425802136-3-25-2026-29-AS-KBUY-DSK4GU-20260326190606

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 425802136
Report Date: 03/25/2026
Date Signed: 03/25/2026 01:52:11 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
03/18/2026 and conducted by Evaluator Melisa Rankin

COMPLAINT CONTROL NUMBER: 29-AS-20260318172959

FACILITY NAME:	TELECARE CARMEN LANE		FACILITY NUMBER:	425802136
ADMINISTRATOR:	HANNA DIAZ		FACILITY TYPE:	772
ADDRESS:	212 WEST CARMEN LANE STE 201		TELEPHONE:	(805) 212-7680
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93458
CAPACITY:	12	CENSUS:	DATE:	03/25/2026
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Hanna Diaz		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Staff did not provide records to a resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rankin conducted a subsequent complaint visit to the facility above to issue final findings. LPA met with Hanna Diaz, Administrator, and explained the purpose of the visit.

During the initial visit on 03/20/26 LPA Rankin interviewed administrator, staff, and reviewed records.

During the investigation LPA conducted telephone interviews with Behavior Wellness and requested and reviewed documentation from the facility.

On the allegation: Staff did not provide records to a resident in care

It was alleged that a client requested copies of medical records and notes, but the documents provided were incomplete and contained incorrect information. The reporting party stated that multiple attempts were made to obtain the missing records.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026

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 29-AS-20260318172959

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: TELECARE CARMEN LANE	FACILITY NUMBER: 425802136
	VISIT DATE: 03/25/2026

NARRATIVE

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The facility reported that clients request records by completing an authorization form, and internal facility records are copied and provided directly to the client. In this case, the facility provided the internal documents to the client on 11/24/25 via email.

The issue arose with the client’s request for medical records and notes maintained in the county behavioral wellness database. During interviews, the Administrator stated that staff had informed her that the client claimed there were missing documentation and concerns that some notes entered in the county system may not belong to the client. Several documents had initially not been uploaded by the facility into the county system, and to date—approximately five months later—the client has still not received those records.

The Administrator reported that the missing records were uploaded into the county database on 1/8/26 and it was believed that staff responsible for communicating with the client and the county had done so. The Administrator also acknowledged that the documentation in question—allegedly belonging to another client—has not been reviewed because the requesting client did not specify which entries were believed to be incorrect.

LPA clarified that while Community Care Licensing cannot enforce access to medical records governed under HIPAA, the facility is responsible for ensuring that records they are required to be maintain are complete, accurate, and accessible. LPA requested that the facility provide CCL with evidence that the missing records were uploaded and that communication with the client and the county occur to ensure the client obtains the requested information.

Based on record reviews and interviews, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026

LIC9099 (FAS) - (06/04)

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