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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 12/21/2022
Date Signed: 12/21/2022 03:41:38 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
11/10/2022 and conducted by Evaluator Joscelyn Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20221110125646
FACILITY NAME:CEDARS ASSISTED LIVING, THEFACILITY NUMBER:
197608267
ADMINISTRATOR:ARISTOTLE B. VERGARAFACILITY TYPE:
740
ADDRESS:17300 ROSCOE BLVD.TELEPHONE:
(818) 344-2042
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:175CENSUS: 125DATE:
12/21/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Aristotle Vergara TIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Facility staff sexually abused residents in care.
Facility staff handled resident in a rough manner.
INVESTIGATION FINDINGS:
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On 12/21/22 Licensing Program Analysts (LPAs) Joscelyn Martinez and Melissa Ruiz arrived at the facility to conduct an unannounced subsequent vist. Upon arrival LPAs met with administrator Aris Vergara and the purpose of the visit was explained.

Allegation: Facility staff sexually abused residents in care.

On 12/01/22 Investigator Peter Zertuche interviewed R1 and R1’s son regarding the allegation mentioned above. Interview revealed that R1 alleged they had been molested at a previous facility but did not know the name of the facility nor the staff. R1 stated the allegation occurred at a facility located at a facility located o Rinaldi street and stated that R1’s son had all of the information regarding the allegation. Investigator Zertuche asked for details regarding the allegation but R1 did not want to discuss the allegation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Joscelyn MartinezTELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
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 31-AS-20221110125646
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: CEDARS ASSISTED LIVING, THE
FACILITY NUMBER: 197608267
VISIT DATE: 12/21/2022
NARRATIVE
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Interview with R1’s son revealed that R1 tends to require a lot of attention and when things do not go according to R1’s way R1 will complain. R1’s son stated R1 tends to exaggerate a lot and does not feel that R1 is in danger. Due to the interviews conducted, there is not sufficient evidence to prove the allegation mentioned above may or may not have happened, therefore it is deemed Unsubstantiated.

Allegation: Facility staff handled resident in a rough manner.

On 12/01/22 Investigator Peter Zertuche interviewed R1 and R1’s son regarding the allegation mentioned above. Interview revealed that R1 alleged they received rough care at the hospital where R1 was left in bed all day and almost became paralyzed. R1 stated staff member twisted R1’s arm at the facility but did not go to the doctor nor did R1 call the police. Interview with R1’s son revealed that R1 tends to require a lot of attention and when things do not go according to R1’s way R1 will complain. R1’s son stated R1 tends to exaggerate a lot and does not feel that R1 is in danger. Due to the interviews conducted, there is not sufficient evidence to prove the allegation mentioned above may or may not have happened, therefore it is deemed Unsubstantiated.

Exit interview conducted. Report signed and delivered.

SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Joscelyn MartinezTELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2