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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 04/08/2025
Date Signed: 04/08/2025 03:18:45 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
04/07/2025 and conducted by Evaluator Gina Saucedo
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20250407223612
FACILITY NAME:CEDARS ASSISTED LIVING, THEFACILITY NUMBER:
197608267
ADMINISTRATOR:KANDICE VERGARAFACILITY TYPE:
740
ADDRESS:17300 ROSCOE BLVD.TELEPHONE:
(818) 344-2042
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:175CENSUS: 101DATE:
04/08/2025
UNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Jolene Halog, Medication TechnicianTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff does not have planned activities for the residents
Staff does not meet the needs of the residents
Staff are unable to properly lift a resident while in care
INVESTIGATION FINDINGS:
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On 04/08/25, at 11:55am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Medication Technician, Jolene Halog. LPA explained the purpose of this visit was to interview staff, residents and deliver findings for this complaint.

On 04/08/25, LPA Saucedo asked for the census, staff, and resident rosters. On 04/08/25, LPA Saucedo conducted a physical tour and interviewed staff and residents.

LIC 9099C-continued
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
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 31-AS-20250407223612
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: CEDARS ASSISTED LIVING, THE
FACILITY NUMBER: 197608267
VISIT DATE: 04/08/2025
NARRATIVE
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Regarding the allegation: Staff does not have planned activities for the residents. It is being alleged that there are no planned activities. During LPA's interview with resident #1 (R1), R1 stated the planned activities do not come to their room. LPA asked R1 if they were bedridden and R1 stated, "no." LPA advised R1 that the activities room is upstairs and there are different types of activities such as bingo, movies to watch, chair yoga, exercise sessions, coloring sessions conducted with different dates and times. During LPA's interview with the Activities Director, the Activities Director provided the LPA with three (3) calendars displaying the different times and dates and displaying the type of activity. The calendar was for the two (2) memory care areas and the Assisted Living area. During LPA's tour, LPA observed bingo, movies, a large television, coloring items, games and books in the Activities Room. Furthermore, LPA observed one (1) of the memory care areas having an activity session in the patio area. LPA interviewed nine (9) residents that confirmed there is different types of activities everyday. Therefore, based on the LPA's record review and observations, resident and staff interviews, the above allegation(s) above is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff does not meet the needs of the residents. It is being alleged that Resident #1 (R1)'s needs are not being met. During LPA's interview with R1, R1 denied that their needs were not being met. R1 confirmed that everything they want takes some time to get but the staff do help them. Be advised, R1 is under Orange Home Health and receives medical and physical therapy. R1 also gets help from two (2) staff for different needs such as transferring from bed to wheelchair, showers, toiletry, dressing, grooming. LPA interviewed nine (9) residents that confirmed their needs are being met. Therefore, based on the LPA's record review, resident and staff interviews, the above allegation(s) above is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff are unable to properly lift a resident while in care. It is being alleged that Resident #`1 (R1) cannot be lifted properly by staff. During LPA's interview with R1, R1 confirmed that staff do help them transfer from the bed to their electric wheelchair. LPA asked R1 how many staff do you need to help you and R1 stated, "one (1) or two (2) depends what they need help with." LPA interviewed two (2) staff that confirmed R1 always has two (2) staff helping them unless its a diaper change which one (1) staff can do that. Let it be noted, R1 is also under Orange Home Health. LPA asked R1 if they go outside and R1 stated, "yes, in my electric wheelchair." Therefore, based on the LPA's record review, resident and staff interviews, the above allegation(s) above is UNSUBSTANTIATED at this time.

Exit interview was conducted, no citation(s) were issued for the above allegation(s) and a copy of this report was given to the Medication Technician, Jolene Halog.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
LIC9099 (FAS) - (06/04)
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