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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425801403
Report Date: 08/13/2025
Date Signed: 08/13/2025 03:04:01 PM

Unsubstantiated


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
08/13/2025 and conducted by Evaluator Melisa Rankin
COMPLAINT CONTROL NUMBER: 29-AS-20250813120622
FACILITY NAME:ALEJANDRO'S RCFEFACILITY NUMBER:
425801403
ADMINISTRATOR:AUREA ALEJANDROFACILITY TYPE:
740
ADDRESS:1130 GRAPEVINE ROADTELEPHONE:
(805) 349-9446
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:6CENSUS: 0DATE:
08/13/2025
UNANNOUNCEDTIME BEGAN:
12:38 PM
MET WITH:VENIER AUREA ALEJANDROTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility failed to provide utilities
INVESTIGATION FINDINGS:
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On 8/13/25 at 12:38 pm, Licensing Program Analyst (LPA) Rankin conducted a 10-day complaint visit to the facility above. LPA met with Venier Alejandro Licensee and explained the purpose of the visit.
During the visit LPA interviewed 1 staff, the Licensee, and via a phone call, the Administrator Aurea Alejandro. LPA toured facility, no residents are present, rooms have furniture, but no personal belongings. Staff were cleaning out kitchen when LPA arrived.

On the allegation: Facility failed to provide utilities
It was alleged that the facility had shut off power to part of the facility intentionally. LPA went to all rooms turning on and off lights. LPA went to the back half of the facility where 3 bedrooms and one bathroom is located, and found that 2 rooms and the bathroom did not have power. Staff stated the power went off yesterday and they weren’t sure why. LPA was shown a breaker panel which appeared to have all power switchs on. LPA flipped one breaker switch that seemed to not be all the way on, and the power immediately came on.
Based on LPA’s observations, and interviews conducted, the preponderance of evidence standard has not been met; therefore, the above allegation is found to be UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
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 4
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
08/13/2025 and conducted by Evaluator Melisa Rankin
COMPLAINT CONTROL NUMBER: 29-AS-20250813120622

FACILITY NAME:ALEJANDRO'S RCFEFACILITY NUMBER:
425801403
ADMINISTRATOR:AUREA ALEJANDROFACILITY TYPE:
740
ADDRESS:1130 GRAPEVINE ROADTELEPHONE:
(805) 349-9446
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:6CENSUS: 0DATE:
08/13/2025
UNANNOUNCEDTIME BEGAN:
12:38 PM
MET WITH:AUREA ALEJANDROTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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9
Facility illegally evicted resident
INVESTIGATION FINDINGS:
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On 8/13/25 at 12:38 pm, Licensing Program Analyst (LPA) Rankin conducted a 10-day complaint visit to the facility above. LPA met with Venier Alejandro Licensee and explained the purpose of the visit.
During the visit LPA interviewed 1 staff, the Licensee, and via a phone call, the Administrator Aurea Alejandro, obtained records of Resident 1 (R1). During visit LPA was able to interview R1’s representative via a phone conversation. LPA toured facility, no residents are present, rooms have furniture, but no personal belongings. Staff were cleaning the kitchen when LPA arrived.
On the allegation: Facility illegally evicted resident
It was alleged that R1 and their representative were not provided a proper notice of eviction.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 29-AS-20250813120622
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: ALEJANDRO'S RCFE
FACILITY NUMBER: 425801403
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/22/2025
Section Cited
HSC
1569.682(a)(2)(A)
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1569.682(a)(2)(A)licensee ...shall, prior to transferring a resident...as a result of the forfeiture of a license...take all reasonable steps to transfer affected residents safely...at a minimum, do all of the following:...(2)Provide each resident or the resident’s responsible person with a written notice no later than 60 days...The notice shall include all of the following:(A) The reason...with specific facts... (B)A copy...resident’s current service plan.(C)The relocation evaluation. (D) A list of referral agencies.
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(E) The right of the resident ...to contact the department to investigate the reasons...
(F) The contact information for the local long-term care ombudsman..This requirement is not met based on interview and record review when facility did not provide A-F in the written eviction letter which posed a potential health and safety risk to residents in care.
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Administrator agrees to provide LPA with a statement that the eviction process has been reviewed and is understood for future processes.
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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: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 29-AS-20250813120622
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: ALEJANDRO'S RCFE
FACILITY NUMBER: 425801403
VISIT DATE: 08/13/2025
NARRATIVE
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Eviction is due to closure of the facility which requires a 60 day written notice and per regulations requires the resident and their representative to receive documents including copy of resident current service plan, a relocation evaluation, list of referral agencies, the rights of the resident to contact department to investigate reasons given for eviction…, contact information for the local long-term care ombudsman, including address and telephone number.
LPA reviewed the eviction document received by the Community Care Licensing agency on 6/20/25, letter dated 6/13/25 and noted that all elements required above were not provided to the resident. Date of eviction noted was 8/13/25.
Call was made to the ombudsman on 8/13/25, in which the representative alleged facility required R1 to leave today (8/13/25). LPA received a complaint and conducted a visit on 8/13/25 and it was explained by the administrator and Licensee that R1 was not forced to leave, that the administrator and representative communicated for the past 6 months prior, that R1 was on notice of the intent to sell the facility, but that the facility was willing to keep R1 until a place could be secured.
No other written communication was made available to the LPA. It is unclear whether further discussion occurred between R1 and their representative or not, but the letter of eviction does not follow required Health and Safety guidelines.
Based on LPA’s interviews, and records reviewed, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.

Pursuant to Health and Safety Code section 1569.682(a)(2)(A) through (F), the following deficiencies are cited (refer to LIC9099-D).
Exit interview conducted, appeal rights discussed, and a copy of this report issued.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4