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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850299
Report Date: 08/13/2025
Date Signed: 08/13/2025 03:02:14 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/10/2025 and conducted by Evaluator Martha Arroyo
COMPLAINT CONTROL NUMBER: 29-AS-20250810215523
FACILITY NAME:IVY PARK AT SIMI VALLEYFACILITY NUMBER:
565850299
ADMINISTRATOR:BOGOYEVAC, LEAFACILITY TYPE:
740
ADDRESS:5300 E. LOS ANGELES AVE.TELEPHONE:
(805) 583-3500
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY:175CENSUS: 137DATE:
08/13/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Lea BogoyevacTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Staff did not ensure that resident's grooming needs were met.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Martha Arroyo conducted an initial complaint investigation visit for the above allegation. Upon arrival, the LPA met with Executive Director (ED), Lea Bogoyevac and explained the reason for the visit. Entrance interview.

During today's visit, between 10:10 a.m. and 11:00 a.m., the LPA conducted a brief plant tour, interviewed four staff and reviewed and obtained copies of pertinent documents relevant to the investigation. The LPA also interviewed two independent contractors during the investigation.

Report Continued on LIC 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
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 2
Control Number 29-AS-20250810215523
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: IVY PARK AT SIMI VALLEY
FACILITY NUMBER: 565850299
VISIT DATE: 08/13/2025
NARRATIVE
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Report Continued from LIC 9099...

It was alleged that staff did not ensure that resident’s grooming needs were met. It was reported that a beautician may be taking advantage of residents by sending them back to their rooms with soaking wet hair, causing their clothing to become wet, and exclusively accepting cash as payment. Record review and interviews conducted revealed that the individuals providing beauty salon services are considered "suppliers" who operate as independent contractors, not employees of the facility. Furthermore, each supplier has a signed Beauty Salon Services and Rental Agreement on file with the facility, which confirms that their services are contracted independently of the facility. The LPA also reviewed the facility’s most recent Personnel Report (LIC 500), which verifies that these contracted individuals are not listed as employees. Additionally, interviews with staff revealed that no residents or family members have reported any concerns regarding the care provided by the facility staff. Based on the information obtained through interviews and record review, the Department has insufficient evidence to say the alleged violation occurred. Therefore, allegation “staff did not ensure that resident’s grooming needs were met” is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2