565801563-9-24-2026-29-AS-KHEN-DYE84N-20260929221124

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565801563
Report Date: 09/24/2026
Date Signed: 09/24/2026 11:13:57 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
08/12/2025 and conducted by Evaluator Quoc Huynh

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20250812091649

FACILITY NAME:	HAPPY HOME CARE		FACILITY NUMBER:	565801563
ADMINISTRATOR:	KAREN ROSALES		FACILITY TYPE:	740
ADDRESS:	179 NORTHAM AVE.		TELEPHONE:	(818) 219-5998
CITY:	NEWBURY PARK	STATE: CA	ZIP CODE:	91320
CAPACITY:	6	CENSUS: 5	DATE:	09/24/2026
		UNANNOUNCED	TIME BEGAN:	10:04 AM
MET WITH:	Karina Antig - Assistant Administrator		TIME COMPLETED:	11:25 AM

ALLEGATION(S):

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Due to staff neglect resident developed multiple pressure injuries while in care
Staff left resident in soiled linens for an extended period of time
Staff did not meet resident's nutritional needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Quoc Huynh conducted an unannounced subsequent complaint visit to deliver findings for the above allegations. The LPA arrived at 10:04AM and met with Assistant Administrator (AA) Karina Antig who arrived shortly thereafter . Entrance interview conducted.

On 08/15/2025 from 11:30am to 2:00pm, an initial visit was conducted by LPA Emily Peraldi. The LPA conducted interviews with the AA and staff, and obtained pertinent documents. The LPA also conducted an interview with hospital personnel on 08/13/2025 at approximately 9:08am and 10:10am. During the investigation, medical records were reviewed including hospital assessments and home health documentation.

Report Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026

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 29-AS-20250812091649

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: HAPPY HOME CARE	FACILITY NUMBER: 565801563
	VISIT DATE: 09/24/2026

NARRATIVE

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On 09/01/2026, LPA Huynh conducted a subsequent visit. Between 12:55PM and 3:16PM, the LPA conducted a physical plant tour and interviewed four (4) residents, two (2) staff, and the AA.

During today’s visit, LPA Huynh and Staff toured the physical plant at 10:09AM, and no immediate concerns were observed. The following was then determined:

Allegations: “Resident developed multiple pressure injuries due to staff neglect” and “Staff did not meet resident's nutritional needs”

It was alleged that R1 developed several pressure injuries due to neglect, lack of repositioning, skin breakdown with excoriation, and sepsis; and that staff did not meet R1’s nutritional needs. R1’s physician’s report dated 12/20/2024 documented multiple chronic and progressive medical conditions including Alzheimer’s disease, chronic kidney disease, anemia, malnutrition, and impaired mobility. The physician’s report was largely incomplete and did not contain current wound information or detailed mobility or nutritional directives.

R1’s appraisal dated 04/03/2025 showed R1 had longstanding diagnoses of generalized weakness, severe protein-calorie malnutrition, chronic anemia, hypotension, upper gastrointestinal bleeds, and failure to thrive. The plan documented that R1 preferred to remain in bed due to weakness and poor appetite, and that R1 frequently stated they did not want to eat because they believed they were overweight. The plan also indicated R1 required assistance with all ADLs except feeding, though staff continued to monitor and cue R1 during meals due to refusal.

A Home Health assessment (Oct–Dec 2024) described R1 as extremely frail, bedridden, with advanced Alzheimer’s disease, severe functional decline, total ADL dependence, and clinically documented malnutrition and failure to thrive. R1’s weight during this period (78 lbs at 62 inches tall) reflected chronic, progressive medical decline. The assessment noted a Stage 1 pressure injury and identified R1 as high-risk for pressure injuries due to immobility, malnutrition, and fragile skin, requiring ongoing preventative measures.

Report Continued on LIC 9099-C

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250812091649

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: HAPPY HOME CARE	FACILITY NUMBER: 565801563
	VISIT DATE: 09/24/2026

NARRATIVE

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A Home Health plan of care (06/03/2025–08/01/2025) documented a Stage 3 pressure injury to the right buttock and Stage 2 injury to the left buttock. Nursing notes reflected ongoing wound care with Calmoseptine and A&D ointment, periodic cleansing, and monitoring. The plan further included directions for frequent repositioning and pressure-ulcer prevention. Notes indicated caregivers were completing wound-care treatments on non-skilled nursing visit days. Records also described minor skin breakdown on the upper back consistent with R1’s fragile skin condition.

Home Health records dated 07/21/2025 documented a follow-up visit for a reopened cheek wound caused by R1 scratching. The wound was small, without signs of infection, and was treated and dressed.

On 08/07/2025, R1 was transported to the hospital due to decreased mentation. Hospital staff documented pressure injuries on the left lateral side of the body, along with excoriation and malnutrition. However, medical records did not contain full measurements, staging details, or clinical evidence supporting some of the verbal statements made by hospital personnel, including the assertion that R1 had not been repositioned. Additionally, the hospital documentation does not clarify whether changes in R1’s condition occurred prior to facility care, during hospitalization, or as part of R1’s chronic disease progression. R1 had been previously hospitalized several times earlier in the year for anemia and dehydration, consistent with R1’s long-standing medical decline.

Regarding nutritional concerns, hospital staff stated R1 appeared emaciated and dehydrated upon arrival. However, facility staff reported consistent efforts to encourage feeding and hydration, noting R1 frequently refused meals and fluids due to poor appetite and cognitive impairment. Staff stated they assisted R1 with feeding despite R1’s ability to self-feed. Over time, R1 became increasingly unable to open their mouth, reflecting significant progression of underlying medical conditions rather than lack of care.

Interviews with facility staff revealed R1 and other bed-bound residents were repositioned at least every two hours, and more frequently upon request or when staff observed a need.

Report Continued on LIC 9099-C

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250812091649

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: HAPPY HOME CARE	FACILITY NUMBER: 565801563
	VISIT DATE: 09/24/2026

NARRATIVE

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Staff documented contacting Home Health when changes to R1’s skin were observed and maintained photographs showing R1’s condition before and after hospital visits. Staff also stated R1 had a history of extremely sensitive skin and chronic anemia, contributing to bruising and skin fragility unrelated to neglect. Interviews with residents indicated no concerns regarding repositioning or nutritional support. Bedbound residents confirmed staff repositioned them frequently and assisted with meals as needed.

Based on interview and record review, although the allegations may have happened or are valid, there is insufficient evidence to prove the alleged violations did or did not occur; therefore, the allegations are deemed UNSUBSTANTIATED at this time.

Allegation: “Staff left resident in soiled linens for an extended period of time”

It was alleged that R1 was left in soiled bedding or clothing for an extended period of time. Emergency department nursing staff reported that R1’s back exhibited excoriation with bleeding and open skin, which they believed could be consistent with moisture-associated skin damage. Hospital personnel verbally stated that the resident’s back appeared irritated and raw; however, the medical record did not include detailed documentation confirming that the condition resulted from prolonged exposure to soiled linens or from inadequate hygiene care prior to hospitalization.

Interviews with facility staff and residents did not reveal concerns about individuals being left in soiled linens. Residents were observed with clean bedding, and none reported issues related to hygiene or linen changes. Staff reported following regular incontinence care and linen-changing protocols. Staff additionally reported that prior to R1’s hospitalizations, staff ensured R1 received incontinence changes.

Based on interviews, although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur; therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No deficiency cited. Exit interview conducted. A copy of the report was reviewed and provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Quoc Huynh
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026

LIC9099 (FAS) - (06/04)

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