425802136-3-25-2026-29-AS-KBUY-DSK4JK-20260326190851

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 425802136
Report Date: 03/25/2026
Date Signed: 03/25/2026 01:40:48 PM

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
02/09/2026 and conducted by Evaluator Melisa Rankin

COMPLAINT CONTROL NUMBER: 29-AS-20260209125828

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:	02:30 PM

ALLEGATION(S):

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Staff did not ensure that the client’s personal belongings were properly safeguarded

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 Administrator Hanna Diaz and explained the purpose of the visit. During the initial visits on 02/10/26 and 3/20/26, LPA Rankin interviewed administrator, toured the facility, interviewed client, and staff, and reviewed records.

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

On the allegation: Staff did not ensure that the client’s personal belongings were properly safeguarded

It was alleged that a client’s lock for their personal possessions had broken and that staff made no attempt to replace the lock. It was also alleged that some clients are permitted to disregard house rules, including having contraband items in their possession. Continued on 9099-C

Substantiated

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)

Page: 1 of 9

Control Number 29-AS-20260209125828

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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On 02/10/26 at 12:30 p.m. and again on 03/20/26 at approximately 11:02 a.m., LPA inspected the dining room common area where client lockers are located. All locks were tested during both visits and found to be operational and secure. Staff reported that the facility has recently maintained a small supply of replacement locks. Facility had an unwritten policy regarding locker access which required that staff escort clients to their lockers. Facility is now putting this policy in writing going forward. However, staff acknowledged that at times they observed staff hand keys directly to clients, which they stated has contributed to lost keys and the need for lock replacements. Clients interviewed reported that staff typically walk them to their lockers and expressed no current concerns about accessing their lockers or obtaining their personal belongings.

During the 02/10/26 visit, while LPA was reviewing files in the HUB at approximately 12:15 p.m., a client approached requesting access to the sharps container. LPA observed the client holding approximately four to five disposable blue razors. Staff commented on the quantity. Staff interviews confirmed that facility standard has been to allow for razors to be issued and requires it be returned and disposed of immediately after use. Staff interviewed stated they were not aware of a formal tracking system for items such as razors, curling irons, or straighteners.

LPA reviewed the Telecare protocol #CS-1019-177 titled “Personal Belonging Check In and Check Out,” which states its purpose is to ensure that contraband or restricted items are issued, monitored, and stored safely. The protocol requires documentation of the date, time, and condition of items when checked out and when returned. When interviewed, staff stated there was no active check out list or consistent process in place, and responses varied regarding how items were monitored. Staff explained that items were issued and collected but agreed there was no formal mechanism to record or verify return.

Client interviews reflected mixed awareness of house rules but did not provide consistent concerns related to obtaining and returning contraband items.

Following identification that the check in/check out protocol was not being implemented as written, the Administrator created and stated they would implement a formal Check In/Check Out sheet to ensure appropriate tracking and documentation moving forward. As of visit on 3/20/26 staff interviewed had not been informed of the policy and tracking requirements. Continued on 9099-C

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)

Page: 2 of 9

Control Number 29-AS-20260209125828

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/25/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/10/2026 Section Cited CCR 81022(j)	1 2 3 4 5 6 7	81022 Plan of Operation (j) The facility shall operate in accordance with the terms specified in the plan of operation and may be cited for not doing so. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Administrator will provide LPA with a copy of the updated policy regarding lockers, razors and provide training sheets and meeting minutes that staff have been made aware of new process.
	8 9 10 11 12 13 14	Based on observation, interviews, and record reviews, the facility did not comply with the regulation above when they did not follow their plan of operation for safeguarding items, which poses a potential health and safety risk to clients in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: 03/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 9

Control Number 29-AS-20260209125828

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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Although there is no specific regulation that requires facilities to lock personal items or hazardous materials, the facility’s Plan of Operation includes internal policies requiring that such items be safeguarded, tracked, and stored in a manner that ensures client safety.

The investigation determined that staff were not following the facility’s own procedures regarding the monitoring and management of personal items, including the check in and check out of restricted or potentially hazardous items. Because the facility did not adhere to the policies outlined in its Plan of Operation the facility is being cited for failure to follow its internal processes as required per Title 22 81022 Plan of Operation (j) The facility shall operate in accordance with the terms specified in the plan of operation and may be cited for not doing so.

Based on LPA’s observations, interviews, and record review, the preponderance of evidence standard has been met, and the allegation that property is not being properly safeguarded is SUBSTANTIATED.
Pursuant to Title 22, California Code of Regulations, 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: 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)

Page: 9 of 9

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
02/09/2026 and conducted by Evaluator Melisa Rankin

COMPLAINT CONTROL NUMBER: 29-AS-20260209125828

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:	02:30 PM

ALLEGATION(S):

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Staff did not safeguard client’s confidential information
Staff did not provide group activities to clients in care
Staff did not provide proper food service to clients 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 Administrator Hanna Diaz and explained the purpose of the visit. During the initial visits on 02/10/26 and 3/20/26, LPA Rankin interviewed administrator, toured the facility, interviewed client, and reviewed records.

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

On the allegation: Staff did not safeguard client’s confidential information

It was alleged that staff use speakerphones in the Residential Counselor office (“The HUB”) to discuss client medication in a manner that can be overheard. It was also alleged that staff contacted client insurances and made questionable attempts to check insurance information after services were declined. Continued on 9099-C page1

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)

Page: 4 of 9

Control Number 29-AS-20260209125828

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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LPA found no evidence supporting concerns related to insurance. The Administrator stated that medication technicians do not contact insurance providers, and that insurance information is only used for medication and appointment billing. Staff responsible for appointments stated that if services are declined, they follow up with the doctor’s office for further direction.
During the 2/10/26 visit, at approximately 12:09 p.m., LPA observed a medication technician contact a pharmacy regarding a client’s medication. The call began on speakerphone but was moved to a headset when personal client information was requested.

Interviews with staff regarding privacy practices revealed inconsistent responses. Some staff reported that conversations in the HUB can be overheard due to the open layout, while others stated that client-specific discussions occur privately during shift exchange in the dining room. LPA observed that a noise masking device is in place in the medication room but does not work when used in the HUB.

LPA interviewed six clients, all of whom stated they have not overheard conversations and had no concerns about their privacy or confidentiality.

Based on interviews and observations, the allegation regarding staff use of speakerphones while discussing client information and staff contacting insurance and making questionable requests is UNSUBSTANTIATED at this time, as there is not a preponderance of evidence to prove the alleged violations did or did not occur.

On the allegation: Staff did not provide proper food service to clients in care

It was alleged that food allergies and religious dietary restrictions are not consistently followed and that staff do not review ingredients to ensure clients with allergies are not provided with restricted foods.

During the visit on 2/10/26 at approximately 12:00 p.m., LPA reviewed 11 current client files for dietary restrictions, food allergies, or religious requirements. LPA also observed the dietary/allergy list posted in the kitchen, which at that time reflected one client with diabetic dietary needs. No other allergies or restrictions were documented. On 3/10/26, the facility provided an updated list identifying one resident with an allergy to bee pollen.
Continued on 9099-C page2

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)

Page: 5 of 9

Control Number 29-AS-20260209125828

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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At 12:34 p.m. on 2/10/26, LPA reviewed five discharged client files and identified one client with documented dietary restrictions. Interviews with the Administrator revealed that staff frequently communicated with Patients’ Rights due to the client’s ongoing concerns about food items. Documentation showed that staff made multiple efforts to accommodate the client, including preparing modified meals, labeling gluten free options, providing additional fruits, and purchasing alternative items. Staff also provided photos of meals prepared for the client. Staff reported the client made frequent and highly specific requests that changed daily.

Between 3/13/26 and 3/20/26, LPA interviewed facility staff regarding procedures used to identify and follow dietary restrictions. Staff reported that a dietary/allergy list is posted in the kitchen, on teams for the client’s profiles, and in their medical file and that restrictions are typically identified during pre-assessment, intake and/or noted in the Physicians Report (LIC 602A). Staff stated they separate plates as needed and that clients may exercise personal choice in what they eat. Staff did not recall any instances of food allergy concerns or clients being denied foods consistent with their restrictions.

Clients interviewed stated they have had no issue with food quality, quantity, or options. Current clients do not have dietary restrictions, except for a client with an allergy.

LPA also noted that on 12/18/25, the Administrator emailed documentation showing steps taken to accommodate a client with dietary concerns. During visit on 3/20/26 LPA observed staff with hair net, and gloves preparing food. The current dietary restrictions list was updated in the kitchen.

Based on observation, interviews, and record review, the facility maintains procedures for identifying and accommodating dietary restrictions. Dietary/allergy information is documented and updated in client records and posted in the kitchen for staff awareness. At this time, there is not a preponderance of evidence to determine that the alleged violation occurred. Therefore, the allegation is UNSUBSTANTIATED.
Continued on 9099-C page3

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)

Page: 6 of 9

Control Number 29-AS-20260209125828

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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On the allegation: Staff did not provide group activities to clients in care

It was alleged that group sessions are not conducted regularly and that some staff remain in the HUB using computers or phones instead of interacting with clients. It was also alleged that clients are credited for groups that were not actually conducted and are instead given daily check in sheets.

The facility’s has multiple documents that describe the support of their clients to include groups. Their Plan of Operation, their Policies, the “Daily Program Schedule,” and their “Member Handbook”. The Plan of Operation states “group sessions/activities…which will offer a minimum of four groups skills…and/or wellness classes daily.” The Member Handbook is reviewed during intake with all clients. The Handbook specifically notes “Groups are offered at least four times a day during the week.”

During interviews, staff reported that although groups are scheduled daily, they are times they are unable to complete all planned sessions due to operational demands. Staff described prioritizing admissions and discharges, transportation, medication distribution, documentation, and meal preparation. Staffing fluctuations and Resident Counselor availability also impact the number of groups that can be offered.

Client interviews were consistent, indicating they typically receive 2 to 3 groups per day. Clients stated other activities they participate in throughout the week, giving the impression that some activities also are groups and clients may not be aware of those titles. Clients denied signing group sheets for groups that did not occur.

On 3/25/26, LPA reviewed group sign in sheets for two months. The facility produced sign-in sheets, including daily meetings and movement groups showing that in January there were 81 groups documented and in February there were 77 groups documented. Documentation showed occasional days with four groups, but most days reflected two to three groups. Average amount of groups based on Monday through Friday time frames was 3.7 groups per day. Continued on 9099-C page5

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)

Page: 7 of 9

Control Number 29-AS-20260209125828

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 has proven consistent attempts to meet the program plan of 4 groups per day. A discussion that staff need to be aware of filing sheets and a process for managers to track when planned groups are canceled should occur to track that they are staying in policies.

Based on LPA’s interviews and record review, at this time the facility showed intent to conduct the required amount of groups and there is not a preponderance of evidence to determine that the alleged violation of staff did not provide group activities occurred. Therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted. A copy of this report was issued.

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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