<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609496
Report Date: 04/18/2026
Date Signed: 04/18/2026 12:07:27 PM

Substantiated


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
09/10/2025 and conducted by Evaluator Tihesha Smith
COMPLAINT CONTROL NUMBER: 31-AS-20250910141622
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: 74DATE:
04/18/2026
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Vick Stepanian, Maintenance DirectorTIME COMPLETED:
12:18 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff gave resident medications twice
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Tihesha Smith made an unannounced subsequent complaint visit to this facility at 10:15 a.m. LPA met with staff and disclosed the reason for the visit.

Staff gave resident medications twice

It was alleged that Staff #1 (S1) administered medications twice to Resident #1 (R1). To investigate the allegation on 09/11/25, LPA Smith interviewed the executive director and requested copies of facility documents relevant to the investigation and on 10/17/25 LPA Smith conducted interviews with staff and residents. The administrator revealed the following:R1 had an early morning medical appointment and requested to have their morning medications dispensed ahead of time so they could take them with them. (S1) dispensed R1’s medications and placed them in a plastic bag for R1 to take to the appointment. The administrator stated that R1 did not attend the appointment.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
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 5
Control Number 31-AS-20250910141622
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: 04/18/2026
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
(Cont from 9099)

Later that same morning, during routine medication rounds, R1 requested their medications again and became verbally aggressive to S1 by yelling and screaming, and due to the escalating behavior, S1 re-dispensed the same morning medications to R1.

During interview, R1 revealed S1 told them they had to take their medications again. R1 revealed they felt scared and intimidated, so they accepted the medications but did not ingest them. R1 acknowledged raising their voice but denied screaming at S1. LPA was unable to confirm whether the medications dispensed were the same medications due to the facility’s inability to retrieve the electronic records from a system that is no longer used. Interviews with residents revealed the following: five (5) residents received medications as prescribed and two (2) residents revealed they didn’t receive their medications. However, the administrator confirmed that S1 acknowledged dispensing the same medications twice to R1. S1 was not available for interview during licensing visits.

Based on the information obtained, there is enough information to verify the allegation. Therefore, the allegation is deemed SUBSTANTIATED at this time.

Deficiency cited on 809D

Exit interview conducted/Appeal rights/copy of report given.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 31-AS-20250910141622
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/24/2026
Section Cited
CCR
87465(c)(2)
1
2
3
4
5
6
7
Incidental Medical and Dental Care Services.
[...]Once ordered by the physician the medication is given according to the physician's directions.
1
2
3
4
5
6
7
All Med Techs will receive refresher training on proper dispensing, verifying prior administration, documentation, and de escalation. POC:04/24/26
8
9
10
11
12
13
14
This requirement was not met base on information obtained during investigation: Staff #1 dispensed R1’s morning medications twice.This duplicate medication administration posed a potential health and safety risk to R1.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
09/10/2025 and conducted by Evaluator Tihesha Smith
COMPLAINT CONTROL NUMBER: 31-AS-20250910141622

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: 74DATE:
04/18/2026
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Vick Stepanian, Maintenance DirectorTIME COMPLETED:
12:18 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Due to lack of supervsion, residents physically assaulted another resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Tihesha Smith made an unannounced subsequent complaint visit to this facility at 10:15 a.m. LPA met with staff and disclosed the reason for the visit.

Due to lack of supervsion, residents physically assaulted another resident

It was alleged that due to lack of supervision three residents kicked and threw water on R1 during breakfast. To investigate the allegation on 09/11/25, LPA Smith interviewed the executive director and requested copies of facility documents relevant to the investigation and on 10/17/25 LPA Smith conducted interviews with staff and residents. Interviews with three (3) of three (3) staff revealed they have never witnessed Resident #2, Resident # 3 (R3) Resident (R4) in a physical fight with (R1) although disagreements and arguments have occurred and reveal residents have supervison in common areas including the dining room.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20250910141622
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: 04/18/2026
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
(cont from 9099A)

On 09/10/25, R2 told R1 in a firm voice to stop yelling at the staff. Staff intervened before anything escalated. Administrator revealed she arrived later but staff were present in dining room providing supervision.

Based on the information obtained there is insufficient evidence to support the above 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.

Exit interview conducted/copy of report given.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5