197608267-2-24-2026-31-AS-TAGD-DSRLPS-20260402085625

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 02/24/2026
Date Signed: 02/24/2026 12:37:22 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
11/18/2025 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20251118164042

FACILITY NAME:	CEDARS ASSISTED LIVING, THE		FACILITY NUMBER:	197608267
ADMINISTRATOR:	DAVID AGUINIGA		FACILITY TYPE:	740
ADDRESS:	17300 ROSCOE BLVD.		TELEPHONE:	(818) 344-2042
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91325
CAPACITY:	175	CENSUS: 114	DATE:	02/24/2026
		UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	David Aguiniga, Administrator		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Resident sustained unexplained fractures while in care
Resident sustained severe unexplained bruising while in care

INVESTIGATION FINDINGS:

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On 02/24/26, at 11:35pm, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Resident Care Director Mary Jane Reyes. LPA explained the purpose of this visit was to deliver findings for this complaint.

On 11/19/25, the complaint was referred to The Community Care Licensing Investigations Branch (IB) and accepted as a full investigation. It was assigned to Investigator, Christine Ferris. On 11/19/25, LPA Saucedo initiated the twenty-four (24) complaint investigation and asked for the census, staff, resident roster and obtained documents regarding R1- Resident Identification and Emergency Information, Physician’s Report, Resident Information Care Plan, Pre-placement Appraisal, Functional Capability Assessment, Resident Appraisal, Needs and Services Plan.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2026

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-20251118164042

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: 02/24/2026

NARRATIVE

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On 11/19/25, IB subpoenaed medical records from two (2) different hospitals-Valley Presbyterian Hospital and California Hospital Medical Center. On 12/04/25, California Hospital Medical Center responded by saying, “they had no records for R1.” On 12/16/25, medical records were subpoenaed for R1 from Southern California Hospital at Hollywood and were received on 01/20/26. The medical records from Southern California Hospital at Hollywood show via X-rays that there were no fractures noted and no falls at the hospital were documented on 08/09/24. On 01/27/26, medical records were received from Valley Presbyterian Hospital.

Regarding the allegation: Resident sustained unexplained fractures while in care. It is being alleged that resident #1 (R1) fractured their left arm and rib. The investigation revealed the following; During a record review per Southern California Hospital at Hollywood medical records, R1 was admitted to the hospital on 08/09/2024, X-rays were taken with no fractures noted and no falls at the hospital were documented. R1 was discharged back to Cedars Assisted Living on 08/15/2024. Per Valley Presbyterian Hospital medical records, R1 was admitted on 08/19/2024 and was diagnosed with multiple fractures “likely from an unwitnessed fall.” The fractures included an acute left wrist fracture, an acute left 10th displaced rib fracture, and a lumbar 1 vertebral body fracture of an indeterminate age. R1 was also noted to have bruising around their neck, chest, left hip, and left wrist. The cause of the fractures was unknown and the information regarding the bruising, which began at Southern California Hospital at Hollywood was not relayed to Valley Presbyterian Hospital. Staff at the facility denied R1 sustained any falls or incidents to explain the fractures prior to their hospitalization on 08/19/2024. On 12/10/25, IB Investigator interviewed five (5) facility staff and two (2) residents. Four (4) out of the five (5) caregivers stated, “that they did not witness and/or recall R1 having any falls, bruising and/or swelling while at the facility.” One (1) out of the five (5) staff stated, “they had just started working there within the last three (3) months and they did not know R1.” Two (2) out of two (2) residents stated, “that they were happy and felt safe at the facility.”

There was no documentation, statements, or other evidence to show where, how, or when R1 sustained the fractures. Therefore, with no sufficient evidence found to substantiate the allegation, it is unsubstantiated.

LIC 9099C-continued

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20251118164042

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: 02/24/2026

NARRATIVE

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Regarding the allegation: Resident sustained severe unexplained bruising while in care. It Is being alleged that Resident #1 (R1) had bruises all over their body.

The investigation revealed the following; During a record review per Southern California Hospital at Hollywood medical records, R1 was admitted to the hospital on 08/09/2024, notations of bruising on R1’s left jaw, neck, and right breast began on 08/13/2024, after their admission, with no notations of bruising upon R1’s admission. Per staff, R1 had no bruising prior to being admitted to Southern California Hospital at Hollywood and denied R1 had any falls or causes for bruising prior to their hospitalization but had bruising, and documented it, upon their return to the facility from the hospital on 08/15/2024. On 12/10/25, IB Investigator interviewed five (5) facility staff and two (2) residents. Four (4) out of the five (5) caregivers stated, “that they did not witness and/or recall R1 having any falls, bruising and/or swelling while at the facility.” One (1) out of the five (5) staff stated, “they had just started working there within the last three (3) months and they did not know R1.” Two (2) out of two (2) residents stated, “that they were happy and felt safe at the facility.”

There is no evidence to show the bruising occurred at the facility, therefore, the allegation is unsubstantiated.

Exit interview was conducted, no citation(s) were issued for the above allegation(s) and a copy of this report was given to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2026

LIC9099 (FAS) - (06/04)

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