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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610370
Report Date: 12/29/2025
Date Signed: 12/29/2025 12:02:32 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
12/23/2025 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20251223092143
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: 56DATE:
12/29/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Joseph WeiderTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff withheld medication from a resident in care.
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 #1 (S1) withheld Resident #1's (R1) insulin at 4:30p.m on 12/29/2025. when requested. To investigate the allegation, on 12/29/2025 at around 10:00a.m, LPA requested documents and interviewed three (03) staff and six (06) residents 10:30a.m. to 12:00p.m. A review of physician's orders states R1 is to take insulin at 8:00a.m., 12:00p.m. and 4:00p.m. A review of facility staff records shows R1 received all medications as prescibed on the date of the alleged incident. A review of the facility staff schedule shows S1 was not working on the date of the alleged incident. During interviews with staff, all staff stated they do not refuse resident medications and R1 was given their medications as prescribed.
(CONT. on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025
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-20251223092143
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: 12/29/2025
NARRATIVE
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During interviews with residents, R1 stated S1 did not give insulin when requested and did not offer a reason why R1 was not going to get insulin. All other residents stated staff give medications as prescribed and are not refused medications.

Based on interviews and record review, 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: 12/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2