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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 05/22/2024
Date Signed: 05/22/2024 02:01:02 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
12/21/2023 and conducted by Evaluator Gina Saucedo
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20231221160517
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: 122DATE:
05/22/2024
UNANNOUNCEDTIME BEGAN:
12:37 PM
MET WITH:Kandice VergaraTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Illegal drug activities on the premises
INVESTIGATION FINDINGS:
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On 05/22/24, at 12:37pm, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Administrator, Kandice Vergara. LPA disclosed the purpose of the visit. LPA explained the purpose of this visit was to deliver findings for this complaint.

On 12/26/2023, LPA Gina Saucedo initiated the complaint investigation. On 12/26/23, LPA Saucedo asked for the census, staff, and resident roster. On 12/26/23, LPA Saucedo interviewed staff and residents. On 12/26/23, the complaint was referred to Investigations Branch (IB) and it was accepted for investigation. The Investigator assigned was Lorraine Patterson. On 05/22/24, at 12:50pm, LPA conducted the physical tour. The investigation from Investigator Lorraine Patterson revealed the following:

LIC 9099C-continued
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy AgardTELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina SaucedoTELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
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-20231221160517
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: 05/22/2024
NARRATIVE
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Regarding the allegation: Illegal drug activities on the premises. It is being alleged that there is illegal drug readily available, for free, and it's allowed, and no one does anything about the drugs and drug use in the facility. On 01/04/2024, IB Investigator Lorraine Patterson spoke to the reporting party (RP) via telephone. RP mention the facility was made aware of the drug use. On 01/10/24, IB investigator Patterson and Special Investigator Assistant (SIA) Rocio Flores conducted a physical tour along with staff and resident interviews. When investigator Patterson interviewed the Residential Care Director, they mentioned the house rules/policy and how drug use is a violation, and an eviction or warning can be issued to the resident. The Residential Care Director showed Investigator Patterson recent Unusual Injury/Incident reports and one (1) showed an eviction notice due to drug use in the facility. Investigator Patterson also reviewed Resident #1 (R1)’s file, previous complaints, and took some pictures of the no smoking signs and smoking areas. Investigator Patterson interviewed two (2) more staff that confirmed that they do not have any concerns relative to drug activity/use taking place on the premises and/or being provided for free and that illegal drugs are not permitted. Investigator Patterson interviewed three (3) out of three (3) residents that confirmed that they have not seen, heard and denied any drugs being used on premises, allowed, permitted, and or provided for free. Investigator Patterson attempted to interview three (3) out of three (3) additional residents that were not available and/or refused to speak to them. Based on the observation of the IB Investigator, interviews conducted, and record review, the allegation is UNSUBSTANTIATED at this time.

An exit interview was conducted, and a copy of this report was given to the administrator.

SUPERVISOR'S NAME: Troy AgardTELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina SaucedoTELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2