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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610362
Report Date: 06/04/2026
Date Signed: 06/04/2026 04:54:24 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/01/2026 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20260501102227
FACILITY NAME:ANTORIA ASSISTED LIVING OF TARZANAFACILITY NUMBER:
197610362
ADMINISTRATOR:CAMPOS, MARYCELFACILITY TYPE:
740
ADDRESS:5912 CAHILL AVENUETELEPHONE:
(626) 840-2830
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY:6CENSUS: 3DATE:
06/04/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Iha SolihatTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not meeting resident's incontinence care needs
Staff do not treat resident with dignity
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately 9:00 a.m. on 06/04/26 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with staff and disclosed the reason for the visit.

To investigate the allegations above, LPA conducted an initial visit on 05/07/26 and interviewed staff and residents between 9:00 a.m. and 10:30 a.m., toured the facility inside and out at 9:15 a.m., and conducted a record review of pertinent records, including but not limited to an admission agreement, medical assessment, care plan, and staff and client rosters at 11:00 a.m. Today, LPA toured the facility at approximately 10:00 a.m.

Regarding the allegation "Staff are not meeting resident's incontinence care needs" it was alleged Resident #1 (R1) was found covered in dry feces. Additionally, R1 was changed every four (04) hours when they requested to be changed every two (02) hours. Interview with R1 at 10:15 a.m. on 05/07/26 revealed they did not see feces, but they heard about the feces from a personal caregiver.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
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 31-AS-20260501102227
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ANTORIA ASSISTED LIVING OF TARZANA
FACILITY NUMBER: 197610362
VISIT DATE: 06/04/2026
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
Interview with Staff #1 (S1) at 9:00 a.m. and Staff #2 (S2) at 9:10 a.m. on 05/07/26 revealed they have never seen dried feces on R1. Staff stated they change R1 about every three (03) hours. The investigation revealed only R1 and one (01) other resident, Resident #2 (R2), required incontinence care from staff. Interview with Resident #2 (R2) at 9:20 a.m. on 05/07/26 revealed they are changed frequently and had no issue with staff care. Record review of R1’s medical assessment and care plan revealed they were incontinent for their bowels and bladder and required “substantial” assistance with toileting. The plan did not specify frequency of changing. Based on interviews and record review, although R1 requested more frequent changing, staff followed R1’s care plan. The investigation did not reveal sufficient evidence to verify that R1 was covered in dry feces. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Staff do not treat resident with dignity" it was alleged staff are “divisive and rude” towards R1. Interviews with four (04) out of five (05) residents on 05/07/26 revealed they have good relationships with staff and are treated well. Interview with S1 and S2 revealed they treat R1 with respect. R1 yells and cusses at them. Interview with R1 revealed they did not get along with S1 or S2 when they arrived to the facility in March 2026. R1 eventually warmed up to staff and now has a good relationship with them. LPA did not observe staff being rude during the facility visits on 05/07/26 an today. Based on observations and interviews, there is not enough evidence to verify that staff treated a resident without dignity. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health or safety concerns observed during today’s visit.\

Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/01/2026 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20260501102227

FACILITY NAME:ANTORIA ASSISTED LIVING OF TARZANAFACILITY NUMBER:
197610362
ADMINISTRATOR:CAMPOS, MARYCELFACILITY TYPE:
740
ADDRESS:5912 CAHILL AVENUETELEPHONE:
(626) 840-2830
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY:6CENSUS: 3DATE:
06/04/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Iha SolihatTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not properly addressing cockroaches in the facility
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately 9:00 a.m. on 06/04/26 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with staff and disclosed the reason for the visit.

To investigate the allegations above, LPA conducted an initial visit on 05/07/26 and interviewed staff and residents between 9:00 a.m. and 10:30 a.m., toured the facility inside and out at 9:15 a.m., and conducted a record review of pertinent records, including but not limited to an admission agreement, medical assessment, care plan, and staff and client rosters at 11:00 a.m. Today, LPA toured the facility at approximately 10:00 a.m.

Regarding the allegation "Staff are not properly addressing cockroaches in the facility” it was alleged cockroaches were found in the room of Resident #1 (R1) and other bedrooms. Interview with R1 at 10:15 a.m. on 05/07/26 revealed they saw a cockroach in their room in early April 2026. Interview with a Witness (W1) at 3:15 p.m. on 04/29/26 confirmed they saw a cockroach in R1’s room.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 31-AS-20260501102227
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ANTORIA ASSISTED LIVING OF TARZANA
FACILITY NUMBER: 197610362
VISIT DATE: 06/04/2026
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
Interviews with five (05) out of five (05) residents revealed they have seen cockroaches or bugs in the facility. Interview with Staff #2 (S2) at 9:10 a.m. on 05/07/26 confirmed the facility had bugs, so they sprayed to get rid of them. Interview with the administrator at 3:45 p.m. today revealed exterminator services were acquired on 05/21/26 to address the issue. The administrator provided proof of service to the LPA at approximately 4:00 p.m. today. Based on interviews and record review, the facility had cockroaches, but the administrator took the proper steps to address the issue. Therefore, the allegation is SUBSTANTIATED at this time.

No immediate health or safety concerns observed during today’s visit.

Exit interview conducted. Appeal rights discussed. Copy of report provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20260501102227
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ANTORIA ASSISTED LIVING OF TARZANA
FACILITY NUMBER: 197610362
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/14/2026
Section Cited
CCR
87303(a)
1
2
3
4
5
6
7
87303 Maintenance and Operation
(a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The licensee showed proof of monthly exterminator services beginning on 05/21/26. Deficiency cleared.
8
9
10
11
12
13
14
Based on interviews, the licensee did not comply with the section cited above through not addressing the cockroach issue in a timely manner, which posed a potential risk to the Health, Safety, or Personal Rights of 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.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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