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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609496
Report Date: 11/05/2025
Date Signed: 11/05/2025 05:11:23 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
08/06/2025 and conducted by Evaluator Tihesha Smith
COMPLAINT CONTROL NUMBER: 31-AS-20250806114836
FACILITY NAME:ENCINO TERRACE SENIOR LIVINGFACILITY NUMBER:
197609496
ADMINISTRATOR:ROSE YOUSEFIANFACILITY TYPE:
740
ADDRESS:16025 VENTURA BLVDTELEPHONE:
(818) 986-8466
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY:85CENSUS: 58DATE:
11/05/2025
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Rose Yousefian, Executive DirectorTIME COMPLETED:
05:10 PM
ALLEGATION(S):
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Staff do not ensure medications are dispensed as prescribed to resident in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tihesha Smith conducted an unannounced subsequent complaint visit to this facility to investigate the allegations above. LPA Smith was greeted by staff and LPA Smith disclosed the purpose of the visit.
At approximately 10:35 am, LPA Smith requested copies of facility documents relevant to the investigation from approximately 10:35 am, interviewed six (6) residents and six (6) staff from 11:15-4:17pm. LPA Smith also toured facility grounds at 1:28 pm and 3:05 pm. LPA Smith conducted an initial investigation on 08/13/25.

Staff do not ensure medications are dispensed as prescribed to resident in care
It was alleged that Resident #1 (R1) is not receiving thier medications twice a day. Interview with the administrator on revealed 08/13/25 revealed that the medication staff use Caring data to dispense the medication and deny validity of the allegation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
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-20250806114836
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: 11/05/2025
NARRATIVE
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Three (3) staff interviewed revealed they or staff dispensing medication follow proper medication administration and deny the allegation. Interview with R1 revealed they do not have an issue with the dispensing of their medication.

Based on the information obtained, there is not enough evidence to prove that Staff do not ensure medications are dispensed as prescribed to resident in care. Therefore, the allegation is deemed Unsubstantiated.

Exit interview conducted, Copy of report given.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3