197610442-4-22-2026-31-AS-TAGD-DTVSW3-20260508141342

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610442
Report Date: 04/22/2026
Date Signed: 04/22/2026 01:35:13 PM

Substantiated

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
03/10/2026 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20260310154619

FACILITY NAME:	LEISURE VALE ASSISTED LIVING		FACILITY NUMBER:	197610442
ADMINISTRATOR:	STEPHANIE ODEN		FACILITY TYPE:	740
ADDRESS:	413 E. CYPRESS STREET		TELEPHONE:	(818) 244-2323
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	199	CENSUS: 161	DATE:	04/22/2026
		UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Stephanie Oden- Executive Director		TIME COMPLETED:	01:35 PM

ALLEGATION(S):

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Staff do not prevent resident from eloping from the facility

INVESTIGATION FINDINGS:

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On 04/22/26, at 8:20am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Stephanie Ogden, Administrator. LPA explained the purpose of this visit was to gather additional information and deliver findings for this complaint.

On 03/18/26, LPA Saucedo conducted the initial complaint visit. On 04/22/26, at 8:50am, LPA Saucedo conducted a physical tour, interviewed additional staff and residents.

LIC 9099C-continued

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026

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 3

Control Number 31-AS-20260310154619

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: 04/22/2026

NARRATIVE

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Regarding the allegation: Staff do not prevent resident from eloping from the facility. It is being alleged that resident #1 (R1) is currently missing and has dementia. During LPA’s file review of R1, R1 did not have an updated physician report, did not have a resident reappraisal and did not have a needs and services plan. On 12/11/23, 01/05/24 and 02/05/24, R1 had a doctor stating, "R1's Psychiatric Evaluation behavior/problem/Issue is Dementia." R1 was admitted to the above facility on 06/28/23 and R1's physician report was dated 08/30/24. R1's pre-placement Appraisal was dated 03/28/23 and under service needed states R1 needs special observation/night supervision (due to confusion, forgetfulness, wandering). R1 was also under the Assisted Living Waiver which states R1 had dementia. R1 could not be interviewed because R1 never returned to the facility after they left, instead R1 was found and taken to a hospital. R1 is now transferred to a Memory Care Facility and is no longer at the above facility. During LPA's physical tour, LPA determined that there are two (2) exit doors towards the left side of the facility that are not monitored by staff and/or do not have an auditory device and/or perimeter fence gates. LPA interviewed five (5) staff that confirmed anyone can come in and out of those exit areas. One (1) staff did confirm that “R1 had left the facility a couple years ago but did return.” Another staff stated, "R1 along with other residents are not to leave the facility and the front desk is aware of it." During LPA’s interview with the front desk staff, the front desk staff did not know and could not give the LPA a list of the residents not able to leave the facility unattended/unassisted but did state, "we have cameras." LPA took a look at the cameras and five (5) of the cameras were not working. Furthermore, LPA took a picture of the cameras not working and the two (2) side exit doors where anyone can enter and exit. LPA interviewed sixteen (16) residents. Eight (8) out of the sixteen (16) residents, were residents that cannot leave the facility unassisted/unattended. Therefore, based on the LPA's observations, file review, staff and resident interviews, the above allegation(s) above is SUBSTANTIATED at this time.

An exit interview was conducted, citation(s) were issued, an appeals right was provided and a copy of this report was given to the Executive Director.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260310154619

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/22/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/06/2026 Section Cited CCR 87705(d)	1 2 3 4 5 6 7	87705(d) Care of Persons with Dementia (d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement...This requirement is not met by:	1 2 3 4 5 6 7	The Administrator/Licensee will send a written plan for the facility to monitor exit doors. The licensee will also need to repair the cameras at the front desk that are not working which help monitor the exit doors. POC 05/06/26
	8 9 10 11 12 13 14	Based on LPA's observation and interviews, the licensee/administrator did not comply with the section cited above by ensuring that exit doors and cameras at the front are working properly which posed a potential Health, Safety, or Personal Rights risk to persons in care.	8 9 10 11 12 13 14
Type B 05/06/2026 Section Cited HSC 1569.269(a)(6)	1 2 3 4 5 6 7	(a) Residents of residential care facilities for the elderly shall have all of the following rights:(6) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met by:	1 2 3 4 5 6 7	The Administrator/Licensee will need to provide all staff with the names of the individuals that cannot leave unassisted/unattended and provide training. POC 05/06/26
	8 9 10 11 12 13 14	Based on LPA's observation and interviews, the licensee/administrator did not comply with the section cited above by ensuring that Resident #1's individual needs were met which posed a potential Health, Safety, or Personal Rights risk to persons in care.	8 9 10 11 12 13 14

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: 04/22/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026

LIC9099 (FAS) - (06/04)

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