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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850093
Report Date: 06/16/2026
Date Signed: 06/16/2026 01:30:29 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
02/03/2026 and conducted by Evaluator Valeria Conway
COMPLAINT CONTROL NUMBER: 29-AS-20260203102145
FACILITY NAME:VENTURA VILLA ASSISTED LIVINGFACILITY NUMBER:
565850093
ADMINISTRATOR:WARD-MICHAYLUK, EVANGELINEFACILITY TYPE:
740
ADDRESS:3482 LOMA VISTA ROADTELEPHONE:
(805) 644-1292
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:49CENSUS: 13DATE:
06/16/2026
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Dora IslasTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff did not meet residents' medical needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct subsequent complaint visit with the purpose of delivering findings for the allegation listed above. AT 10:15 A.M., LPA met with facility Lead Med Tech, Dora Islas, and explained the reason for today’s visit. Administrator, Joy Michayluk, and Office Manager, Angelica Arambulo, were contacted via telephone at 10:21 A.M and 10:51 A.M. Administrator and Office Manager were available during today's visit. Office Manager authorized Lead Med Tech to sign today's reports. Entrance interview conducted.

During an initial complaint visit conducted on 02/11/2026, LPA Conway interviewed Lead Med Tech, Office Manager, Hospice Nurse, facility staff and residents. LPA also reviewed and obtained copies of documents pertinent to the investigation. Throughout the course of the investigation, LPA reviewed all documents and conducted additional interviews with relevant parties.

Continued on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Valeria Conway
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
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-20260203102145
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: VENTURA VILLA ASSISTED LIVING
FACILITY NUMBER: 565850093
VISIT DATE: 06/16/2026
NARRATIVE
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Continued from LIC 9099

During today's visit, a brief physical plant tour was conducted. The following was then determined:

Regarding allegation of “Staff did not meet residents' medical needs” the Reporting Party (RP) alleged that during an emergency situation, emergency medical personnel were called and observed that multiple residents appeared to have required medical intervention days before the 911 call was placed. The investigation revealed that on 01/31/2026, emergency medical personnel responded to the facility during an influenza outbreak involving multiple residents. Interviews conducted with a hospice nurse revealed that upon arriving to provide services to a resident, the nurse observed the resident’s oxygen saturation level was critically low and instructed facility staff to call 911 immediately. When paramedics arrived, they observed additional residents exhibiting similar symptoms. Paramedics assessed additional residents and identified several individuals who required transportation to a hospital for further evaluation and treatment of low oxygen saturation levels and influenza-like symptoms. Interviews with facility staff indicated that changes in condition had been observed among multiple residents in the days preceding the emergency response and that management had been made aware of these concerns. Staff reported that the symptoms were believed to be consistent with a common flu illness and that the severity of the residents’ conditions, as well as the presence of an influenza outbreak, were not recognized, resulting in a delay in obtaining medical care. As a result, medical evaluation and treatment were not obtained until emergency responders were contacted. Based on interviews conducted, records reviewed, and documents obtained during the investigation, the allegation of “Staff did not meet residents' medical needs” is deemed Substantiated.

Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 9099-D.) Administrator was informed that failure to correct the deficiencies may result in civil penalties.

Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Valeria Conway
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20260203102145
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: VENTURA VILLA ASSISTED LIVING
FACILITY NUMBER: 565850093
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/17/2026
Section Cited
CCR
87464(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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Facility will conduct an in-service training provided by a third-party vendorship that is approved by the Department with all staff including management about the importance of noticing the signs/symptoms of illness and seeking appropriate medical attention in a timely manner.
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Based on interview and record review the licensee did not comply with the section cited above as the facility did not provide appropriate timely care for several residents during an influenza outbreak which posed an immediate health concern to clients in care.
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This training shall be schedule by POC due date and proof shall be submitted to LPA and proof of the completed training will be sent to LPA once training is conducted.
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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: Desaree Perera
LICENSING EVALUATOR NAME: Valeria Conway
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
LIC9099 (FAS) - (06/04)
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