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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 421700411
Report Date: 08/26/2026
Date Signed: 08/26/2026 06:06:30 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
03/19/2026 and conducted by Evaluator Kristin Kontilis
COMPLAINT CONTROL NUMBER: 29-AS-20260319092319
FACILITY NAME:VALLE VERDEFACILITY NUMBER:
421700411
ADMINISTRATOR:SUSAN E PONCEFACILITY TYPE:
741
ADDRESS:900 CALLE DE LOS AMIGOSTELEPHONE:
(805) 883-4193
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY:547CENSUS: 330DATE:
08/26/2026
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Tracie Fairley, Associate Executive Director; Mark Hansen, Executive DirectorTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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Staff did not respond to residents calls for assistance timely.
Staff did not ensure the door in memory care works properly.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced subsequent complaint visit to deliver final findings for the above-stated allegations. During today’s visit, LPA met with Mark Hansen, Executive Director; and Tracie Fairley, Associate Executive Director. LPA explained the purpose of the visit. LPA Kontilis conducted the initial visit on 3/25/2026 from approximately 12:40 pm – 5:30 pm at which time LPA conducted interviews and obtained documents pertaining to the investigation. LPA conducted additional interviews on 7/3/2026, 7/6/2026, and 8/25/2026.
On the allegation, staff did not respond to residents’ calls for assistance timely: Reporting Party voiced concern that there was no staff on duty in the independent, assisted living and/or memory care units of the facility on one particular night with no response to emergency pendants throughout the night.
Administrator Williams stated residents wear a pendant around their neck as a necklace and when the pendant is pressed, it is a call for assistance and/or help. Administrator Williams stated the care partners wear a pager and care partners are assigned to specific residents. Administrator stated when a resident
Please continue to 9099-C, Pg 2.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026
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 3
Control Number 29-AS-20260319092319
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: VALLE VERDE
FACILITY NUMBER: 421700411
VISIT DATE: 08/26/2026
NARRATIVE
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presses their pendant, it sends an alarm to the care partner who is assigned to that resident. Administrator stated the pager identifies the resident by the resident’s name, their room number and their location even if the resident is not in their designated room. Administrator stated the time responding to residents’ calls should be within 10 minutes – 15 minutes and if a care partner cannot respond timely, they will call another colleague to assist the incoming call.
Records reviewed and interviews conducted revealed on 3/15/2026 a call pendant was pressed at 7:12 pm sending an alarm for assistance to care staff in the Assisted Living area of the community. The call was cleared at 7:40 pm. Records reviewed revealed the duration of time from when the alarm was initiated until it was cleared was 28 minutes, 1 second. The allegation, Staff did not respond to residents’ calls for assistance timely is deemed Substantiated at this time. While the allegation is Substantiated, a deficiency will not be cited as the deficiency has been cited on this day on Complaint Investigation Report #29-AS-202608115226.
On the allegation, staff did not ensure the door in Memory Care works properly: Reporting Party voiced concern that the door in Memory Care is not working properly resulting in resident(s) leaving the locked Memory Care facility without supervision. Interviews conducted revealed Resident 1 (R1) left the secured memory care unit unassisted and without supervision and was found in another resident’s room a far distance from the memory care unit. The Memory Support Manager located R1 and brought R1 back to their living area. It was later determined that R1 exited the building through the Memory Care “white door” which leads through the Assisted Living area. Interviews conducted revealed Resident 2 (R2) exited the Memory Care unit through the “white doors”. Interviews conducted revealed R2 was observed walking down the hall of the Assisted Living unit, staff followed R2, and returned R2 to the Memory Care unit. Records reviewed revealed Estimate #2409 for repairs and replacement of the white door leading between Memory Care and Assisted Living. Based on interviews conducted and records reviewed, the staff did not ensure the door in Memory Care works properly allowing residents to leave the Memory Care unit unsupervised is deemed Substantiated at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D):

Exit interview conducted. Copy of report issued at the time of the visit. Appeal Rights issued.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20260319092319
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VALLE VERDE
FACILITY NUMBER: 421700411
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/26/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/28/2026
Section Cited
CCR
87464(f)(1)
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Basic Services (f) Basic services shall at a minimum include:(1) Care and supervision as defined ...
This requirement was not met as evidenced by:
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Executive Director/Associate Executive Director state the doors have been repaired and keypads function properly and new keypads will be arriving within the next 14 days. POC cleared at the time of the visit.
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Based on interviews and record review, the licensee did not comply with the section cited above, when R1 exited from the memory care unit of the facility without supervision and R2 wandered from the Memory Care Unit into the Assisted Living area which poses an immediate safety risk to residents 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: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026
LIC9099 (FAS) - (06/04)
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