191290642-4-9-2024-28-AS-TAGD-D56KVP-20240511081442

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191290642
Report Date: 04/09/2024
Date Signed: 04/09/2024 02:15:35 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/09/2023 and conducted by Evaluator Gina Saucedo

COMPLAINT CONTROL NUMBER: 28-AS-20230309123659

FACILITY NAME:	LEISURE VALE RETIREMENT HOTEL		FACILITY NUMBER:	191290642
ADMINISTRATOR:	CELIA GARCIA		FACILITY TYPE:	740
ADDRESS:	413 E. CYPRESS		TELEPHONE:	(323) 697-2248
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	199	CENSUS: 134	DATE:	04/09/2024
		UNANNOUNCED	TIME BEGAN:	10:07 AM
MET WITH:	Brandy Rangel		TIME COMPLETED:	02:35 PM

ALLEGATION(S):

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Staff do not provide a safe environment for resident's in care
Staff do not prevent drug use in the facility

INVESTIGATION FINDINGS:

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On 04/09/24, at 8:50am, Licensing Program Analysts (LPAs) Gina Saucedo and Leizl DeLaCerra arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Assistant Administrator, Brandy Rangel. LPAs disclosed the purpose of the visit. LPAs explained the purpose of this visit was to gather additional information, conduct interviews and deliver findings for this complaint.

On 03/14/2023, LPA Agard initiated the complaint investigation. On 04/09/24 at 8:55am, LPA Saucedo and DeLaCerra asked for the census, resident, and staff roster. The Assistant Administrator, Brandy Rangel met with LPA Saucedo and DeLaCerra to conduct the physical tour at 9:35am. During the tour, eleven (11) residents and five (5) staff were interviewed.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

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 28-AS-20230309123659

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: LEISURE VALE RETIREMENT HOTEL	FACILITY NUMBER: 191290642
	VISIT DATE: 04/09/2024

NARRATIVE

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Regarding the allegation: Staff do not provide a safe environment for residents in care. It is being alleged that the neighbors next door from Mariposa Street stay overnight at the facility. LPAs interviewed eleven (11) out thirteen (13) residents that confirmed that the neighbors next door from Mariposa Street do not stay overnight at the facility. Eleven (11) out of thirteen (13) residents confirmed that all surrounding doors are closed by 8:00pm and there is no entry/exit access into the above facility. In addition, the front lobby door is also locked by 8:00pm and there is a front receptionist that works overnight and oversees the front area. LPAs also interviewed five (5) out of five (5) staff that confirmed the front door and all the doors accessing the facility close by 8:00pm. During LPA's physical tour, the LPAs were able to observe the facility surroundings including Mariposa Street and were able to observe the gated doors that can be locked. Based on LPA's observations, staff and residents interviews the allegation(s) above is unsubstantiated at this time.

Regarding the allegation: Staff do not prevent drug use in the facility. It is being alleged that the neighbors next door from Mariposa Street come over to the above facility do drugs and alcohol are disruptive and loiter. Eleven (11) out of thirteen (13) residents confirmed that neighbors from Mariposa Street do not come over to the above facility to do drugs and alcohol and are also not disruptive and loiter. Eleven (11) out of thirteen (13) confirmed that drugs and alcohol are not allowed at the above facility. Five (5) out of five (5) staff also confirmed that drugs and alcohol are not allowed at the above facility, it is against the facility rules. LPA was able to obtain the above facility rules. Based on LPA's observations, staff and residents interviews the allegation(s) above is unsubstantiated at this time.

An exit interview was conducted, no citations were issued for above allegation(s), and a copy of this report was given to the assistant administrator.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

LIC9099 (FAS) - (06/04)

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