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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610375
Report Date: 12/23/2025
Date Signed: 12/23/2025 11:44:12 AM

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
12/18/2025 and conducted by Evaluator Gina Saucedo
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20251218215152
FACILITY NAME:ELITE RETIREMENT RESIDENCEFACILITY NUMBER:
197610375
ADMINISTRATOR:BERKOWITZ,DENISEFACILITY TYPE:
740
ADDRESS:6900 ROYER AVENUETELEPHONE:
(818) 640-2475
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY:6CENSUS: 5DATE:
12/23/2025
UNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Denise Berkowitz, AdministratorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff did not allow residents to have private conversations
Staff did not provide resident adequate food service
Staff did not provide resident with comfortable living accomodations
Staff did not ensure residents were provided daily activities
INVESTIGATION FINDINGS:
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On 12/23/25, at 7:50am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Caregiver, Martha Detloff. The Caregiver called the Administrator and they arrived shortly after. LPA explained the purpose of this visit was to gather information, interview staff and residents and deliver findings for this complaint.

On 12/23/25, LPA Saucedo asked for the census, staff, and resident rosters. On 12/23/25, at 8:15am, LPA Saucedo conducted a physical tour, interviewed staff and attempted to interview residents. LPA also obtained Resident #1 (R1)'s, Admission Agreement, Medical Assessement, Preplacement Plan and Appraisal Needs/Services Plan.

LIC 9099C-continued

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
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 6
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
12/18/2025 and conducted by Evaluator Gina Saucedo
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20251218215152

FACILITY NAME:ELITE RETIREMENT RESIDENCEFACILITY NUMBER:
197610375
ADMINISTRATOR:BERKOWITZ,DENISEFACILITY TYPE:
740
ADDRESS:6900 ROYER AVENUETELEPHONE:
(818) 640-2475
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY:6CENSUS: 5DATE:
12/23/2025
UNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Denise Berkowitz, AdministratorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide sufficient notice prior to increasing resident's rent
Staff did not provide a detailed itemized explanation of the additional
services to be provided in resident's rental increase
Staff did not appraise resident as needed to determine resident's required level of service
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
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10
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13
On 12/23/25, at 7:50am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Caregiver, Martha Detloff. The Caregiver called the Administrator and they arrived shortly after. LPA explained the purpose of this visit was to gather information, interview staff and residents and deliver findings for this complaint.

On 12/23/25, LPA Saucedo asked for the census, staff, and resident rosters. On 12/23/25, at 8:15am, LPA Saucedo conducted a physical tour, interviewed staff and attempted to interview residents. LPA also obtained Resident #1 (R1)'s, Admission Agreement, Medical Assessement, Preplacement Plan and Appraisal Needs/Services Plan.

LIC 9099C-continued

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
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 6
Control Number 31-AS-20251218215152
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: ELITE RETIREMENT RESIDENCE
FACILITY NUMBER: 197610375
VISIT DATE: 12/23/2025
NARRATIVE
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Regarding the allegation: Staff did not provide sufficient notice prior to increasing resident's rent. It is being alleged that resident #1 (R1)’s was issued a 30-day notice increase from $6,500 to $9,000. LPA interviewed R1, and asked why the rent had increased but R1 did not know. R1 stated, “I just moved in August 31 and my rent was $6500.00.” LPA asked how much notice did you receive and R1 stated, “I didn’t receive a notice my daughter did.” LPA interviewed R1’s daughter via telephone and R1’s daughter stated, “I received a written 30-day notice. LPA received and reviewed the 30-day notice that was given to R1’s daughter. LPA interviewed staff #1 (S1) that admitted a 30-day notice had been given to R1’s daughter because R1 was demanding more help. Therefore, based on the LPA’s interviews and record review the allegation(s) are SUBSTANTIATED at this time.

Regarding the allegation: Staff did not provide a detailed itemized explanation of the additional
services to be provided in resident's rental increase. During LPA's interview with staff #1 (S1), S1 did not have a detailed itemized explanation of the additional services to raise resident #1 (R1)'s rent. LPA asked staff #2 if anything had changed with R1's services since R1's admission to the facility in August of 2025 and S2 confirmed there was no changes to R1 and that R1's health had actually improved since they arrived to the facility. Therefore, based on the LPA’s interviews and record review the allegation(s) are SUBSTANTIATED at this time.

Regarding the allegation: Staff did not appraise resident as needed to determine resident's required level of service. It is being alleged that resident #1 (R1) did not get the appraisals for a change in condition. During LPA’s interview with R1, LPA asked if any resident reappraisals were conducted and/or did anything change with their condition and R1 stated, “no, I wasn’t even there for three (3) months, nothing has changed.” During LPA’s interview with R1’s daughter, LPA asked if R1 was ever reappraised and/or did any health condition, functional capabilities, physician’s report/medical assessment change and R1’s daughter stated, “nothing has changed with R1 since their arrival to the facility.” LPA interviewed staff #1 (S1) and staff # 2 (S2) and asked for the resident’s reappraisal’s, changes in functional capabilities and/or physician’s report/medical assessment showing that R1 needed increased level of care but there was no change to R1's health requiring higher level of care. S1 did not have any updated paperwork since R1’s arrival to the facility on August 2025. Therefore, based on the LPA’s interviews and record review the allegation(s) are SUBSTANTIATED at this time.

An exit interview was conducted, citation(s) were issued for the above allegation(s), appeals rights provided,a copy of this report was given to the Administrator/Licensee.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 31-AS-20251218215152
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: ELITE RETIREMENT RESIDENCE
FACILITY NUMBER: 197610375
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/06/2026
Section Cited
HSC
1569.655(a)
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(a) If a licensee of a residential care facility for the elderly increases the rates of fees for residents...the licensee shall provide no less than 90 days’ prior written notice to the residents or the residents’ representatives setting forth the amount of the increase and the reason or reasons for the increase, including a description of the additional costs, except for an increase in the rate due to a change in the level of care of the resident. This requriement is not met by:
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The licensee/Administrator shall provide training to all staff to update all paperwork for higher level of care such as resident reappraisals to increase rent.

POC Due Date: 01/06/26
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Based on the LPA's observations the licensee/administrator failed to ensure that the facility gave a proper notice to resident #1 for rent increase. This posed an potential health and safety risk to residents in care.
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Type B
01/06/2026
Section Cited
CCR
87507(3)(b)(2)
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Payment provisions, including the following: (B) Rate for additional items and services, including:2. A separate charge for an item or service may be assessed only if that charge is included in and authorized by the admission agreement. This requirement was not met by:
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The licensee/Administrator shall provide a separate charge for additional services not included in the admission agreement to resident and/or resident's guardian with proper notice.

POC Due Date: 01/06/26
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Based on the LPA's observations the licensee/administrator failed to ensure that a separate charge for an item/service was not included in the admission agreemment changing their rate. This posed an potential health and safety risk to residents in care.
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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: 12/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 31-AS-20251218215152
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: ELITE RETIREMENT RESIDENCE
FACILITY NUMBER: 197610375
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/06/2026
Section Cited
CCR
87463(a)
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The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes... For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. This requirement was not met by:
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The licensee/Administrator shall update/provide resident reappraisals for all residents upon changes of resident's conditions.


POC Due Date: 01/06/26
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Based on the LPA's observations the licensee/administrator failed to ensure that the facility reappraised resident #1. This posed an potential health and safety risk to residents in care.
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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: 12/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 31-AS-20251218215152
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: ELITE RETIREMENT RESIDENCE
FACILITY NUMBER: 197610375
VISIT DATE: 12/23/2025
NARRATIVE
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Regarding the allegation: Staff did not allow residents to have private conversations. It is being alleged that the residents don’t have confidential calls. During LPA's interview with staff # 1, 2 and 3, they all confirmed that resident #1 (R1) could not hear well and R1 would sit in the living room and talk loudly on the phone. During LPA interview with R1, R1 did admit they cannot hear well. During LPA's record review of Preplacement Appraisal and Appraisal/Needs and Services Plan it does show that R1 has a hearing problem. Therefore, based on the LPA’s interviews and record review the allegation(s) are UNSUBSTANTIATED at this time.

Regarding the allegation: Staff did not provide resident adequate food service. It is being alleged that there are no snacks provided for the residents. During LPA's interview with staff # 1, 2 and 3, they all confirmed that resident #1 (R1) ate several meals throughout the day. There is no designated time for residents to eat. Residents are provided three (3) meals a day with food in between if they get hungry. During LPA's interview with R1, R1 did confirm that they never asked for any snacks. Therefore, based on the LPA’s interviews and food menu review the allegation(s) are UNSUBSTANTIATED at this time.

Regarding the allegation: Staff did not provide resident with comfortable living accommodations. It being alleged that the mattress for resident #1 (R1) gave R1 back issues. During LPA's interview with staff # 1, 2 and 3, they all confirmed that resident #1 (R1) was not happy with their bed upon their admission but they did change it. Staff 1and 2 did confirm that R1's bed was changed twice since they had lived at the facility. During LPA's interview with R1, R1 did confirm that they were comfortable at the end of their stay at the above facility. Therefore, based on the LPA’s interviews, the allegation(s) are UNSUBSTANTIATED at this time.

Regarding the allegation: Staff did not ensure residents were provided daily activities. It is being alleged that there are no scheduled activities. During LPA's interview with staff # 1, 2 and 3, they all confirmed that all residents are provided different activities. Staff # 2 confirmed that resident # 1 and resident #2 would play checkers all the time. During LPA's interview with R1, R1 confirmed that all residents like to stay in their room including them so they didn't participate in all, only some activities. Therefore, based on the LPA’s interviews, the allegation(s) are UNSUBSTANTIATED at this time.

An exit interview was conducted, no citation(s) were issued for the above allegation(s), a copy of this report was given to the Administrator/Licensee.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6