197609076-10-5-2026-31-AS-NMAN-DYVV6X-20261015161015

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609076
Report Date: 10/05/2026
Date Signed: 10/05/2026 12:16:13 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
12/17/2025 and conducted by Evaluator Raymond Comer

COMPLAINT CONTROL NUMBER: 31-AS-20251217160735

FACILITY NAME:	MELROSE VILLAS		FACILITY NUMBER:	197609076
ADMINISTRATOR:	ALLEN, CANDIS		FACILITY TYPE:	740
ADDRESS:	823 N POINSETTIA PLACE		TELEPHONE:	(323) 746-7840
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	68	CENSUS: 51	DATE:	10/05/2026
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Stepan Sarmazian-Administrator		TIME COMPLETED:	12:25 PM

ALLEGATION(S):

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Staff do not ensure residents receive necessary incidental medical services.
Staff did not observe and manage resident for changes in his health condtion.
Staff did not ensure resident was evaluated for changes of the health condtion.

INVESTIGATION FINDINGS:

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On 10/05/26, Licensing Program Analyst, (LPA) Raymond Comer, arrived at the facility to conduct a subsequent visit regarding the allegation(s) listed above. On 12/22/25, LPA Tuesday Cabiness conducted the initial complaint visit, at which time, LPA spoke with the facility Administrator, obtained and reviewed facility roster, staff roster, Resident #1's (R1's) file, and other documents relevant to the investigation.

At 10:10 am today, LPA Comer conducted a tour to the facility; no health/safety issues were observed.
Between 10:25 am and 11:15 am, LPA spoke with Administrator, and a staff. Between 11:30 am and 12:10 pm, LPA Comer spoke with five (5) out of a total of fifty-one (51) residents. It is noted that on 10/03/26, LPA Comer obtained and reviewed facility roster, staff roster, R1's physicians report, Health progress notes, Unusually Incident Reports (UIR's) and other documents relevant to the investigation.

[LIC 9099C] Continued-

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2026

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-20251217160735

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: 10/05/2026

NARRATIVE

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Allegation: Staff do not ensure residents receive necessary incidental medical services- It was reported that Resident #1 (R1) had a leg wound whose condition worsened due to staff neglecting to provide R1 incidental medical services. LPA Comer's Interviews with Administrator and a staff revealed that staff observed R1 experiencing pain and the appearance of inflammation from the wound. The facility arranged R1's transportation to the hospital for a health assessment and treatment for the wound.
All five (5) residents interviewed stated their satisfaction with staff's provision of incidental med services.
LPA Comer's review of documents revealed the following: R1's file provides evidence showing that R1 received weekly wound care assistance from Home Health (HH) staff. Internal records revealed that staff assisted R1 as required while HH Nurse was not present. Incident reporting verified that staff noted a worsening condition of R1's wound and arranged transportation sending R1 to the Hospital for medical assessment/treatment of the wound.

Based on interviews, and documents review, the facility assisted R1 with obtaining medical care. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Allegation: Staff did not observe and manage resident for changes in his health condition-
Allegation: Staff did not ensure resident was evaluated for changes of the health condition -It was reported Staff neglected to monitor and evaluate R1’s leg wound and provide required medical evaluation/assessment to appropriately respond to changes in the condition of the leg wound. LPA Comer's Interviews with Administrator and a staff revealed the following: Staff observed the appearance of inflammation and consulted with HH staff concerning R1's wound. However, facility staff were not medical professionals and were unable to provide skilled nursing care. Since HH nurse was not present at the facility, facility staff arrange medical transportation to send R1 to the hospital for further evaluation. All five (5) residents interviewed by LPA stated they are consistently monitored and responded to by staff for any health changes.
LPA Comer's review of documents verified the information revealed by Admin and staff. HH Nursing Visit Notes show that R1 was provided weekly evaluation and assessment of their wound. Records also revealed that upon observation of worsening changes in R1's wound, staff sent R1 to the Hospital for further evaluation and treatment.

Based on interviews and documents review, the facility observed and responded to changing conditions of R1’s wound and ensured proper medical evaluation due to change in the condition of R1's wound. Therefore, the allegations are deemed UNSUBSTANTIATED at this time.

Exit interview provided, and a copy of report given to Administrator.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2026

LIC9099 (FAS) - (06/04)

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