<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850451
Report Date: 03/02/2026
Date Signed: 03/02/2026 04:05:40 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
02/26/2026 and conducted by Evaluator Esther Cortez
COMPLAINT CONTROL NUMBER: 29-AS-20260226100507
FACILITY NAME:CARING HEARTS OF SANTA PAULAFACILITY NUMBER:
565850451
ADMINISTRATOR:GO, RAMRUSHFACILITY TYPE:
740
ADDRESS:404 E MAIN STREETTELEPHONE:
(805) 420-9605
CITY:SANTA PAULASTATE: CAZIP CODE:
93060
CAPACITY:6CENSUS: 2DATE:
03/02/2026
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Ramrush GoTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not properly trained.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Esther Cortez conducted an unannounced initial 10-day complaint visit for the above allegations. Upon arrival, LPA met with staff and explained the reason for the visit. Administrator Ramrush Go and Assistant Administrator Abygail Go arroved shortly after and were explained the reason for the visit.

During today's inspection, between 11:00 a.m. and 3:45 p.m., the LPA interviewed the Administrator, Assistant Administrator, conducted one phone interview with Witness 1 (W1) and obtained copies of resident records and other pertinent documents relevant to the investigation.

Report will continue on LIC9099-C, 2nd page.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
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 4
Control Number 29-AS-20260226100507
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: CARING HEARTS OF SANTA PAULA
FACILITY NUMBER: 565850451
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/13/2026
Section Cited
CCR
1569.69(a)(2)
1
2
3
4
5
6
7
1569.69 Employees assisting residents with self-administration of medication: training requirements (a)(2)... shall complete 10 hours of initial training.. 6 hours of hands-on shadowing training, .. and 4 hours of other training or instruction.. This requirement is not met as evidence by:
1
2
3
4
5
6
7
Assistant Administrator agreed to hold training for all staff on H&S code 1569.69 by a third party and provide staff missing any of these requirements with medication training, provide proof of training to LPA by 03/13/26
8
9
10
11
12
13
14
Based on record review and staff interviews the Licensee did not comply with the regulation cited above as staff was missing 9 hours of medication training which possess a potential health, safety and personal rights risk to residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 29-AS-20260226100507
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: CARING HEARTS OF SANTA PAULA
FACILITY NUMBER: 565850451
VISIT DATE: 03/02/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
On the allegation, “Staff are not properly trained” it is the concern of the reporting party (RP) that caregivers appeared inexperienced and insufficiently trained. It was further reported caregivers are not trained on how to contact hospice if needed. To investigate the complaint the LPA conducted a file review and interviews. File review revealed that two (2) out of two (2) caregivers were missing nine (9) out of ten (10) initial medication training. Interview with the administrator revealed that all of the staff training was in the files and a copy of the staff training was given to the LPA. Based on staff interview and file review, there is sufficient evidence to support the allegation and that a violation occurred; therefore, the above allegation is deemed Substantiated at this time.

The following deficiency was cited from the CA Code of Regulations, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview held, appeal rights and report copy provided.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4