561702356-3-24-2026-29-AS-KHEN-DTLVAT-20260429161628

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 561702356
Report Date: 03/24/2026
Date Signed: 03/24/2026 06:49:58 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
12/01/2025 and conducted by Evaluator Emily Peraldi

COMPLAINT CONTROL NUMBER: 29-AS-20251201113735

FACILITY NAME:	COTTONWOOD, THE		FACILITY NUMBER:	561702356
ADMINISTRATOR:	FLORO P CORTES JR		FACILITY TYPE:	735
ADDRESS:	1417 LIRIO AVENUE		TELEPHONE:	(805) 647-6046
CITY:	SATICOY	STATE: CA	ZIP CODE:	93004
CAPACITY:	24	CENSUS: 22	DATE:	03/24/2026
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Floro Cortes Jr		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility staff does not ensure resident’s room is adequately cleaned.
Facility staff do not keep facility free from odor.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Emily Peraldi conducted an unannounced subsequent complaint visit to this facility. At 10:10 a.m., the LPA met with staff and explained the reason for the visit. At 10:40 a.m., the LPA spoke with the Administrator/ Licensee Floro Cortes Jr via telephone call as he was unavailable to meet the LPA during today's visit.

During the initial visit on 012/05/2025, between 10:40 a.m. and 1:15 p.m., the LPA conducted a physical plant tour, interviews with eight (8) clients and two (2) staff. During today’s visit, starting at 10:37 a.m., the LPA conducted a physical plant tour, interviews with five clients (5) and three (3) staff. During both visits, the LPA requested copies of pertinent documents during the visit. Continued on LIC 9099-C.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

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-20251201113735

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: COTTONWOOD, THE	FACILITY NUMBER: 561702356
	VISIT DATE: 03/24/2026

NARRATIVE

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Regarding allegations: 1.) Facility staff does not ensure resident’s room is adequately cleaned. 2.) Facility staff do not keep facility free from odor. During today’s physical plant tour, the LPA observed multiple client rooms and restrooms in need of cleaning. There were foul odors throughout some client rooms. The LPA observed two (2) client rooms with holes on the ceilings and walls. Throughout the time of the visit, the LPA observed the housekeeper washing clients’ clothing and linens as well as taking out the trash, cleaning client rooms and restrooms. Staff explained that they only have one (1) housekeeper, however other staff do assist with cleaning clients’ rooms and restrooms. Client interviews revealed that staff clean their rooms usually three (3) times a week. Client interviews expressed concerns regarding staffing shortages leading to staff being overworked and not being able to properly keep the facility clean. Based on the information provided by observations and interviews, the preponderance of evidence standard has been met, therefore the above allegations are deemed Substantiated at this time. The same deficiency was cited during the annual visit conducted on 03/24/2026 therefore it will not be duplicated on this complaint.

Exit interview conducted. A copy of the report and appeal rights were provided. Reports were emailed and mailed to the Licensee for signature.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

LIC9099 (FAS) - (06/04)

Page: 2 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
12/01/2025 and conducted by Evaluator Emily Peraldi

COMPLAINT CONTROL NUMBER: 29-AS-20251201113735

FACILITY NAME:	COTTONWOOD, THE		FACILITY NUMBER:	561702356
ADMINISTRATOR:	FLORO P CORTES JR		FACILITY TYPE:	735
ADDRESS:	1417 LIRIO AVENUE		TELEPHONE:	(805) 647-6046
CITY:	SATICOY	STATE: CA	ZIP CODE:	93004
CAPACITY:	24	CENSUS: 22	DATE:	03/24/2026
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Floro Cortes Jr		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility staff do not provide appropriate sleeping arrangements for a resident.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 29-AS-20251201113735

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: COTTONWOOD, THE	FACILITY NUMBER: 561702356
	VISIT DATE: 03/24/2026

NARRATIVE

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Regarding the allegation: Facility staff do not provide appropriate sleeping arrangements for a resident. The complainant had concerns regarding client rooms being located behind the kitchen area. The LPA conducted a file review and noted that the client room behind the kitchen was part of the facility sketch submitted to the Department. The facility sketch was submitted to the Department upon licensure and upon fire safety reinspection dated 06/19/2020, no issues were noted during inspections. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided.
Reports were emailed and mailed to the Licensee for signature.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

LIC9099 (FAS) - (06/04)

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