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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610659
Report Date: 01/09/2025
Date Signed: 01/09/2025 01:59:25 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
01/06/2025 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20250106110504
FACILITY NAME:VAGTHOL'S RESIDENTIAL CARE CENTER #1FACILITY NUMBER:
197610659
ADMINISTRATOR:ROMERO, ELIZABETHFACILITY TYPE:
735
ADDRESS:601 N VALLEY STTELEPHONE:
(323) 788-9924
CITY:BURBANKSTATE: CAZIP CODE:
91505
CAPACITY:6CENSUS: 6DATE:
01/09/2025
UNANNOUNCEDTIME BEGAN:
09:31 AM
MET WITH:Elizabeth Romero - AdministratorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff left clients screaming for an hour
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Gary Tan conducted an unannounced initial complaint visit at this facility to investigate the above allegation. LPA met with Administrator Elizabeth Romero 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 10:03 AM and interviewed reporting party (RP) and staff between 10:30 AM to 12:30 PM. It was alleged that staff are leaving the clients screaming for over an hour. LPA's observation during today's visit revealed that there is only one client at the facility who is loud. LPA's interview with three (3) staff today who attend to C1 as 1:1 staff revealed that Client #1 (C1) is non-verbal and gets loud when becomes excited and/or in pain due to a periodical medical condition. LPA's interview with four (4) staff today between 10:30 AM to 12:30 PM revealed that no staff left any client nor witness any staff left any client alone or by themselves at any time in the facility. All four (4) staff also stated that the only client who is loud but not for long as they have to calm C1 down. (continued on LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
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-20250106110504
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: VAGTHOL'S RESIDENTIAL CARE CENTER #1
FACILITY NUMBER: 197610659
VISIT DATE: 01/09/2025
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
(continued from LIC 9099)

Further, C1 is loud and sometimes after calming down, repeats being loud as it is the only expression C1 knew to express C1's self.

Based on the information gathered during this visit, the allegation is 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: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2