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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 421700457
Report Date: 06/10/2025
Date Signed: 06/11/2025 08:13:08 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/03/2025 and conducted by Evaluator Kristin Kontilis
COMPLAINT CONTROL NUMBER: 29-AS-20250603085058
FACILITY NAME:WOOD GLEN HALL, INC.FACILITY NUMBER:
421700457
ADMINISTRATOR:JESSICA HONGFACILITY TYPE:
740
ADDRESS:3010 FOOTHILL ROADTELEPHONE:
(213) 544-2070
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY:72CENSUS: 51DATE:
06/10/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Jessica Hong, Interim Executive DirectorTIME COMPLETED:
06:45 PM
ALLEGATION(S):
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Facility is unsanitary.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced 10-day complaint investigation based on the above stated allegations. LPA met with Jessica Hong, Interim Executive Director and explained the purpose of the visit. June Davila, Wellness Director and Holly Walling, Sales & Marketing Manager participated in the visit.
During today’s visit, from 11:45 am to 1:10 pm, LPA conducted a tour of the facility with Interim Executive Director, Wellness Director, and Sales & Marketing Manager. Also during today’s visit, LPA obtained documents pertaining to the investigation and conducted in-person interviews.
On the allegation Facility is unsanitary: The complainant’s concern was that there was a “fly trap” with trapped flies located directly above an area where food is prepared and a kitty litter box was located in Wellness Room staff bathroom posing a risk for potential contamination and/or cross contamination.

Please continue to 9099-C, Pg 2.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/03/2025 and conducted by Evaluator Kristin Kontilis
COMPLAINT CONTROL NUMBER: 29-AS-20250603085058

FACILITY NAME:WOOD GLEN HALL, INC.FACILITY NUMBER:
421700457
ADMINISTRATOR:JESSICA HONGFACILITY TYPE:
740
ADDRESS:3010 FOOTHILL ROADTELEPHONE:
(213) 544-2070
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY:72CENSUS: 51DATE:
06/10/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Jessica Hong, Interim Executive DirectorTIME COMPLETED:
06:45 PM
ALLEGATION(S):
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Facility has rodents.
Staff failed to maintain accurate residents' records.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced 10-day complaint investigation based on the above stated allegations. LPA met with Jessica Hong, Interim Executive Director and explained the purpose of the visit. June Davila, Wellness Director and Holly Walling, Sales & Marketing Manager participated in the visit.
During today’s visit, from 11:45 am to 1:10 pm, LPA conducted a tour of the facility with Interim Executive Director, Wellness Director, and Sales & Marketing Manager. Also during today’s visit, LPA obtained documents pertaining to the investigation and conducted in-person interviews.
On the allegation the facility has rodents: The concern was that there were ‘repeated sightings of rodents in the kitchen area’. At approximately 11:45 am to 1:10 pm, LPA toured the facility with Interim Executive Director, Wellness Coordinator, and Sales & Marketing Manager. Additionally, LPA conducted in-person interviews with Facility Culinary Director/Executive Chef, Facility Maintenance/Housekeeping Supervisor, Business Office Manager, and Interim Executive Director. Tour throughout the facility revealed there was no evidence of rodents and/or rats within the facility. Interviews conducted revealed rodents and/or rats have not been observed within the facility, nor have evidence of rats/rodents been reported to facility directors including Interim Executive Director.

Please continue to 9099-C, Pg 2.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20250603085058
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: WOOD GLEN HALL, INC.
FACILITY NUMBER: 421700457
VISIT DATE: 06/10/2025
NARRATIVE
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 LPA also conducted a tour of the outside of the facility with Maintenance/Housekeeping Supervisor. The facility is located in a high vegetation rural neighborhood where many of the neighboring homes have multiple fruit trees, gardens, and other varieties of vegetation. There was no evidence of rodents and/or rats, or sign of rodent/rat excrement, or rodent/rat destruction in the outside area of the facility.
Further interviews conducted revealed the facility contracts with a local vendor for rat and rodent removal, pest control, termite inspection, bird control, and fumigation. The contract with the vendor includes a monthly routine visit for spraying and a more in-depth spraying every four months outside the facility. The last four-month in-depth spraying was conducted in March 2025. Interim Executive Director stated no reports of rats, rodents, insects, etc. have been reported to facility directors and if there were, it would show in the vendors’ reports. LPA reviewed pest control Invoice #501984 dated 5/6/2025 for routine spraying on the same date as invoiced from 10:52 am to 11:47 am. No note of rodents, rats, insects, etc. were noted in the invoice. Further, Interim Executive Director stated, “I have never received a report that there were rats or rodents within our facility. If there was, I would have done something about it immediately!”
Based on interviews conducted and observations made, the allegation that the facility has rodents is deemed Unsubstantiated at this time.
On the allegation, staff failed to maintain accurate residents' records: Complainant’s concern is residents’ charts are not being regularly updated. During today’s visit, LPA conducted staff interviews and obtained copies pertaining to the allegation. Interviews conducted revealed upon a resident's admission, each resident’s records are compiled as the “admission packet” including the resident’s face sheet, LIC602, POLST form, insurance information and Pre-Appraisal. Interviews conducted revealed each resident’s records are updated on an “as needed" basis including but not limited to medical visits, medical emergencies, and other serious illness/serious injury reports. Interviews conducted revealed Wellness Director is responsible for chart keeping and regularly updates residents’ files. Interviews conducted further revealed a “care plan” is kept for each resident in the resident’s binder. The Care Plan lists the services that are offered and the price value for each service. It is originated with the family just prior to move in and it is maintained and changed based on a resident’s need. Re-appraisals are conducted on an “as needed” basis as well as on a regular basis as a “care conference”. Wellness Director communicates with the residents and their responsibility parties on an “ongoing basis”. Record review of the documents revealed no discrepancies or inaccuracies in residents' records. Therefore, based on interviews conducted and records reviewed, the allegation Staff failed to maintain accurate residents records is deemed Unsubstantiated at this time.
Due to technical difficulties, copy of report issued at the time of the visit.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 29-AS-20250603085058
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: WOOD GLEN HALL, INC.
FACILITY NUMBER: 421700457
VISIT DATE: 06/10/2025
NARRATIVE
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 At approximately 11:45 am to 1:10 pm, LPA toured the facility with Interim Executive Director, Wellness Coordinator, and Sales & Marketing Manager. At approximately 11:49 am, LPA observed a fly trap/strip with dead flies attached on the strip placed above a warming station of a food service work area. LPA observed the food service area had plates with sandwiches covered with plastic wrap and a cutting board with a cutting knife and crumbs on the cutting board. At approximately 1:50 pm, LPA observed the fly trap/strip had been removed.
During the tour of the facility, at approximately 11:56 am, LPA observed Staff Room 3 with mold on the wall, dirt on the carpet, and an electrical light panel lying on the floor. During the tour of the facility at approximately 12:15 pm and 12:25 pm, LPA observed two residents’ rooms to have stained and soiled carpets.
At approximately 12:30 pm, LPA observed that there was no kitty litter box in the staff bathroom of the Wellness Office. Interim Executive Director stated at one time the litter box was kept in the bathroom, but upon the recommendation of Allen Flores Consulting in March 2025, it was recommended that the litter box be kept in the staff bathroom of the Wellness Office with no accessibility to residents. As of March 2025, the litter box is kept in the staff bathroom and the bathroom is kept clean on a daily basis and a staff member cares for the facility cat including feeding the cat and keeping the litter box clean. Per Interim Executive Director, the Wellness Office is inaccessible to residents in care.
Based on observation and interviews conducted, the allegation that the facility is unsanitary is deemed Substantiated at this time.

Pursuant to Title 22, California Code of Regulations, the following deficiencies are cited (refer to LIC 9099-D).

Exit interview conducted. Due to technical issues, copy of report and appeal rights issued at the time of the visit via email.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 29-AS-20250603085058
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: WOOD GLEN HALL, INC.
FACILITY NUMBER: 421700457
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/20/2025
Section Cited
CCR
87303(a)
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87303(a) Maintenance and Operation: (a) The facility shall be clean, safe, sanitary and in good repair at all times.

This requirement is not met as evidenced by:
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Administrator agrees to have carpets cleaned in Residents' rooms noted to be soiled and stained no later than POC due date.
Administrator agrees to provide photos of cleaned carpets no later than POC due date.of cleaning conducted.
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Based on observation, the licensee did not comply with the section cited above per observations made: fly trap with trapped flies, staff room with mold and dirt on the wall, and two residents’ rooms with stained and soiled carpet which poses/posed a potential health, safety or personal rights risk to persons in care.
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Administrator agrees to create a Housekeeping checklist to ensure rooms are thoroughly cleaned and any issues brought to the attention of the Housekeeping Supervisor.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5