565850311-5-17-2026-29-AS-DPEA-DUFNJH-20260526103023

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850311
Report Date: 05/17/2026
Date Signed: 05/17/2026 11:02:38 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
03/10/2026 and conducted by Evaluator Zabel Chochian

COMPLAINT CONTROL NUMBER: 29-AS-20260310103157

FACILITY NAME:	OMNICARE III		FACILITY NUMBER:	565850311
ADMINISTRATOR:	VERONA ISAMBI		FACILITY TYPE:	740
ADDRESS:	1446 SUFFOLK AVENUE		TELEPHONE:	(818) 274-1809
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY:	6	CENSUS: 6	DATE:	05/17/2026
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Maria Len Apolinario, Staff		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Staff do not ensure a comfortable temperature for residents is maintained
Staff do not treat resident with dignity

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Zabel Chochian conducted an unannounced subsequent complaint visit to this facility today to deliver investigation finding. LPA met with staff and introduced self. Staff contacted Laila Kulungu, Assistant Administrator and reason for the visit was explained. Investigation finding was discussed and staff was designated to sign the report.

On 03/10/2026, the Department received the above listed allegations. On 03/18/2026, LPA Chochian conducted complaint visit. Beginning at approximately 12:15PM, LPA and staff toured the facility common areas and resident rooms. Facility temperature observed at 72 degrees Fahrenheit (F) and outside temperature was approximately 93 degrees F. At approximately 12:45PM LPA reviewed facility records including but not limited to resident files. Between 1:15PM-2:45PM, LPA interviewed the Administrator, staff, and other potential witnesses. LPA attempted to interview residents. All residents currently have cognitive issues however two (2) out of the four residents were able to converse with LPA and expressed being happy with the facility and staff. No issues were reported about the facility being cold. (Continue to LIC9099c)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2026

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-20260310103157

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: OMNICARE III	FACILITY NUMBER: 565850311
	VISIT DATE: 05/17/2026

NARRATIVE

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Following is a summary of the allegations and finding:

Regarding allegation “Staff do not ensure a comfortable temperature for residents is maintained”.
Information was received that resident #1 was observed to be cold, and staff did not ensure resident was appropriately covered. During the initial visit LPA attempted to interview resident #1 however resident was unable to answer questions. Other residents and families were interviewed during the initial visit and reported no issues and shared that they are very satisfied with the care staff. No issues were reported about the facility temperature. Facility temperature was observed to be 72 degrees during the visit on 03/18/2026. Staff reported that resident #1 is often cold especially after showers, therefore staff provide a blanket for resident #1 when in the common area. Staff reported that each resident has a blanket and the facility also has extra blankets. LPA observed sufficient supply of blankets at the facility for residents use. LPA attempted to reach the reporting party on 3/18/2026, 4/23/2026 and 5/12/2026.

Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the allegations “Staff do not ensure a comfortable temperature for residents is maintained” is deemed unsubstantiated at this time.

Regarding allegation “Staff do not treat resident with dignity”. Information was received that staff said “don’t pay attention to what residents say because they have dementia”. Staff interviewed denied the allegation and reported that residents are all treated with dignity and respect. Staff explained that resident do have cognitive issues and repeat things and staff do acknowledge that and redirect and ensure residents health and safety is not compromised in any way. Interview was attempted with all residents. Two out of the four residents were able to communicate and shared no concerns about the treatment of staff. Both residents interviewed reported that they are pleased with the staff at the facility and are treated well. Residents’ responsible persons interviewed expressed being very satisfied with the care and staff. No issues were reported. LPA attempted to reach the reporting party on 3/18/2026, 4/23/2026 and 5/12/2026.

Based on the above information gathered although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the allegation “Staff do not treat resident with dignity” is deemed unsubstantiated at this time.

Exit interview conducted and copy of report issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2026

LIC9099 (FAS) - (06/04)

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