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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197607880
Report Date: 06/10/2026
Date Signed: 06/11/2026 08:46:50 AM

Unsubstantiated


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
06/02/2026 and conducted by Evaluator Valeria Conway
COMPLAINT CONTROL NUMBER: 29-AS-20260602181714
FACILITY NAME:FOUNTAINVIEW AT EISENBERG VILLAGEFACILITY NUMBER:
197607880
ADMINISTRATOR:KATHLEEN GLASSFACILITY TYPE:
741
ADDRESS:6440 WILBUR AVENUETELEPHONE:
(818) 654-5534
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:216CENSUS: 104DATE:
06/10/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kathleen GlassTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff mismanage resident's medication
INVESTIGATION FINDINGS:
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At 10:00 A.M, Licensing Program Analyst (LPA) Valeria Conway conducted an unannounced 10-day complaint investigation visit to the facility listedabove. LPA met with Executive Director (ED), Kahtleen Glass and Director of Health Care Services, Clarissa Townes and the reason for the visit was explained. Entrance interview conducted.

During today's visit, the LPA conducted a physical plant tour of the community starting at approximately 10:50 A.M. Between 10:15 A.M. and 1:30 P.M. LPA interviewed the the ED, the Director of Heath Care Services, the Med Tech on duty, Resident #1’s (R1’s) family members, a private caregiver and the Kaiser Hospice Registered Nurse (RN). Additionally, LPA gathered copies of pertinent documents. Throughout the course of the investigation, the LPA reviewed all documents obtained and the following was then determined:

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

DATE: 06/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2026
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 2
Control Number 29-AS-20260602181714
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: FOUNTAINVIEW AT EISENBERG VILLAGE
FACILITY NUMBER: 197607880
VISIT DATE: 06/10/2026
NARRATIVE
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Continued from LIC 9099

Regarding allegation of “Staff mismanage resident’s medication” it was reported that during a routine hospice visit, the Kaiser Hospice Registered Nurse (RN) observed that liquid morphine drawn from the medication bottle appeared altered, noting a difference in color and a fruity odor. Interviews conducted with family members stated that R1 receives hospice care and 24-hour care from several private caregivers in addition with support from facility's care staff. They expressed satisfaction with services provided by this facility. Family members revealed that R1’s medication are not stored, safeguarded, or managed by the facility. Interview with the RN revealed that R1 has been receiving hospice services at this facility for approximately two (2) years. The RN stated that throughout that time there have been no previous concerns regarding missing or tampered medications and confirmed that facility staff have not been responsible for storing, safeguarding, refilling or administering R1’s medication. Interviews with the ED and the Director of Health Care Services confirmed that R1’s medications are managed and dispensed by Kaiser hospice personnel and are not maintained by the facility and/or facility staff. Adding, that facility has a list of medication on file for R1; however, facility does not maintain records of medication administration or dosages dispensed for R1. Based on interviews conducted, all parties consistently reported that facility staff are not responsible for the storage, safeguarding, or administration of R1’s medication. Records reviewed revealed that R1 receives 24 hour one-to-one (1:1) care provided by caregivers hired by the family. Medication management responsibilities are overseen by R1's designated Power of Attorney (POA). There was insufficient evidence to support the allegation or that a violation occurred; therefore, the allegations “Staff mismanage resident’s medication” is deemed unsubstantiated at this time.

Exit interview conducted. No citations issued. A copy of this report was provided.

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

DATE: 06/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2026
LIC9099 (FAS) - (06/04)
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