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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610370
Report Date: 11/04/2025
Date Signed: 11/04/2025 03:17:07 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
08/12/2025 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20250812142625
FACILITY NAME:MELROSE GARDENSFACILITY NUMBER:
197610370
ADMINISTRATOR:VILLEGAS, MARCOFACILITY TYPE:
740
ADDRESS:960 N. MARTEL AVENUETELEPHONE:
(323) 876-1746
CITY:LOS ANGELESSTATE: CAZIP CODE:
90046
CAPACITY:100CENSUS: 54DATE:
11/04/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Joseph WeiderTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Staff failed to ensure proper medication administration.
Staff violated resident rights to privacy and property security.
INVESTIGATION FINDINGS:
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Licensing Program Analyst, Abeye Duguma (LPA) conducted a subsequent complaint visit to investigate the above allegations. LPA met with Joseph Weider and explained the reason for the visit.

---Staff failed to ensure proper medication administration.

It was alleged that staff are leaving Resident #1’s (R1) medications in their rooms in a cup and then walking away without ensuring R1 took their medications once dispensed. To investigate the allegation, on 08/15/2025 at around 10:30a.m. LPA conducted a physical plant tour and requested documents. LPA also interviewed four (04) staff from 11:30a.m. to 2:00p.m. On 10/21/2025, LPA interviewed six (06) residents from around 11:30a.m. to 1:00p.m. A review of facility staff records shows that all MedTechs have completed all required training.
(CONT. on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
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 2
Control Number 31-AS-20250812142625
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 GARDENS
FACILITY NUMBER: 197610370
VISIT DATE: 11/04/2025
NARRATIVE
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During the physical plant tour, LPA did not observe medication left unattended or accessible to residents. During interviews with staff, all staff stated they do not leave medication unattended. During interviews with residents, R1 stated staff are leaving Resident #1’s (R1) medications in their rooms in a cup and then walking away without ensuring R1 took their medications once dispensed. All other residents stated staff ensure residents take their medications before walking away.

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

---Staff violated resident rights to privacy and property security.

It was alleged that staff do not knock on the door before entering. To investigate the allegation, on 08/15/2025 LPA interviewed four (04) staff from 11:30a.m. to 2:00p.m. On 10/21/2025, LPA interviewed six (06) residents from around 11:30a.m. to 1:00p.m. During interviews with staff, all staff stated they respect the residents’ right to privacy and knock on the door and announce their presence before entering. During interviews with residents, R1 stated staff do not knock on the door before entering. All other residents stated they feel staff do respect their privacy and knock before entering.

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

No health and safety hazards noted during the visit.

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

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2