565801764-5-12-2026-29-AS-KLOZ-DUJUB2-20260529152534

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565801764
Report Date: 05/12/2026
Date Signed: 05/12/2026 02:35:37 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
05/11/2026 and conducted by Evaluator Erica Mosley

COMPLAINT CONTROL NUMBER: 29-AS-20260511155110

FACILITY NAME:	HAPPY HOME CARE II		FACILITY NUMBER:	565801764
ADMINISTRATOR:	MICHAEL ROSALES		FACILITY TYPE:	740
ADDRESS:	1273 SHEFFIELD PLACE		TELEPHONE:	(805) 371-7801
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY:	6	CENSUS: 5	DATE:	05/12/2026
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Karina Antig - Designee		TIME COMPLETED:	02:33 PM

ALLEGATION(S):

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Staff are not providing adequate care for residents due to not being properly qualified/trained.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Erica Mosley conducted an unannounced initial 10-day complaint visit to investigate the above listed allegation. Upon arrival at approx.10 a.m. LPA was greeted by staff who called the Administrator and explained the reason for the visit. The LPA met with Designee Karina Antig and reason for the visit was explained. Entrance interview conducted.
On 05/11/2026, the Department received a complaint regarding the following allegation, Staff are not providing adequate care for residents due to not being properly qualified/trained.
During today's visit LPA and staff toured the physical plant areas inside and outside to ensure there are no immediate health and safety hazards, and facility is in compliance with Title 22 Regulations. Starting at 10:36 a.m. LPA conducted a file review on facility live in Staff #1 (S1) and Staff #2 (S2), Administrator, Assistant Administrator, Designee, conducted three (3) staff interviews including the Designee, S1, S2, two (2) resident interviews and attempted three (3) resident interviews and obtained copies of pertinent documents relevant to the investigation.Report continued on LIC 9099-C PAGE 2...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Erica Mosley
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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 3

Control Number 29-AS-20260511155110

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: HAPPY HOME CARE II	FACILITY NUMBER: 565801764
	VISIT DATE: 05/12/2026

NARRATIVE

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(PAGE 2) Report continued from LIC 9099...On the allegation, Staff are not providing adequate care for residents due to not being properly qualified/trained it is the concern of the Reporting Party (RP) that the facility staff are not properly trained leading to poor care. To investigate this complaint, LPA conducted in person interviews, file and record review and obtained copies of pertinent documentation relevant to the investigation.

Record review revealed that the facility has two primary live-in staff who work regular shifts from 7:00 a.m. to 7:00 p.m. Staff S1 and S2 have both been employed as caregivers since January 2012. Their CPR and First Aid certifications were verified by the LPA at 10:52 a.m. and confirmed to be valid and active as of 01/08/2026. LPA reviewed the facility’s 2025–2026 training logs and confirmed that both staff members have completed more than the required 20 hours of annual training. Documented trainings include: Elder Abuse (March 2025, 1 hour), Personal Rights (April 2025, 2 hours, videos and discussions noted), Acceptance and Retaining (May 2025, 1 hour), Responsibilities and Duties (June 2025, 4 hours), Fire Safety (July 2025, 1 hour), Calling 911 (August 2025, 1 hour), Dementia—Getting Through the Day (August 2025, 2 hours), Dementia—Communication (September 2025, 2 hours), Dementia—Behavior (October 2025, 4 hours, videos and situational discussions noted), Common Infectious Diseases (November 2025, 2 hours), Hospice Care—Restricted/Prohibited Conditions (December 2025, 4 hours), Medication Administration (January 2026, 2 hours), Activities of Daily Living (February 2026, 4 hours, including needs, reporting, cleanliness, and redirection), and Transfer Training and Body Mechanics (March 2026, 2 hours).

Interviews with S1 and S2 revealed that both staff members are CPR and First Aid certified. Staff reported that they receive regular training, with the most recent conducted by the home health physical therapist on proper transferring techniques. Staff stated that "they believe they are qualified to care for their residents."

Interview with Designee revealed the staff at the facility are well-trained and are considered some of the strongest caregivers within the Happy Home Care Company. It was noted that “Although some staff may be older, they are experienced, knowledgeable, and highly dedicated to providing quality care”. It was noted that staff receive formal training once a month, and additional reminders and refreshers are provided whenever the trainer visits the home. They also participate in Zoom training, phone consultations, and group discussions on current issues. Most recently, they reviewed elopement procedures. Training topics vary based on current needs, and staff consistently receive feedback to ensure they remain prepared and informed. Report continued on LIC 9099-C PAGE 3...

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Erica Mosley
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 29-AS-20260511155110

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: HAPPY HOME CARE II	FACILITY NUMBER: 565801764
	VISIT DATE: 05/12/2026

NARRATIVE

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(PAGE 3) Report continued from LIC 9099-C PAGE 2...

Resident interviews revealed Residents were pleased with the quality of care they are provided by the facility staff specifically by S1 and S2. Residents state that the staff are helpful and have no complaints.

Although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation of Staff are not providing adequate care for residents due to not being properly qualified/trained is deemed unsubstantiated at this time. No citations issued at this time. Exit interview conducted. Report was reviewed and a copy was provided.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Erica Mosley
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC9099 (FAS) - (06/04)

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