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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609076
Report Date: 04/20/2026
Date Signed: 04/20/2026 04:11:26 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
04/17/2026 and conducted by Evaluator Raymond Comer
COMPLAINT CONTROL NUMBER: 31-AS-20260417090152
FACILITY NAME:MELROSE VILLASFACILITY NUMBER:
197609076
ADMINISTRATOR:ALLEN, CANDISFACILITY TYPE:
740
ADDRESS:823 N POINSETTIA PLACETELEPHONE:
(323) 746-7840
CITY:LOS ANGELESSTATE: CAZIP CODE:
90046
CAPACITY:68CENSUS: 42DATE:
04/20/2026
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Candis Allen-AdministratorTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff do not distribute resident's medication as prescribed.
Staff do not provide a safe environment for resident.
INVESTIGATION FINDINGS:
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On Monday, 04/20/26, Licensing Program Manager, Naira Margaryan, and Licensing Program Analyst, (LPA) Ray Comer, arrived to conduct an unannounced initial 10-day visit to investigate the allegation(s). LPM/LPA met with the Administrator, presented official CDSS badge identification, and reason for the visit was disclosed.

During this investigation at 1:35pm LPM Margaryan conducted a quick tour to the facility and observed no health and safety issues. At 2:00pm LPM and LPA spoke with three (3) staff members, staff #1 (S1), staff #2 (S1), and staff #3 (S3), that had knowledge of R1’s care and supervision at the facility. At 2:40 pm, LPA spoke with five (5) facility residents, including Resident#1's (R1’s) roommate, and Resident #2 (R2).
In addition, LPA Commer, requested and received facility records, including but not limited to R1’s physician report, medication administration and destruction records, incident reports involving R1, staffs testimonial about R1, and other documents pertinent to investigation.
(Continued on LIC9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2026
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 3
Control Number 31-AS-20260417090152
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: MELROSE VILLAS
FACILITY NUMBER: 197609076
VISIT DATE: 04/20/2026
NARRATIVE
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During this investigation at 1:40 pm, LPM Margaryan conducted a quick tour to the facility and observed no health and safety issues.
At 2:00pm, LPM and LPA spoke with three (3) staff members staff #1 (S1), staff #2 (S1) and staff #3 (S3) that had knowledge about R1’s care and supervision at the facility. At 2:40 pm, LPA spoke with five (5) facility residents, including Residnent'#1' (R1's) roommate and Resident #2 (R2).
In addition, LPA Comer, requested and reviewed facility records, including, but not limited to, R1’s physician report, medication administration and destruction records, incident reports involving R1, staff testimonials about R1, and other documents pertinent to investigation.

Allegation: Staff do not distribute resident's medication as prescribed.
It was alleged that R1’s medications, including patches, were not distributed to R1 as prescribed. Staff revealed that R1 does not follow facility medication administrator procedures and refuses to take their pills as prescribed. S1, who is a med tech assisting R1, revealed that R1 goes to the doctor, requests to change the dosage of medications, gets new orders from the pharmacy, and wants med techs to dispense a new order. When med tech explains that they need new prescription to change the order in the file, R1 gets upset, refuses the medication, yells at the staff and throws the med cup at them. Other residents interviewed during this visit, including R2, had no concerns regarding their medication assistance. R2 verified the information revealed by staff. A review of medication administration and destruction records corroborated the information received from the staff.
Based on interviews, and records review, there is not sufficient information to verify the allegation. Therefore, the allegation is unsubstantiated at this time.

Allegation: Staff do not provide a safe environment for residents.
It was alleged that R1 was verbally and physically abused by Resident #3 (R3). R3 was harassing R1 by calling him names, and talking badly about R1’s mother. On 04/16/26, R3 tried to fight R1, but did not touch them. S2, who witnessed both incidents, denies R3 fighting R1, or calling them names. S3 revealed that R1 always tried to fight and yell at other residents and staff. R3 denied fighting R1, or calling names. R3 stated that R1 yelled at him and called him names. R3 stated while R3 was trying to leave the dining room, R1 blocked the entrance so that R3 was unable to go out. (R3 uses wheelchair to ambulate.)
LPA Comer attempted to speak with R1. However, they were not available. A review of collected records did not provide any information to support the allegation.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20260417090152
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: MELROSE VILLAS
FACILITY NUMBER: 197609076
VISIT DATE: 04/20/2026
NARRATIVE
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Other residents verify that R1 was arguing with staff and residents.

Based on interviews, and records review, there is not verifiable information to support the allegation. Therefore, the allegation is unsubstantiated at this time.

Exit interview conducted and a copy of report was proved to the Administrator.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3