197609724-1-21-2026-31-AS-TAGD-DRTTBW-20260303133549

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609724
Report Date: 01/21/2026
Date Signed: 01/21/2026 01:30:43 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
01/16/2026 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20260116105316

FACILITY NAME:	MELROSE CHATEAU		FACILITY NUMBER:	197609724
ADMINISTRATOR:	ALLEN, CANDIS		FACILITY TYPE:	740
ADDRESS:	819 N POINSETTIA PL		TELEPHONE:	(323) 746-7840
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	12	CENSUS: 7	DATE:	01/21/2026
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Candis Allen, Administrator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff are refusing to administer medication to a resident in care

INVESTIGATION FINDINGS:

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On 01/21/26, at 9:15am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Administrator, Candis Allen. LPA explained the purpose of this visit was to gather information, interview staff and residents and deliver findings for this complaint.

On 01/21/26, LPA Saucedo asked for the census, staff, and resident rosters. On 01/21/26, at 9:55am, LPA Saucedo conducted a physical tour. On 01/21/26, at 10:15am, LPA Saucedo started to conduct resident and staff interviews.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
01/16/2026 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20260116105316

FACILITY NAME:	MELROSE CHATEAU		FACILITY NUMBER:	197609724
ADMINISTRATOR:	ALLEN, CANDIS		FACILITY TYPE:	740
ADDRESS:	819 N POINSETTIA PL		TELEPHONE:	(323) 746-7840
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	12	CENSUS: 7	DATE:	01/21/2026
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Candis Allen, Administrator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff relocated resident without proper notification

INVESTIGATION FINDINGS:

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Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 31-AS-20260116105316

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: MELROSE CHATEAU	FACILITY NUMBER: 197609724
	VISIT DATE: 01/21/2026

NARRATIVE

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Regarding the allegation: Staff relocated resident without proper notification. It is being alleged that resident #1 (R1) was moved without notice from one (1) building to another without notice. During LPA's interview with R1, R1 stated, "that they were originally in building 819 and was moved to building 823 without notice." During LPA's interview with Staff #1 (S1), S1 confirmed that R1 was moved from building 819 to building 823 because R1 was causing issues with residents in building 819 and was yelling at staff. LPA obtained and reviewed R1's admission agreement-page #12 and it did say that residents can be moved with the discretion of the executive director. Although the admission agreement does say this, S1 did not send any unusual reports to community care licensing department on behalf of R1's behaviors with residents and/or staff and S1 did not give R1 a thirty (30) day written notice of their room change. LPA interviewed four (4) out of five (5) residents that did not have an issue with R1 while living in building 819. LPA interviewed two (2) staff that did have an issue with R1 but those staff are also in the vicinity of building 823 that R1 now lives in. Therefore, based on the record reviews and interviews conducted, the allegation is SUBSTANTIATED at this time.

An exit interview was conducted, citation(s) were issued, appeal rights and a copy of this report was given to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260116105316

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: MELROSE CHATEAU	FACILITY NUMBER: 197609724
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/21/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/04/2026 Section Cited CCR 87468.2(a)(16)	1 2 3 4 5 6 7	(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (16)To written notice of any room changes at least 30 days in advance unless a room change is agreed to by the resident, required to fill a vacant bed, or necessary due to an emergency. This requirement is not met by:	1 2 3 4 5 6 7	A training record of staff about personal rights of residents is to be sent to CCLD/LPA. POC Due Date: 02/04/26
	8 9 10 11 12 13 14	Based on the LPA observation, record reviews and interviews the licensee/administrator did not ensure proper notice was given to the resident for room change the above facility which poses a potential Health, Safety or Personal Rights risks to persons in care.	8 9 10 11 12 13 14
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	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: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260116105316

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: MELROSE CHATEAU	FACILITY NUMBER: 197609724
	VISIT DATE: 01/21/2026

NARRATIVE

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Regarding the allegation: Staff are refusing to administer medication to a resident in care. It is being alleged that resident #1 (R1) is not been giving their medication. During LPA's interview with R1, R1 stated, "they had recently moved to the above facility and was not receiving their medication for about two (2) or three (3) days but now they are receiving their medication. LPA interviewed staff #1 (S1) and stated, "that R1 is receiving their medication." In addition, S1 confirmed that they were waiting for R1's prescription to transfer from the other facility that R1 came from. LPA also interviewed staff #2 (S2), that stated, "they were waiting for R1's medication release form from the prior facility that R1 came from to provide R1 with their medication." Also, S2 did confirm that R1 is receiving their medication since January 13, 2026. During LPA's record review of R1's admission agreement and Centrally Stored Medication Record R1 moved in January 12, 2026 and R1's medication was transferred the following day January 13, 2026 from the other facility R1 transferred from. The Centrally Stored Medication Record shows R1 was receiving their medication since January 13, 2026. LPA also interviewed seven (7) residents that confirm they do receive their medication. Therefore, based on the record reviews and interviews conducted, the allegation is UNSUBSTANTIATED at this time.

An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

LIC9099 (FAS) - (06/04)

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