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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 567609818
Report Date: 09/23/2026
Date Signed: 09/24/2026 07:00:28 AM

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
01/12/2026 and conducted by Evaluator Valeria Conway
COMPLAINT CONTROL NUMBER: 29-AS-20260112144756
FACILITY NAME:ESTATE HOME 1, THEFACILITY NUMBER:
567609818
ADMINISTRATOR:ALARCON, ESTRELLAFACILITY TYPE:
740
ADDRESS:705 CAMINO CONCORDIATELEPHONE:
(805) 383-4668
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY:6CENSUS: 5DATE:
09/23/2026
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Francie DemereyTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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 Manual fecal impaction removal on resident
INVESTIGATION FINDINGS:
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At 9:50 A.M., Licensing Program Analyst (LPA) Valeria Conway, conducted a subsequent complaint visit to the facility above to deliver final findings of the complaint allegations. LPA was greeted by Back-Up Administrator, Francie Demerey, and explained the purpose of the visit. At 9:57 A.M., Licensee, Estrella Alarcon contacted LPA via telephone and explained that they were unavailable during today's visit, but authorized Back-Up Administrator to sign today's reports. Entrance interview conducted.

On 01/14/2026, LPA Conway conducted an initial 10-day visit. During the visit, between 9:05 A.M. and 12:50 P.M., the LPA conducted a physical plant tour, interviewed the administrator and two (2) staff members, and reviewed files, medication logs and obtained copies of pertinent documents relevant to the investigation. Additional in-person interview with Staff #1 (S1) was conducted on 01/28/2026. During today’s visit, LPA conducted a brief tour of the physical plant. The following was determined:

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

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
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-20260112144756
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: ESTATE HOME 1, THE
FACILITY NUMBER: 567609818
VISIT DATE: 09/23/2026
NARRATIVE
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Continued from LIC 9099

Regarding the allegation of “Staff performed manual fecal impaction removal on resident”, it was alleged that on or around 01/12/2026, Resident #1 (R1) stated that staff hurt R1’s bottom. It was further reported that S1 informed R1’s family that R1 was constipated and compacted therefore, S1 removed the fecal matter from R1s bottom with S1s hands. Interviews conducted during the course of the investigation reflected that R1 was admitted to the facility on 01/01/2023. Per R1’s Physicians Report dated 09/03/2025, R1 has a primary diagnosis of dementia, and is non-ambulatory. R1 is noted to be confused/disoriented, is able to follow instructions; however, unable to communicate needs. R1 requires assistance with all Activities of Daily Living (ADLs) except for feeding R1’s self. Additionally, R1 requires transfer assistance and incontinence care due to bowel/bladder impairment. Moreover, R1 is unable to determine their own need for prescription/non-prescription medication.

During the course of the investigation, interview with Staff #1 (S1) reflected that S1 administered suppositories and performed digital stimulation to the rectum with ointment to assist R1 with bowel movements. S1 is not an Appropriately Skilled Professional (ASP) and was unaware that such procedures could only be performed by an ASP. Medication records further documented the administration of Bisacodyl 10MG suppositories on an as-needed basis during the months of November and December 2025. LPA compared the initials recorded on the documentation reviewed with the staff interviewed and observed that the initials appeared to indicate that facility staff administered the suppositories to the resident. Administrator denied allegation, however, interview with R1’s family reflected that administrator and S1 informed the family that S1 performed manual fecal removal on resident. Based on information gathered during the course of the investigation, and interviews there is sufficient evidence to support the allegation occurred. Therefore, the allegation of “Staff performed manual fecal impaction removal on resident” is deemed SUBSTANTIATED at this time.

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: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 29-AS-20260112144756
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: ESTATE HOME 1, THE
FACILITY NUMBER: 567609818
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/23/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/24/2026
Section Cited
CCR
87622
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Fecal Impaction Removal, Enemas, and/or Suppositories...use of suppositories under the following circumstances:...according to physician's orders by either the resident or an appropriately skilled professional. This requirement is not met as evidenced by.
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A plan to comply with regulation cited and in-service training from a skilled professional regarding this regulation will be submitted to LPA prior to POC due date.
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Based on interview and record review, the licensee did not comply with the section cited above as digital stimulation and suppositories are being administered by non-skilled medical professionals.
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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: 09/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
01/12/2026 and conducted by Evaluator Valeria Conway
COMPLAINT CONTROL NUMBER: 29-AS-20260112144756

FACILITY NAME:ESTATE HOME 1, THEFACILITY NUMBER:
567609818
ADMINISTRATOR:ALARCON, ESTRELLAFACILITY TYPE:
740
ADDRESS:705 CAMINO CONCORDIATELEPHONE:
(805) 383-4668
CITY:CAMARILLOSTATE:CAZIP CODE:
93010
CAPACITY:6CENSUS: 5DATE:
09/23/2026
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Francie DemereyTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Resident sustained multiple bruises due to staff neglect or physical abuse
INVESTIGATION FINDINGS:
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At 9:50 A.M., Licensing Program Analyst (LPA) Valeria Conway, conducted a subsequent complaint visit to the facility above to deliver final findings of the complaint allegations. LPA was greeted by Back-Up Administrator, Francie Demerey, and explained the purpose of the visit. At 9:57 A.M., Licensee, Estrella Alarcon contacted LPA via telephone and explained that they were unavailable during today's visit, but authorized Back-Up Administrator to sign today's reports. Entrance interview conducted.

On 01/14/2026, LPA Conway conducted an initial 10-day visit. During the visit, between 9:05 A.M. and 12:50 P.M., the LPA conducted a physical plant tour, interviewed the administrator and two (2) staff members, and reviewed files, medication logs and obtained copies of pertinent documents relevant to the investigation. Additional in-person interview with Staff #1 (S1) was conducted on 01/28/2026. During today’s visit, LPA conducted a brief tour of the physical plant. The following was determined:

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

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20260112144756
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: ESTATE HOME 1, THE
FACILITY NUMBER: 567609818
VISIT DATE: 09/23/2026
NARRATIVE
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Continued from LIC 9099

Regarding the allegation of “Resident sustained multiple bruises due to staff neglect or physical abuse” it was alleged that Resident #1 (R1) was being physically and mentally abused by a staff member. Per the Reporting Party (RP), R1 had sustained multiple unexplained bruises and that facility staff were unable to explain how they occurred. Interviews conducted during the course of the investigation reflected that R1 was admitted to the facility on 01/01/2023. Per R1’s Physicians Report dated 09/03/2025, R1 has a primary diagnosis of dementia, and is non-ambulatory. R1 is noted to be confused/disoriented, is able to follow instructions; however, unable to communicate needs. R1 requires assistance with all Activities of Daily Living (ADLs) except for feeding R1’s self. Additionally, R1 requires transfer assistance and incontinence care due to bowel/bladder impairment. Moreover, R1 is unable to determine their own need for prescription/non-prescription medication.

Interviews conducted reflected that R1 becomes agitated when visitors leave the facility, displaying changes in mood and attempting to leave with the visitor. Additionally, interviews reflected that when R1 displays these behaviors staff respond by attempting to calm and redirect R1 and offering alternative activities. The Administrator further stated that R1 has fragile skin and takes blood-thinning medication and other medications that may increase the risk of bleeding and bruising. Interviews with other residents did not reveal any concerns related to staff abusing residents. Administrator and staff denied allegations of physically and mentally abusing residents. During the visit, LPA did not observe visible bruising on residents. Additionally, during prior visit on 11/07/2025 unrelated to this complaint, LPA observed that R1 had visitor remain at the facility for a few hours. However, once the visitor left the facility, R1 became visibly upset and agitated and staff responded by redirecting R1 in a calm manner. Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the allegations “Resident sustained multiple bruises due to staff neglect or physical abuse” is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of this report was provided.

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

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5