197609496-9-15-2025-31-AS-NMAN-DMARL8-20251009130643

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609496
Report Date: 09/15/2025
Date Signed: 09/15/2025 04:08:06 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
09/12/2025 and conducted by Evaluator Tihesha Smith

COMPLAINT CONTROL NUMBER: 31-AS-20250912151449

FACILITY NAME:	ENCINO TERRACE SENIOR LIVING		FACILITY NUMBER:	197609496
ADMINISTRATOR:	ROSE YOUSEFIAN		FACILITY TYPE:	740
ADDRESS:	16025 VENTURA BLVD		TELEPHONE:	(818) 986-8466
CITY:	ENCINO	STATE: CA	ZIP CODE:	91436
CAPACITY:	85	CENSUS: 57	DATE:	09/15/2025
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Rose Yousefian, Executive Director		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff did not provide adequate food service to resident in care
Staff are unable to communicate with resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tihesha Smith conducted an unannounced complaint visit to this facility to investigate the allegations above. LPA Smith was greeted by staff. The administrator was present at the facility and LPA Smith disclosed the purpose of the visit.

Allegation #1 Staff did not provide adequate food service to residents in care

To investigate this allegation, on 09/15/2025, from approximately 10:35 a.m. - 3:45 p.m. LPA Smith conducted interviews with the Administrator, staff, and residents, and reviewed facility files relevant to the investigation. During record review Resident #2 (R2) records did not have any notes, assessments, service plan or doctors’ instructions requiring food to be served cut up. Interviews with staff reveal no instructions for R2 foods to be cut up. During the interview with R2, they communicated by hand gesture and shaking head in response to needing food cut up.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025

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-20250912151449

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: ENCINO TERRACE SENIOR LIVING	FACILITY NUMBER: 197609496
	VISIT DATE: 09/15/2025

NARRATIVE

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(Cont from 9099)

The sample population of residents interviewed revealed they do not have an issue with the food service, the food is good, staff are timely with food service and do their best in providing prompt services and any food services needed. LPA also observed staff delivering food to residents who prefer to dine in their room, observed fresh food being served and menu available.

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

Allegation #2 Staff unable to effectively communicate with residents while in care

LPA Smith conducted interviews with the Administrator, staff, and residents, and reviewed facility files relevant to the investigation. During interviews staff revealed they don’t have issues communicating with residents although staff may need to take time or talk slowly or louder with some clients due to hearing aids or residents that speak another language. During today’s visit, LPA observed that Resident #1 (R1) does not speak English and required some assistance to speak with the LPA, however LPA and staff were able to communicate with resident using short phrases, single words, and gestures. According to Title 22 Regulations, staff must be able to communicate with residents but are not required to speak the residents’ language. Per interview with staff: Resident #2 (R2) speaks Spanish and most facility staff including kitchen staff are able to communicate in Spanish. Interview with R2 (with the assistance of staff providing translation) R2 states does not have any issues communicating with staff. The sample population interviewed revealed they do not have any issues concerning communicating with staff and/or ordering food. Based on interviews, observation and Title 22 Regulations this allegation is unsubstantiated.

No health and safety hazards noted during the visit.

Exit interview conducted/Copy of report given.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025

LIC9099 (FAS) - (06/04)

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