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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850570
Report Date: 07/27/2026
Date Signed: 07/27/2026 04:15:46 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
02/24/2026 and conducted by Evaluator Trevor Byrne
COMPLAINT CONTROL NUMBER: 29-AS-20260224084559
FACILITY NAME:WISDOM WILLOW SENIOR LIVINGFACILITY NUMBER:
195850570
ADMINISTRATOR:SARKISIAN, LOUSINEFACILITY TYPE:
740
ADDRESS:7342 BECK AVENUETELEPHONE:
(818) 255-6295
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY:6CENSUS: 6DATE:
07/27/2026
UNANNOUNCEDTIME BEGAN:
02:52 PM
MET WITH:Lousine SarkisianTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Due to neglect and lack of supervision, resident sustained injuries
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Trevor Byrne conducted an unannounced subsequent complaint investigation visit at the facility at 02:52 PM. LPA met with facility staff who contacted the Administrator Lousine Sarkisian. The Administrator arrived to the facility at 03:08 PM. Entrance interview was conducted and the reason for the visit was explained.

On 02/24/2026 the Woodland Hills North Adult and Senior Care Regional Office (RO) received a complaint which alleged that due to neglect and lack of supervision Resident #1 (R1) sustained injuries. The complaint was investigated by the Department.

CONTINUED ON LIC 9099C.
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2026
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-20260224084559
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: WISDOM WILLOW SENIOR LIVING
FACILITY NUMBER: 195850570
VISIT DATE: 07/27/2026
NARRATIVE
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On 02/25/2026 LPA Byrne initiated the investigation and conducted a brief physical plant tour, collected copies of pertinent documentation, and conducted interviews with two (2) residents, the Administrator, and one (1) staff. During the course of the investigation, the Department subpoenaed medical records and the police report related to this incident. On 03/12/2026 an Investigator conducted interviews with the Administrator, Resident #2 (R2), Resident #3 (R3), Resident #4 (R4), and Staff #1 (S1). Additionally, interviews were conducted on 05/06/2026 with Witness #1 (W1), and on 05/21/2026 with Staff #2 (S2). During today’s visit LPA delivered findings and interviewed the Administrator between approximately 02:59 PM and 04:30 PM.

The allegation of “Due to neglect and lack of supervision, resident sustained injuries” alleges that R1 sustained facial bruising and a cut on their nose due to neglect and a lack of staff supervision.

Interviews with the Administrator revealed R1 arrived at the facility on 02/18/2026 around 7:00 PM with only two (2) of their prescribed medications. The Administrator stated the Licensee Representative and the family member of R1 arranged placement of R1 at the facility without their knowledge. When R1 arrived initially they did not want to leave the ambulance and were yelling and screaming although R1’s family member (Witness #1) came to the facility and was able to calm R1 down.

The Administrator stated during their stay, R1 expressed behavioral disturbances including screaming, attempting to get out of bed, and slamming themselves on the floor. The Administrator stated on 02/20/2026 they were informed by staff that R1 was screaming again and had woken up with discoloration around their eye after suffering a fall earlier around 4:00 AM. The Administrator stated they were informed of the injury around 8:00 AM. The Administrator provided a photo of the resident reflecting a bruised eye taken on 02/20/2026 at 9:04 AM. The Administrator stated that R1 was transferred to the hospital due to requiring a higher level of care than the facility was able to provide and medical attention. The Administrator denied any neglect or abuse by staff or any residents. They also denied R1 having a fall in the shower. The Administrator stated a pre-placement appraisal was not conducted prior to accepting the resident nor did the resident arrive with a medical assessment completed by a medical professional indicating the resident was appropriate for assisted living.

CONTINUED ON LIC 9099C.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 29-AS-20260224084559
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: WISDOM WILLOW SENIOR LIVING
FACILITY NUMBER: 195850570
VISIT DATE: 07/27/2026
NARRATIVE
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The interview with S1 revealed that on the day of the incident S2 had informed S1 that R1 had suffered a fall earlier in the morning at approximately 04:00 AM. S1 stated they were instructed by S2 to sit in a chair at R1’s bedside to assist R1 when they woke up. S1 stated that at approximately 05:00 AM R1 woke up, saw S1 sitting in the chair near their bed, attempted to get out of bed, lost their balance, fell forward, became aggressive, threw objects and their walker towards S1. S1 stated that they photographed R1’s injuries that they sustained at approximately 05:00 AM and sent them to the Administrator although S1 no longer had the photo. S1 denied any physical altercations between R1 and staff or residents and denied neglecting any residents.

The interview with S2 revealed that R1 had woken up at approximately 04:00 AM and had requested milk. S2 went to get milk from the kitchen and as they were coming back to the bedroom, they heard a noise and saw R1 on the floor, holding their eye. S2 asked S1 what had occurred and was informed that R1 attempted to get out of bed and fell to the floor. S2 asked R1 if they wanted to go to the hospital and R1 denied medical attention. S2 stated that at 05:00 AM, R1 woke with a black eye. S2 stated that they contacted the facility Administrator and informed them of what had occurred. S2 stated that the Administrator made the decision to transfer R1 to the hospital. S2 denied R1 being in a physical altercation with their peers or falling in the shower. S2 stated R1 required a higher level of supervision and care, possibly 1:1 care which the facility could not provide.

Interview with W1 revealed that R1 had been admitted to the facility but only resided there for three (3) days before suffering the injury and being transported to the hospital. W1 did not know exactly what happened at the facility when R1 was injured. W1 recalled they had visited the facility to drop off clothing when they were informed that R1 had become very aggressive and was involved in an altercation with another resident. The facility informed W1 that R1 had assaulted the other resident and caused a “black eye,” which subsequently led to R1 being transferred to the hospital. W1 asked if R1 was hurt and facility staff said R1 did not sustain any injury. W1 stated they were contacted by the hospital and informed that R1 had sustained a facial injury at the facility. W1 stated when visiting R1 at the hospital the hospital informed W1 that R1 informed them they fell in the shower and hit their face when left alone. Although, W1 theorized that R1 may be confused. W1 denied being notified by the facility of R1’s hospitalization and only learned that R1 had been transferred after making the unannounced visit. W1 questioned the Administrator why they were not notified, and the Administrator said the incident occurred during the night/early hour which W1 understood. However, it was 2:00 PM when W1 arrived at the facility. CONTINUED ON LIC 9099C.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 29-AS-20260224084559
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: WISDOM WILLOW SENIOR LIVING
FACILITY NUMBER: 195850570
VISIT DATE: 07/27/2026
NARRATIVE
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Interviews with two residents (Resident #2 and #3) revealed no issues or concerns regarding the facility. An interview with R1’s roommate, Resident #4 (R4) was attempted but R4 had limited communication skills.
The review of medical records for R1 revealed that R1 was admitted to the emergency room with the chief complaint of a fall and facial trauma on 02/20/2026 at 12:01 PM. The medical records indicated that R1 was admitted with the facial injury as a result of R1 engaging in a physical altercation with another resident of the facility. Upon admission R1 reported that the injury occurred as a result of slipping and falling in the shower the previous night. Medical records reflect that R1 had a diagnosis of Alzheimer’s. A review of the Unusual Incent/Injury Report (LIC 624) submitted by the Administrator revealed on 02/20/2026, R1 sustained a fall from their bed at approximately 4:15 AM injuring their left upper eyebrow. The report indicated they provide night supervision but do not provide 1:1 care at night and R1 was taken to the emergency room for placement. The incident was reported to the hospital social worker where the resident came from, and they advised taking R1 to the closest emergency room. The 02/20/2026 police report was also reviewed.
Based on the information obtained during interviews and record review there is sufficient evidence to support the allegation of “Due to neglect and lack of supervision, resident sustained injuries.” R1 was accepted into the facility without a pre-admission appraisal or medical assessment therefore R1’s care needs were not identified prior to being admitted resulting in neglect and the subsequent fall R1 sustained. Staff also reported the fall occurred around 4:00 AM but hospital records show that R1 did not receive medical attention at the hospital until approximately 12:00 PM. Therefore, the allegation is deemed Substantiated at this time. LPA informed the Administrator that an immediate civil penalty in the amount of $500 is being assessed on today’s date (07/27/2026) for a violation that resulted in the injury or illness of an individual in care. The Administrator was also informed that additional civil penalties might be assessed based on Health and Safety Code 1569.49(e) and/or 1569.49(f).

The following deficiency and civil penalty were cited/assessed (refer to LIC 9099Ds). A copy of the report was printed, appeal rights were provided, and exit interview was conducted.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20260224084559
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: WISDOM WILLOW SENIOR LIVING
FACILITY NUMBER: 195850570
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/27/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/28/2026
Section Cited
CCR
87461(f)(1)
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87464 Basic Services
(f) Basic services shall at a minimum include:
(1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).
This requirement is not met as evidenced by:
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Administrator agreed to conduct an in-service training with facility staff which covers the expectations of facility staff when providing care and supervision to residents and what constitutes appropriate care and supervision of residents. Additionally, the Administrator...
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Based on interviews and record review the Licensee did not comply with the section cited above as R1 sustained a facial injury while under the care of the facility which posed an immediate health and safety risk to clients in care.
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...agreed to submit a statement signed by the Licensee Representative which confirms that the Licensee Representative will involve the Administrator in pre-assessments of all future residents prior to their acceptance into care at the facility. Administrator agreed to submit the POC no later than POC due date.
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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: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5