197610775-9-28-2026-31-AS-MGFS-DYKQVS-20261005123048

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610775
Report Date: 09/28/2026
Date Signed: 09/28/2026 04:32:44 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.RO, 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
09/18/2026 and conducted by Evaluator Evelin Rios

COMPLAINT CONTROL NUMBER: 31-AS-20260918133958

FACILITY NAME:	BELLAMAR LANCASTER		FACILITY NUMBER:	197610775
ADMINISTRATOR:	SPITZNOGLE, KORTNIE		FACILITY TYPE:	740
ADDRESS:	43454 30TH STREET WEST		TELEPHONE:	(661) 949-2177
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	68	CENSUS: 50	DATE:	09/28/2026
		UNANNOUNCED	TIME BEGAN:	08:27 AM
MET WITH:	Miyah Guillory - Resident Care Director		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff do not ensure that resident's care needs are being met.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Evelin Rios and Lorena Casillas conducted an initial visit to the facility to investigate the above noted allegations. LPA arrived to the facility and was greeted by the Resident Care Director, Miyah Guillory. LPA explained the reason for the visit. LPA met with the Executive Director, Kortnie Spitznogle shortly after.

The investigation consisted of the following:
At approximately 8:30 a.m., LPA requested and obtained a copy of the facility's resident roster and staff roster. At approximately 8:50 a.m., LPA initiated a physical plant tour of the facility. LPA interviewed five (5) residents and one (1) resident's family member. LPA also interviewed four (4) staff. At approximately 10:50 a.m., LPA requested and obtained copies of residents' shower logs, laundry logs, Care Plans, Medical Assessments (LIC602s), Task Administration Record and Resident #1 (R1's) most recent 30 day assessment.
(Continue to LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260918133958

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BELLAMAR LANCASTER	FACILITY NUMBER: 197610775
	VISIT DATE: 09/28/2026

NARRATIVE

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The investigation revealed the following:

Regarding the allegation: Staff do not ensure that resident's care needs are being met. It is alleged that Resident (R1) is being neglected at the facility and arrived to an appointment smelling of urine. LPA was unable to interview R1 as they were not in the facility during time of visit. Interviews with five (5) residents, stated they have no issues receiving the required assistance with their activities of daily living. They reported that, overall, the staff is good about providing care. LPAs interview with Resident #2 (R2), a resident familiar with the care R1 receives stated R1 will push their pendent often to request assistance sometimes without needing any assistance. According to R2, R1 requires assistance for showers, toileting and grooming. R2 states they assist R1 when they can but will call for assistance when it becomes too difficult for them to assist R1.

Interviews with staff denied the allegation stating they do their best to meet residents' needs and have not witnessed residents lacking care. Staff interviews reveal they have access to a care plan binder, shower schedule, laundry schedule and will check off a task on a digital Task Administration Record after they have completed a task. Furthermore, staff state they have discussed with R2 that they should allow staff to assist R1 even though R2 may feel that they can provide the assistance to R1 such as toileting. Interview with one (1) staff states R1 may experience intermittent incontinence which means they may need assistance to the toilet or may need to have their undergarments changed.

A review of R1’s records conducted at 12:12 p.m., revealed that R1 requires assistance with grooming, bathing and toileting and will experience intermittent incontinence. LPA's review the Task Administration Record for R1 shows staff have marked of a task once completed from 09/13/26 to 09/25/26 on days R1 was in the facility to include toileting assistance has been provided.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies cites. No other health and safety hazard are noted during this visit. Exit interview is conducted and a copy of report was provided to Executive Director

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026

LIC9099 (FAS) - (06/04)

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