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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850451
Report Date: 04/17/2026
Date Signed: 04/17/2026 12:19:52 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:
04/17/2026
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Eduardo "Eddie" Asuncion-CaregiverTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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Staff did not address resident's change in condition.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Esther Cortez conducted an unannounced subsequent complaint visit to deliver findings for the above allegations. Upon arrival, LPA met with staff Eduardo Asuncion and explained the reason for the visit. Administrator Ramrush Go could not be present during today's visit and designated staff Eduardo Asuncion to review and sign the report.

On 03/02/2026, 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. On 03/11/2026, between 10:30 a.m. and 4:15 p.m., the LPA interviewed the Assistant Administrator, two (2) staff, conducted a resident file review and obtained copies of resident records and other pertinent documents relevant to the investigation. On 03/12/2026, LPA conducted a phone interview with a hospice nurse. On 03/25/2026, the LPA conducted a phone interview with two (2) Hospice agency representatives.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: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
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 5
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: 04/17/2026
NARRATIVE
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 On 04/14/2026, the LPA conducted phone interviews with two (2) family members of R1 including their POA.

On the allegation, “Staff did not address resident's change in condition” it is the concern of the reporting party (RP) that staff did not adequately monitor Resident 1 (R1) or follow hospice nurse instructions regarding R1's care. It was reported that in early 2026 (exact date was not provided), a hospice nurse identified that R1 was constipated and instructed staff to notify the on-call nurse if no bowel movement (BM) occurred by the following day. Staff reportedly failed to provide this update. Family members later discovered R1 feverish, shaking, with cloudy fluid in their Foley bag and noted that R1 had not had a BM in seven days. The family, rather than staff, contacted the on-call nurse. To investigate the allegation the LPA conducted telephonic and in-person interviews, as well as record reviews of facility records.

Interview with Assistant Administrator Abygail Go revealed that staff monitored R1’s condition and documented BMs. She noted that hospice instructions were to call after three days without a BM, though she admitted staff occasionally waited until the fourth day if a nurse visit was already scheduled or if R1 had a BM at night. Staff interviews revealed inconsistent protocols; while one staff member confirmed reporting to the Administrator and not hospice, another was unaware of who was responsible for BM tracking. During a telephone interview, Hospice Nurse 1 (HP1) confirmed that staff were verbally instructed to call after R1 had not had a BM after three (3) days and noted that while staff generally followed it, there was at least one instance where they waited five days to call. HP1 doubted R1 ever went seven days without a BM. Facility BM log for January and February 2026 contradict the seven-day claim but confirm inconsistencies in care. Logs show that in February, R1 went four consecutive days without a BM on two separate occasions (2/6–2/9 and 2/13–2/16), exceeding the three-day limit set by hospice. Based on staff interviews, admissions from the Administrator 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 (refer to LIC 9099-D). 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: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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: 04/17/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/24/2026
Section Cited
CCR
87466
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87466 Observation of the Resident. The licensee shall ensure that residents are regularly observed for changes in physical, mental, funtioning... and that appropriate assistance is provided when such observation reveals unmet needs... This requirement was not met as evidence by:
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Administrator agreed to train staff on when to contact hospice when observing residents and when and how to track BMs log and provide proof of training with a list of staff to CCL by 4/24/25.
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Based on records and interviews the licensee did not comply with the regulation above when R1 went 4 consecutive days without a BM on two occasions exceeding the 3 day notification limit set by hospice and assistant Administrator admitted staff ocassionally waited until the 4th day to
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 notify hospice which posed a potential health and safety risk to persons 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.
SUPERVISOR'S NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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:
04/17/2026
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Eduardo "Eddie" Asuncion-CaregiverTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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9
Staff mismanaged resident's medication.
Staff did not administer resident's medication as prescribed
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Esther Cortez conducted an unannounced subsequent complaint visit to deliver findings for the above allegations. Upon arrival, LPA met with staff and explained the reason for the visit. Administrators Ramrush Go could not be present during today's visit and designated staff to review and sign the report.

On 03/02/2026, 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. On 03/11/2026, between 10:30 a.m. and 4:15 p.m., the LPA interviewed the Assistant Administrator, two (2) staff, conducted a resident file review and obtained copies of resident records and other pertinent documents relevant to the investigation. On 03/12/2026, LPA conducted a phone interview with a hospice nurse. On 03/25/2026, the LPA conducted a phone interview with two (2) Hospice agency representatives. Report will continue on LIC9099-C, 2nd page.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
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: 04/17/2026
NARRATIVE
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 On 04/14/2026, the LPA conducted phone interviews with two (2) family members of R1 including their POA.

On the allegations, “Staff mismanaged resident's medication and staff did not administer resident's medication as prescribed” it is the concern of the Reporting Party (RP) that on 02/20/2026, a family member of Resident 1 (R1) administered full doses of Morphine to R1. The reporting party expressed concern regarding whether the family member was authorized to administer this medication and whether staff had inappropriately deferred this responsibility. To investigate, the LPA conducted interviews with facility management, staff, the hospice agency, and R1’s family, and reviewed facility and hospice records.

Interviews with the Administrators and staff revealed that facility staff do not administer Morphine; per protocol, only hospice nurses or family members were authorized to do so for R1. The Hospice Director and HR Director of R1’s hospice agency confirmed that family members are permitted to administer Morphine once they have received training from a hospice nurse and were aware that a family member of R1 had administered the medication. The family member in question confirmed they administered the Morphine during R1's end-of-life stage and verified they had been trained by the hospice nurse. R1’s Hospice Care Plan, confirmed that family members are able to administer medications. Furthermore, R1’s Power of Attorney (POA) stated they were fully aware of these procedures, had no concerns regarding medication management, and confirmed they were comfortable with the arrangement. Based on the information gathered, the department does not have sufficient evidence to prove the alleged violations did or did not occur; therefore the above allegations, are UNSUBSTANTIATED at this time.

Exit interview held, appeal rights and report copy provided.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5