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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610442
Report Date: 11/07/2025
Date Signed: 11/07/2025 08:55:57 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
11/05/2025 and conducted by Evaluator Abeye Duguma
COMPLAINT CONTROL NUMBER: 31-AS-20251105122800
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: 167DATE:
11/07/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Stephanie OdenTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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9
Staff leaves resident soiled for an extended period of time.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to investigate the above allegation. LPA met with administrator, Stephanie Oden, and explained the reason for the visit.

---Staff leaves resident soiled for an extended period of time.

It was alleged that staff left Resident #1 (R1) waiting for pull ups. R1 called the front desk for the first time and the staff said they'll bring it but still has not received the pull ups and waiting for two (02) hours and it happens frequently. To investigate the allegation, on 11/07/2025 LPA requested documents at around 10:00a.m., interviewed three (03) staff from 11:00a.m. to 12:30p.m. and sixteen (16) residents from 12:30p.m. – 3:00p.m.

(CONT on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
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-20251105122800
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: LEISURE VALE ASSISTED LIVING
FACILITY NUMBER: 197610442
VISIT DATE: 11/07/2025
NARRATIVE
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A review of Residents Care assignments and Facility Staff Schedule shows facility has on average eight (08) care staff providing incontinent care to fifty-seven (57) incontinent residents. During interviews with staff, all staff stated they check on and change incontinent residents every two (02) hours or as needed. Staff added residents are not left soiled for an extended time and calls for service are answered on average within eight (08) to ten (10) minutes. Staff added each caregiver overseas on average seven (07) incontinent residents to check on residents every two (02) hours. Staff do not recall the alleged incident. During interviews with residents, one (01) resident stated they are left soiled for an extended time and finds the response time is very slow. All other residents stated they are checked on often and all incontinent residents stated they are not left soiled for an extended time.

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. A copy of the report was issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2