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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601809
Report Date: 12/18/2025
Date Signed: 12/18/2025 11:03:55 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/11/2025 and conducted by Evaluator Quoc Huynh
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20251211085420
FACILITY NAME:ELWYN NC - BABCOCKFACILITY NUMBER:
198601809
ADMINISTRATOR:LAURIE HERNANDEZFACILITY TYPE:
734
ADDRESS:5149 BABCOCK AVETELEPHONE:
(818) 287-5416
CITY:VALLEY VILLAGESTATE: CAZIP CODE:
91607
CAPACITY:5CENSUS: 3DATE:
12/18/2025
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Joanna Gonzales - Elwyn Regional Director
Terrance Henson - Administrator
Betty Davis - House Manager		TIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Staff did not ensure reporting requirements were followed
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Quoc Huynh conducted an initial complaint visit for the above allegation. LPA arrived at 10:15AM and met with Elwyn Regional Director (RD) Joanna Gonzales, Administrator Terrance Henson, and House Manager (HM) Betty Davis and explained the reason for the visit. Entrance interview conducted.

Beginning at 10:35AM, the LPA and HM conducted a physical plant tour and no immediate concerns were observed. At 10:40AM the LPA interviewed the HM. The following was then determined:

Report Continued on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
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 29-AS-20251211085420
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ELWYN NC - BABCOCK
FACILITY NUMBER: 198601809
VISIT DATE: 12/18/2025
NARRATIVE
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Allegation: “Staff did not ensure reporting requirements were followed”

It was reported that the facility did not follow reporting requirements when Resident #1 (R1) was transported to the hospital on 11/30/2025. Specifically, North Los Angeles County Regional Center (NLACRC) and Department of Developmental Services (DDS) were not notified within a twenty-four (24) hour period. Per Health and Safety Code Section 1538.55(a), “The licensee of an Adult Residential Facility for Persons with Special Health Care Needs (ARFPSHN)… shall report to the department’s Community Care Licensing Division, within the department’s next working day and to the regional center with whom the ARFPSHN or the GHCSHN contracts, and the State Department of Developmental Services, within 24 hours upon the occurrence of any of the following events…”

Record review revealed that facility HM Betty Davis notified two (2) NLACRC staff and included the facility’s Interim Administrator and secondary House Manager Nancy Reyes on 11/30/2025 via email. LPA Huynh was forwarded the notification shortly after the initial notification. NLACRC Nurse Consultant confirmed receipt of the notification on 12/01/2025. On 12/02/2025 secondary House Manager Nancy Reyes provided all Departments of the Incident Report, and at which point included DDS Nurse Consultant.

Interview with the HM stated they were recently employed with the facility and confirmed the oversight and stated they were previously instructed to provide 24-hour notification and were unable to recall if DDS was included on the list.

The LPA determined two (2) out of three (3) Departments were appropriately notified within 24 hours, and despite the oversight, all Departments were notified of the incident in a timely manner and received a written Incident Report within two (2) days. Additionally, the violation did not present a danger or direct impact to residents in care therefore the allegation is SUBSTANTIATED and considered a TECHNICAL VIOLATION. No citation was issued.

The LPA discussed the importance of reporting requirements and ensuring compliance with all Departments to which the RD, Administrator, and HM agreed.

No deficiency cited. Exit interview conducted. A copy of the report was reviewed and provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2