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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610659
Report Date: 08/01/2025
Date Signed: 08/01/2025 02:22:47 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
05/06/2025 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20250506171841
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:
08/01/2025
UNANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:Elizabeth RomeroTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff do not adequately supervise clients at night.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to the facility. LPA met with Elizabeth Romero and explained the reason for the visit.

--- Staff do not adequately supervise clients at night.

It was alleged that staff are allowing residents to slam the lids of trash containers and scream at night. To investigate this allegation, on 05/13/2025 at around 12:15p.m., LPA Leizl De La Cerra interviewed staff. On 08/01/2025 at around 10:30a.m., LPA interviewed one additional staff. During interviews with staff, all staff stated residents and staff are not slamming trash cans at night, however, facility has one resident who yells at night.

(CONT. on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2025
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-20250506171841
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: VAGTHOL'S RESIDENTIAL CARE CENTER #1
FACILITY NUMBER: 197610659
VISIT DATE: 08/01/2025
NARRATIVE
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Staff added that facility residents are not bothered by or complaining about the residents screaming at night, that residents sleep through the night and staff provide care and supervision necessary to meet the client's needs and all services. Staff #1 (S1) stated they follow the behavior specialist instructions and redirect and praise her when she is quiet.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards noted during the visit.

Exit interview conducted and a copy of the report was issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2