Northridge Retirement Villa, LLC

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with Martin and Lani Manzo, Licensee/Administrators, and explained the reason for the visit. At approximately 10:20 am, with the assistance of the Administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. Kitchen: The kitchen appliances and fixtures were functional. Knives were stored in a locked drawer in the kitchen. The first Aid kit was observed to be fully stocked. Laundry Area: The laundry area is located through the kitchen. Appliances were observed to be in good repair. Laundry detergents were locked in a cabinet. LPA observed a fire extinguisher with a purchase date of 08/28/25. Smoke alarms were observed and tested to be functional. Bedrooms: There were five(5) bedrooms designated for residents' use and one (1) room is designated for staff. All five bedrooms used by residents were properly furnished with appropriate bedding and linens, with sufficient lighting. Bathrooms: There were three (3) bathrooms in the facility. One (1) bathroom is the main bathroom and is located in the hallway. One (1) is in a private resident room, and one (1) is designated for staff located in the laundry room. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 105.9 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas: These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. The dining room table is large enough to seat the capacity of the facility. Seating, such as couches, were in good repair and sat the capacity of the facility. The fireplace located in the living room is closed, non-operational, and blocked off. Surrounding Grounds: Entry/exits were free of obstruction. (Continue on 809C) There was furniture appropriate for outdoor use. The outdoor area was free of hazards. Resident Files: There are no residents in the facility; therefore, LPA did not conduct any file review. Staff Files: LPA conducted a file review of staff records to ensure forms and training are up to date and compliant with licensing forms. Medications: The facility has no residents; therefore, no medication review was done by LPA Temperature: Facility maintains a comfortable temperature of 70 degrees Fahrenheit. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued. .the state’s words, verbatim · CDSS document, Oct 22, 2025

Allegation investigated: Staff financially abused resident Staff physically abuse resident

Licensing Program Analysts (LPA) Mariana Agban conducted an unannounced subsquent complaint visit to this facility. LPA met with Administrator Aida Amante and explained the reason for the visit. LPA conducted a physical plant walk-through and observed that there were zero (0) resident at the facility. On 4/23/25, Complaint 31-AS-20250423104405 was received by the Woodland Hills Adult & Senior Care Regional Office. The complaint was referred to the Community Care Licensing Division’s Investigation Branch (IB) on 04/23/25 and was accepted as an assignment to interview the alleged victim (Case #LA3125-04141) An initial complaint visit was made, at the facility by LPA Agban and LPA Shahbizian on 04/23/25. LPA met with S1 and conducted a tour of the physical plant to ensure the health and safety of the residents in care; no deficiencies were observed. Relevant documents were gathered, including residents’ roster, Resident 1(R1) Admission agreement, Appraisal Needs and Services Plan, and Physician’s Report. (Continue on 9099C) Unsubstantiated Allegation: Staff physically abused resident. The complainant alleged that staff physically abused R1 by pushing and shoving, causing R1 to fall and resulting in bruising and the inability to walk independently. On 05/08/25 at approximately 11:30 am, Investigators Christine Ferris and Jorge Rojas conducted an interview with S1 at the facility. At approximately 12:40 pm, the investigators conducted an interview with R1 at the hospital. The interview with R1 included statements that a female staff member had shoved R1’s foot into a pair of small-sized slippers and hit R1 with a wet washcloth. R1 stated that these incidents occurred four to five years ago. R1 refused to disclose the identity of the staff in question. The interview with S1 included statements that R1 was hospitalized for kidney stones. S1 said that R1 had advised S1 that R1 had filed a complaint because S1 had not visited R1 in the hospital. S1 advised that R1 had mild cognitive impairment and that R1’s condition had been progressively deteriorating both mentally and physically. S1 stated that R1 had not suffered any falls while at the facility. On 09/03/25 at approximately 3:00 PM, LPA conducted interviews with six (6) of 6 the residents. Residents' interviews denied the allegations. Interview with Staff#1(S1) and Staff#2(S2) included statements that since R1's admission to the facility, R1 was non-ambulatory and was wheelchair bound. On today's visit at approximately 11:00 AM, LPA conducted a review of R1's Appraisals, and the Physician's Report stated that R1 is unable to walk without assistance and R1 has Motor impairment/Paralysis. The information obtained during interviews conducted by the IB Investigators, as well as interviews and file and document reviews conducted by the LPA, did not corroborate the allegation of physical abuse from facility staff towards Resident 1(R1). Although the allegation may have happened or is valid, there is no corroboration that the alleged violations did or did not occur. The allegation is deemed unsubstantiated per Title 22 Regulations, Division 6, Chapter 8. Allegation: Staff financially abused resident. The complainant alleged that staff had asked R1 for money and for R1 to purchase property for the staff. Money belonging to R1 had disappeared. Staff have access to bank accounts belonging to R1, and the accounts are now locked or frozen, preventing R1 access. To investigate this allegation, LPA conducted staff and resident interviews. LPA also obtained a copy of the Admission Agreement, Identification and Emergency Information, Physician Report, and Resident Appraisals. Record Review indicated that the licensee will not be responsible for any cash resources and that R1 was responsible for his/her financial affairs and payments for the facility. Interviews with two residents out of 6 denied the allegation. LPA attempted to interview 4 residents. Interview with 5 out of 5 staff members also denied the allegation. Based on information obtained, the allegation is deemed Unsubstantiated at this time. Exit interview conducted, and a copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Sep 25, 2025 · control 31-AS-20250423104405

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with staff and explained the reason for the visit. Administrator Lani Manzano was contacted and arrived shortly after. At approximately 10:25 am, with the assistance of the Administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the kitchen cabinets. The first Aid kit was observed to be fully stocked. Laundry Area: The laundry area is located through the kitchen. Appliances were observed to be in good repair. Laundry detergents were locked in a cabinet. LPA observed a fire extinguisher with a purchase date of 09/03/24. Smoke alarms were observed and tested to be functional. Bedrooms: There were four(4) bedrooms designated for residents' use and one (1) room is designated for staff. All four bedrooms used by residents were properly furnished with appropriate bedding and linens with sufficient lighting. Bathrooms: There were three (3) bathrooms in the facility. One (1) bathroom is the main bathroom and is located in the hallway. One (1) is in a private resident room and one (1) is designated for staff located in the laundry room. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 108.9 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas: These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. The dining room table is large enough to sit the capacity of the facility. Seating such as couches were in good repair and sat the capacity of the facility. The fireplace located in the living room is closed, non-operational, and blocked off. Surrounding Grounds: Entry/exits were free of obstruction. (Continue on 809C) There was furniture appropriate for outdoor use. The outdoor area was free of hazards. Resident Files: LPA conducted a file review of resident records to ensure compliance with licensing forms. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliant with licensing forms. Medications: Medication and Medication Records were review for proper documentation. Temperature: Facility maintains a comfortable temperature of 77 degrees Fahrenheit. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Dec 4, 2024