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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610442
Report Date: 06/25/2025
Date Signed: 06/25/2025 03:33:09 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.ASC, 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
06/19/2025 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20250619143905
FACILITY NAME:LEISURE VALE ASSISTED LIVINGFACILITY NUMBER:
197610442
ADMINISTRATOR:ANGELA SMITHFACILITY TYPE:
740
ADDRESS:413 E. CYPRESS STREETTELEPHONE:
(818) 244-2323
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:199CENSUS: 178DATE:
06/25/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Angela SmithTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff do not communicate with responsible party regarding resident's care
INVESTIGATION FINDINGS:
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At approximately 11:00 a.m. on 06/25/25 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with the administrator and disclosed the reason for the visit.

To investigate the allegation above, LPA interviewed the administrator, staff, and residents between 11:15 a.m. and 3:00 p.m. today, conducted a record review of pertinent records, including but not limited to an admission agreement, medical assessment, care plan, and staff and client rosters at 11:30 a.m., and toured the facility inside and out at 12:15 p.m.

Regarding the allegation "Staff do not communicate with responsible party regarding resident's care" it was alleged facility staff have not provided care updates to the responsible party (RP) of Resident #1 (R1). Record review of R1’s facility file revealed they had a different RP from November 2022 until March 2025. R1's current RP tookover and became their Power of Attorney on 03/31/25. Review of R1’s hospice records indicated their most recent care plan update occurred on 02/03/25.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
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-20250619143905
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: LEISURE VALE ASSISTED LIVING
FACILITY NUMBER: 197610442
VISIT DATE: 06/25/2025
NARRATIVE
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 No changes have been to R1's care since then. Interview with the administrator today at 11:30 a.m. revealed they have communicated all aspects of R1’s care with the RP and spoke to the RP yesterday. The administrator also provided contact information of other members of R1’s care team to provide medication updates and documentation. Interview with R1 at 2:45 p.m. today revealed they are satisfied with all aspects of their care. R1 also noted they are informed of all aspects of care by the facility and care team. R1 did not know of any concerns from their RP. Interview with Staff #1 (S1) at 3:00 p.m. today revealed they have also communicated directly with the RP about R1’s care.

Based on interviews and record review, the facility has communicated with R1 and their responsible person for all care updates. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2