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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191290642
Report Date: 08/02/2022
Date Signed: 07/31/2023 01:28:06 PM


Document Has Been Signed on 07/31/2023 01:28 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754



FACILITY NAME:LEISURE VALE RETIREMENT HOTELFACILITY NUMBER:
191290642
ADMINISTRATOR:JESSE MOTAFACILITY TYPE:
740
ADDRESS:413 E. CYPRESSTELEPHONE:
(818) 244-2323
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:199CENSUS: DATE:
08/02/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Markus Metler and Tina Marie CobbTIME COMPLETED:
03:28 PM
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Licensing Program Manager (LPM) Fernando Fierros and Licensing Program Analyst (LPA) Valeria Maldonado conducted a virtual informal office meeting. The purpose of the meeting was to discuss any changes within the corporation. LPM Fierros and LPA Maldonado met with the Board of Directors - Chief Executive Officer Markus Mettler and Tina Marie Cobb, Consultant Joel Goldman, Management Representative Steve Atlas and the Centralized Applications Bureau (CAB) Analyst Bethany Hunter.

LPM Fierros addressed in the meeting that the Department was made aware of a pending Change of Management (CHOM) and it was noted that the previous board of directors had passed away. Per CEO Markus Mettler, the corporation remains active and is still operating as the current licensee of the facility. It was clarified that the corporation has the intention to continue to operate as a Residential Care Facility for Elderly with no additional changes. It was also confirmed that the corporation has maintained control of property throughout the recent changes. A copy of the most recent LIC 309- Administrative Organization has been received by the department dated: 08/01/22 reflecting the changes. The department also received a copy of the corporation's updated organizational chart.

The following documents were requested from the licensee.
- Current Control of Property
- Written notification to the department indicating the changes with the board of directors for the corporation

Regional Office discussed that there were no objections to the pending addition/change of management company.

An exit interview was conducted with CEO Markus Mettler and a copy of the licensing report was provided electronically for their signature.
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Valeria MaldonadoTELEPHONE: 323-981-3342
LICENSING EVALUATOR SIGNATURE:
DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/02/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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