197609076-5-4-2026-31-AS-NMAN-DU9W3N-20260520165614

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609076
Report Date: 05/04/2026
Date Signed: 05/04/2026 11:56:10 AM

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
06/13/2025 and conducted by Evaluator Raymond Comer

COMPLAINT CONTROL NUMBER: 31-AS-20250613093622

FACILITY NAME:	MELROSE VILLAS		FACILITY NUMBER:	197609076
ADMINISTRATOR:	VERGARA, KANDICE		FACILITY TYPE:	740
ADDRESS:	823 N POINSETTIA PLACE		TELEPHONE:	(323) 746-7840
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	68	CENSUS: 44	DATE:	05/04/2026
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Candis Allen-Administrator		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff do not safeguard resident's personal belongings.
Staff is not providing residents with outings.

INVESTIGATION FINDINGS:

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On 5/04/26, Licensing Program Analyst, (LPA) Raymond Comer, arrived at the facility to conduct a subsequent visit regarding the allegation(s) listed above. LPA conducted the initial complaint visit on 06/20/25, at which time LPA spoke with the facility Administrator, Staff, and Witnesses knowledgable of the allegations noted above. From 8:30 am to 10:00 am, LPA reviewed facility's resident and staff roster, and documents which included, but were not limited to, Resident#1's (R1's) file, conservator's documentation, personal property/valuables log, admissions Agreement, assessments, and other documents relevant to the investigation. Between 10:20 am and 11:05 am, LPA conducted a tour of facility commons, and an inspection of random resident bedrooms. From 11:15 am to 1:30 pm, LPA interviewed residents and staff.
During today's visit, at 10:15 am, LPA Comer conducted a quick tour to the facility and inspect for any health and safety issues. At 10: 45 am, LPA spoke with two additional (2) staff members, and three (3) additional residents, making a total of nine (9) out of a total of forty-four (44) residents interviewed.

[LIC 9099C] Continued-

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2026

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-20250613093622

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: 05/04/2026

NARRATIVE

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Allegation: Staff do not safeguard resident's personal belongings- It was alleged several items of R1's clothing (shirts, socks, and underwear) were missing and potentially stolen, due to staff neglect.
Today, LPA's interview with the administrator revealed that during the meeting with R1 and their responsible family member, they had agreed to create an inventory of all the personal belongings of R1 and turn it over to the facility at a later date. However, submittal of said inventory never materialized. Finally, Both Administrator and R1’s conservator confirmed to LPA that although none of the items reported missing are listed on R1’s inventory log, licensee replenished R1 with new shirts, socks, and financially reimbursed R1’s conservator for clothing items. LPA interviews with nine (9) out at total of forty-four (44) residents revealed their satisfaction with staff safeguarding of resident's belongings.
LPA's record review revealed that R1's client/personal property and valuables (LIC 621) signed by R1's conservator did not list any personal belongings. The information documented corroborated with staff statement.

Based on interviews and records review, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Allegation: Staff is not providing residents with outings- It was alleged that staff suspended resident outings, which includes walks to the park, or going to local convenience stores. LPA observed that facility maintains a full time Activities Director, and that staff-supervised resident outings resumed on May 2025.
Interviews with Administrator revealed that during the time the allegation was reported, Staff were unable to conduct resident outings to the park, as major sections of the park were sectioned off by the city in order to complete construction modifications. Most of the facility's residents, including R1, were authorized to leave the facility unattended, coming and going as they choose. LPA interviews with nine (9) out of forty-four (44) residents confirmed they are satisfied with both venturing to the community’s outdoor courtyard areas, and many of the facility's residents are authorized to leave to community unassisted by staff. Residents verified that they had knowledge about construction at the Park. LPA's record review revealed that facility has a posted activity calendar, and the dates were accurate. Outings to the park were not conducted due to issues outside of control of the facility .

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20250613093622

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: 05/04/2026

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	Based on interviews, and records review, it was concluded that residents’ activities were not suspended by facility staff. The participation was hindered by external factors beyond the facility’s control. Therefore, the allegation is UNSUBSTANTIATED at this time. Exit interview conducted, and a copy of the report was issued to the administrator.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2026

LIC9099 (FAS) - (06/04)

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