191290642-4-9-2024-28-AS-TAGD-D55U56-20240510151613

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191290642
Report Date: 04/09/2024
Date Signed: 04/09/2024 02:14:24 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
02/27/2023 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230227152539

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:	08:50 AM
MET WITH:	Brandy Rangel		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility not following/enforcing House Rules

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

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 03/01/2023, LPA Agard initiated the complaint investigation. On 04/09/24 at 8:55am, LPAs 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 four (4) 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)

Page: 1 of 2

Control Number 28-AS-20230227152539

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

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Regarding the allegation: Facility not following/enforcing House Rules. It is being alleged that House Rules are not being enforced. LPAs interviewed eleven (11) out thirteen (13) residents that confirmed that the House Rules are being enforced at the above facility. Eleven (11) out of thirteen (13) residents confirmed that visitors leave at 8pm, there is no smoking in the facility, no loud television after 10pm, there is no overnight guests, there is no abusive treatment toward residents, no loitering or trespassing, no soliciting of sexual services, no breaking and entering and Mariposa St. doors lock after 8pm. LPAs also obtained a copy of the Leisure Vale House Rules and pictures of "no smoking signs" throughout the facility. LPAs also interviewed four (4) out of four (4) staff that confirmed the front door and all the doors accessing the facility close by 8:00pm. The residents can also lock their doors at any time during the day and night. In addition, the visiting hours of the facility are from 9:00am to 8:00pm and there is a check-in and check-out book in the front of the lobby at the receptionist desk that the LPAs were able to look through. 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)

Page: 2 of 2