197610739-4-22-2026-31-AS-MGFS-DVZQHF-20260715121105

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610739
Report Date: 04/22/2026
Date Signed: 04/22/2026 03:47:09 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
04/17/2026 and conducted by Evaluator Leslie Ngo-Castaneda

COMPLAINT CONTROL NUMBER: 31-AS-20260417141106

FACILITY NAME:	PLATINUM CROWN INC		FACILITY NUMBER:	197610739
ADMINISTRATOR:	ALEKSANI, TAMARA		FACILITY TYPE:	740
ADDRESS:	20535 ENADIA WAY		TELEPHONE:	(818) 740-1298
CITY:	WINNETKA	STATE: CA	ZIP CODE:	91306
CAPACITY:	6	CENSUS: 6	DATE:	04/22/2026
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	ALEKSANI, TAMARA- administrator		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff is not assisting resident with obtaining medical appointment.
Staff did not provide copy of admission agreement to responsible person.
Staff did not ensure the resident had appropriate clothing.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced initial complaint visit to the facility to investigate the above allegation. LPA met with the facility staff, Behrouz Atri (S2), and explained the reason for the visit. At 9:50 AM administrator arrived, Tamara Aleksani, arrived and explained the reason of the visit.

To investigate the allegation on 04.22.2026, LPA took a tour of the physical plant at 8:35 AM. LPA requested copies of resident #1 (R1) physician report, admission agreement, appraisal needs and service plan, and other documents pertaining to the investigation. LPA reviewed documents at 11:00 AM, interviewed two (2) staff, and six (6) who are at the facility from 9:05 AM to 10:55 AM.

Allegation: Staff is not assisting resident with obtaining medical appointment.

Continue to LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026

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-20260417141106

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: PLATINUM CROWN INC	FACILITY NUMBER: 197610739
	VISIT DATE: 04/22/2026

NARRATIVE

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It is reported that the facility does not assist R1 in obtaining medical appointments. To investigate this allegation, LPA conducted an interview with the Administrator and staff, who stated that the facility provides timely medical care to all of the residents in care, including obtaining a specialist appointment for R1. Interviews with six (6) residents revealed no concerns regarding the allegation, stating that their medical needs are being met. Interview with R1 at 10:00 AM confirmed that they had an appointment with a specialist on 4.20.2026 which was scheduled by the administrator. Record review confirmed R1 appointment.

Therefore, based on interviews, this allegation is deemed unsubstantiated at this time.

Allegation: Staff did not provide copy of admission agreement to responsible person.

It is alleged that staff did not provide a copy of admission agreement to R1’s responsible person. Interview with R1 stated that they are responsible for themselves and did not authorize anyone to be responsible for them. During record review, LPA did not observe any legal document for R1 to have an authorized representative. Per Identification and Emergency Information sheet dated: 04.03.26, R1 is self responsible. Admission agreement signed on 04.05.26 was signed by R1. Interview with all the residents revealed that they are all responsible for themselves. During interviews with administrator and staff, it was revealed that if a responsible person is available, they would communicate the necessary information to the authorized representative. Based observation and interview, there is not enough information to verify the allegation.

There is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Allegation: Staff did not ensure the resident had appropriate clothing.

In regard to the allegation, it was reported that R1 does not have footwear. Interview with the staff confirms that facility provides all of the necessary supplies’ residents need. The interview with R1 revealed that they were provided with footwear but prefer sneakers instead of slip-ons. Interview with residents revealed that they are properly supplied with all their needs and requests. Based on the information and observation obtained, there was insufficient evidence to corroborate the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.
An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026

LIC9099 (FAS) - (06/04)

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