197609496-3-6-2026-31-AS-NMAN-DU8UFT-20260519153317

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609496
Report Date: 03/06/2026
Date Signed: 03/06/2026 02:51:01 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
08/25/2025 and conducted by Evaluator Tihesha Smith

COMPLAINT CONTROL NUMBER: 31-AS-20250825092249

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: 60	DATE:	03/06/2026
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Rose Yousefian, Executive Director		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Administrator intimidated resident
Staff allowed for a resident to expose themself indecently to others
Resident wandered out of the facility unsupervised
Staff allowed for a resident to shout obscenities at other residents
Staff did not assist a resident with an injury

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tihesha Smith conducted an unannounced subsequent complaint visit to deliver findings. LPA Smith was greeted by staff. and LPA Smith disclosed the purpose of the visit.
On 09/22/25, LPA Smith delivered findings for one allegation. On August 15, 2025, LPA Smith interviewed three (3) staff members, reviewed records, and requested copies of facility documents relevant to the investigation from approximately 10:25 a.m. to 2:10 p.m.

Allegation: Administrator intimidated resident

It was alleged that staff intimidated Resident#1 (R1) into signing paperwork by using threats or coercive behavior. To investigate this allegation, LPA interview staff #1 (S1) and Staff #2 (S2), who both denied forcing or intimidating R1 and stated facility documentation for medication program was explained to (R1) in order for R1 to be compliant with medical care/medications.
(cont to 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

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 4

Control Number 31-AS-20250825092249

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: 03/06/2026

NARRATIVE

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(Cont from 9099)
During the interview with R1 on 12/04/25, R1 was asked about the identity of the unknown male who allegedly intimidated them. R1 indicated they did not know what male was being referenced and did not provide any explanation related to the allegation. When asked whether they had any safety concerns within the community and/or with staff, R1 stated they did not. They reported enjoying living in the community, participating in games and activities, and feeling safe in the facility. They did note, however, that some staff lack appropriate training for their roles. Interviews with five (5) of (6) six residents indicated they had never been intimidated by staff and had never observed staff intimidating other residents.

Based on the information obtained during the course of this investigation, there is insufficient evidence to support the allegation Administrator intimidated resident. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Staff allowed for a resident to expose themself indecently to others

It was alleged that staff allowed a resident to expose themself indecently to others. To investigate the allegations on 8/13/25, LPA Smith conducted a 10-day visit at which time LPA Smith requested documents relevant to the investigation, interviewed with the administrator and three (3) residents. Interview with S2 reveal was assisting resident #3 (R3) in their room when resident #2 (R2) opened door by accident and immediately apologized for opening the wrong door. Staff revealed that R3 did not get into R3 bed and/or expose themself indecently to others nor did R3 scream and run out of their room. Interview with administrator revealed follow-up was conducted with R2 who admitted to having a beverage containing alcohol prior to coming back to the facility and heading to their room. Interview with R2 revealed that they opened the wrong door on the way to their room but denied getting into R3’s bed and denied exposing themselves indecently to anyone. LPA was unable to interview R3 as residents no longer reside at the facility.

Based on the information obtained during course of investigation, there is insufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Continue to (9099C)

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 31-AS-20250825092249

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: 03/06/2026

NARRATIVE

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(Cont from 9099C)
Resident wandered out of the facility unsupervised
Regarding the allegation above, interview with the ED (executive director) revealed that Resident #8 (R8) is not a resident of Encino Terrace Senior Living but of North Lake Villa and does not maintain any records on the resident additionally are no longer providing temporary location services for Northlake Villa residents as of 12/31/25. Per review of dept internal notes and/or incident reports R8 eloped from facility on 08/16/25. However, information received from staff #8 (S8) by licensing staff on 08/18/25 reveal that all relevant parties were contacted and due to R8 having good mental status, they were able to leave the facility unattended.

Staff allowed for a resident to shout obscenities at other residents

It was alleged that Staff allowed for a resident to shout obscenities at other residents. Interview with staff revealed that did not allow resident to shout obscenities however, (R3) has history of psychological issues and having behavior episodes so was sent to the hospital on 08/26/25 and then transferred to a skilled nursing facility (SNF). S1 revealed they took appropriate action to address behavioral issues with R3. LPA Smith was unable to interview R3 as residents no longer reside at the facility.
Based on the information obtained during course of investigation, there is insufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time

Staff did not assist a resident with an injury

It was alleged staff did not assist a resident with an injury. Per interview with S1, resident # 9 (R9) has various repetitive soothing behaviors to include rocking, laughing, and putting tissue or straws in nostrils and S1 denies R9 have any injuries that required medical aid or treatment. Review of R9 physician’s report on 03/06/26 reveal R9 has multiple diagnoses to include but not limited to anxiety disorder and schizophrenia. LPA Smith attempted to interview R9 but R9 did not respond to any questions. During previous licensing visits LPA Smith observed R9 removing tissue from nostrils with no blood present on tissues with staff

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 31-AS-20250825092249

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: 03/06/2026

NARRATIVE

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(cont from 9099C)
attempting to assist R9.

Based on the information obtained during course of investigation, there is insufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time

No hazards observed during visit.

Exit interview /conducted copy of report sent.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026

LIC9099 (FAS) - (06/04)

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