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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609496
Report Date: 03/09/2025
Date Signed: 03/09/2025 04:05:39 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
02/27/2024 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20240227123807
FACILITY NAME:ENCINO TERRACE SENIOR LIVINGFACILITY NUMBER:
197609496
ADMINISTRATOR:ARTEAGA, IRMAFACILITY TYPE:
740
ADDRESS:16025 VENTURA BLVDTELEPHONE:
(818) 986-8466
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY:85CENSUS: 31DATE:
03/09/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Katia ArriagaTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Cluttered room created an unsafe environment for resident.
Resident sustained a fall due to clutter in the room.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Abeye Duguma conducted a subsequent complaint visit to the facility to investigate the above allegations. LPA met with Katia Arriaga and explained the reason for the visit.

--- Cluttered room created an unsafe environment for resident.
--- Resident sustained a fall due to clutter in the room.

It was alleged that Resident #1’s (R1) room is cluttered and unsafe and contributed to a fall injury in September 2023. To investigate the allegations, on 03/04/2024 at around LPA Tihesha Smith conducted a physical plant tour and interviewed one (01) staff from around 01:45p.m. to 02:50p.m. On 03/09/2025 LPA Duguma conducted a physical plant tour at around 10:00a.m., reviewed documents at around 11:30a.m. to 12:15p.m., interviewed three (03) staff from 12:15p.m. to 1:30p.m. and six (06) residents from around 1:30p.m. to 3:00p.m.
(CONT. on LIC9099)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2025
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-20240227123807
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: 03/09/2025
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
During the physical plant tour, LPAs did not observe any clutter. A review of the department’s incident report records revealed R1 did not have a fall reported during the month in question. During interviews with staff on 03/09/2025, all staff stated they do not know R1 and are unfamiliar with their room or if they had a fall as they were all hired after the change of ownership and R1 was not a resident at the time of purchase. Staff #2 added, former owners have all files for R1. During interviews with residents, all residents stated they get housekeeping services one (01) to two (02) times a week and do not feel their room is an unsafe environment.

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

No health and safety hazards were noted during the visit.

Exit interview was conducted and a copy of the report was issued.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3