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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 12/22/2025
Date Signed: 12/22/2025 03:36:56 PM

Substantiated


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
12/17/2025 and conducted by Evaluator Gina Saucedo
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20251217165129
FACILITY NAME:CEDARS ASSISTED LIVING, THEFACILITY NUMBER:
197608267
ADMINISTRATOR:DAVID AGUINIGAFACILITY TYPE:
740
ADDRESS:17300 ROSCOE BLVD.TELEPHONE:
(818) 344-2042
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:175CENSUS: 117DATE:
12/22/2025
UNANNOUNCEDTIME BEGAN:
01:14 PM
MET WITH: Mary Jane Reyes, Resident Care DirectorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility is in disrepair
Staff did not ensure that facility is free of hazards
Staff did not ensure that the facility is free of pests
INVESTIGATION FINDINGS:
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On 12/22/25, at 1:14pm, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Resident Care Director, Mary Jane Reyes. LPA explained the purpose of this visit was to gather information, interview staff and residents and deliver findings for this complaint.

On 12/22/25, LPA Saucedo asked for the census, staff, and resident rosters. On 12/22/25, at 1:14pm, LPA Saucedo conducted a physical tour, and interviewed staff.

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

DATE: 12/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025
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 4
Control Number 31-AS-20251217165129
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: 12/22/2025
NARRATIVE
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Regarding the allegation: Facility is in disrepair. It is being alleged that several rooms'-baseboards, toilets, ceilings, and light fixtures need repairs. During LPA’s physical tour, LPA observed and obtained pictures of several rooms baseboards that were not stuck to the wall, toilets to be leaking, water damage to the wall and ceiling, a light fixture was exposed in one (1) of the resident's bathrooms. Be advised, these rooms were occupied by residents. Two (2) staff confirmed that they have seen the facility in disrepair in several rooms. Therefore, based on the LPA's observations, the allegation is SUBSTANTIATED at this time.

Regarding the allegation: Staff did not ensure that facility is free of hazards. It is being alleged that bathtub(s) lacked slip pads, some room floors were lifting with gaps/dents that may cause hazards to the residents. During LPA’s physical tour, LPA observed and obtained pictures of several rooms bathtubs not to have slip-resistant mats, some room floors were lifting with gaps/dents that may cause trip/fall hazards to the residents. Be advised, these rooms were occupied by residents. Two (2) staff confirmed that they have seen several rooms that are hazardous to the residents and to staff. Therefore, based on the LPA's observations, the allegation is SUBSTANTIATED at this time.

Regarding the allegation: Staff did not ensure that the facility is free of pests. It is being alleged that there were live roaches in some of the rooms. During LPA’s physical tour, LPA observed in one (1) of the rooms to have roaches. Be advised, this room was occupied by a resident. Two (2) staff confirmed that they have seen roaches/pests in several rooms. Therefore, based on the LPA's observations, the allegation is SUBSTANTIATED at this time.

An exit interview was conducted, citation(s) were issued, a civil penalty issued, appeal rights and a copy of this report was given to the Resident Care Director/Administrator.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 31-AS-20251217165129
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/22/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/12/2026
Section Cited
CCR
87303(a)
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Maintenance and Operation
(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met by:


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The licensee/administrator shall send a picture/repair paperwork to the LPA of repairs conducted.

POC due date: 01/12/26.
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Based on the LPA's observations the licensee/administrator failed to ensure that the facility was clean, safe, sanitary and in good repair at all times. This posed an potential health and safety risk to residents in care.
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Type B
01/12/2026
Section Cited
CCR
87303(e)(5)(A)
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Maintenance and Operation (e) Water supplies and plumbing fixtures shall be maintained as follows:(5)Slip-resistant mats, strips, or flooring shall be used in all bathtub and shower floors.(A)All slip-resistant mats, strips, or flooring shall be in good repair and maintain slip-resistant properties. This requirement is not met by:


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The licensee/administrator shall send a picture/repair paperwork to the LPA of repairs conducted.

POC due date: 01/12/26.
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Based on the LPA's observations the licensee/administrator failed to ensure that the facility was free of hazards. This posed an potential health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 31-AS-20251217165129
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/22/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/12/2026
Section Cited
CCR
87468.1(a)(2)
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Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met by:


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The licensee/administrator shall send the Pest Control paperwork to the LPA showing that Pest Control has been providing services.

POC due date: 01/12/26.
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Based on the LPA's observations the licensee/administrator failed to ensure that the facility was accorded safe, healthful and comfortable accommodations, furnishings and equipment. This posed an potential health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4