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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850158
Report Date: 12/11/2025
Date Signed: 12/12/2025 08:37:16 AM

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
08/22/2025 and conducted by Evaluator Valeria Conway
COMPLAINT CONTROL NUMBER: 29-AS-20250822064211
FACILITY NAME:AASTA ASSISTED LIVINGFACILITY NUMBER:
565850158
ADMINISTRATOR:REYES, MONICAFACILITY TYPE:
740
ADDRESS:903 CARMEN DRIVETELEPHONE:
(805) 586-4191
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY:130CENSUS: 71DATE:
12/11/2025
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Agnes GazaryanTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Licensee did not ensure phone calls are answered appropriately
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Valeria Conway and Martha Arroyo conducted an unannounced subsequent complaint visit to the facility above to deliver final findings of the complaint allegation. At 10:45 A.M. LPA met with facility designee Agnes Gazaryan and explained the purpose of the visit. Administrator, Denise Gilroy, was unavailable during today’s visit.

During initial 10-day complaint inspection and subsequent visits, the LPAs briefly toured the facility with facility’s Marketing Director and back-up administrator. LPAs interviewed staff and randomly selected residents and obtained copies of pertinent documents relevant to the investigation.

During today’s visit, the LPAs conducted a plant tour at 12:07 P.M. to ensure there are no health and safety concerns. The following was determined.

Continued on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Valeria Conway
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
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
Control Number 29-AS-20250822064211
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: AASTA ASSISTED LIVING
FACILITY NUMBER: 565850158
VISIT DATE: 12/11/2025
NARRATIVE
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Continued from LIC 9099

Regarding allegation “Licensee did not ensure phone calls are answered appropriately” the Reporting Party (RP) expressed concern that the facility’s main phone line is not answered in a timely manner, making it difficult to get in contact with Resident #1 (R1). The RP and a case manager further reported difficulty communicating with staff at AASTA and R1, noting that R1 does not have a personal cellphone and the only means of communication is through the facility’s main phone line. Staff interviews conducted revealed that staff are sometimes unable to answer the facility phone because they are responsible for transporting residents to appointments, conducting daily activities within the facility, assisting with brief changes and showers, medication distribution, and performing other essential care services. The LPA interviewed R1, who confirmed they do not have a personal cellphone and stated that staff rarely approach them to inform them that they’ve received a call. Interviews with facility representatives denied the allegation, stating that although the facility has encountered challenges maintaining a full-time receptionist, there is always a staff member assigned to answer phone calls throughout the day. During the course of the investigation, the LPA attempted to contact the facility by phone on four (4) separate occasions and at different times of the day. On the first attempt, the LPA reached a live person; however, it took approximately 25 minutes after navigating all menu extensions and being redirected by voice commands. On the remaining three attempts, the LPA was unable to reach a live person, as no one answered the phone. Based on the information gathered during the investigation, the department has sufficient evidence to confirm this allegation occurred. Therefore, the allegation of “Licensee did not ensure phone calls are answered appropriately” has been SUBSTANTIATED at this time.

Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 9099-D.) Administrator was informed that failure to correct the deficiencies may result in civil penalties.

An immediate civil penalty of $1,000 repeat violation is assessed today due to being cited for the same violation within 12 months. Administrator was informed that additional civil penalties might be assessed based on Health and Safety Code 1569.49(e) and 1569.49(f).

Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Valeria Conway
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 29-AS-20250822064211
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: AASTA ASSISTED LIVING
FACILITY NUMBER: 565850158
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/26/2025
Section Cited
CCR
87411(a)
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87411(a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs…. This requirement is not met as evidenced by:
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Licensee agrees to provide a written plan to CCLD as to how the facility will be diligent in answering telephone calls and responding to family members and responsible parties through telephone communication. Written plan will be submitted to LPA before POC due date.
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Based on interviews and observation, the licensee did not comply in the section cited above as facility staff were unable to answer and transfer telephone calls for R1, which poses a potential health and safety risk to residents in care.
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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: Desaree Perera
LICENSING EVALUATOR NAME: Valeria Conway
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
LIC9099 (FAS) - (06/04)
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