents stated that they did not witness S1 being rude to R1 nor experience being given an "attitude" by S1.

Regarding the allegation that Staff denied resident access to medical records, it was alleged that R1 requested own medical and psychiatric record from R1's prior facility but was refused to by the Staff #2 (S2). LPA's interview with S2 today at 12:18 PM, revealed that R1 was requesting a record they don't have and informed R1 so. S2 denied refusing to provide documents but explained to R1 that they do not have the record R1 was requesting. LPA's interview with staff and Administrator confirmed that they do not obtain prior record of any resident admitted to the facility.

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: 03/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026

LIC9099 (FAS) - (06/04)

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