197610442-5-20-2026-31-AS-TAGD-DUWLRU-20260610085943

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610442
Report Date: 05/20/2026
Date Signed: 05/20/2026 01:04:57 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
12/23/2025 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20251223171146

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:	05/20/2026
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Stephanie Oden, Administrator		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

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Staff did not prevent a physical altercation between residents in care

INVESTIGATION FINDINGS:

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On 05/20/26, at 9:15am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Stephanie Oden,Administrator. LPA explained the purpose of this visit was to gather additional information and deliver findings for this complaint.

On 12/29/25 Licensing Program Analyst (LPA) Abeye Duguma conducted the initial complaint visit. On 05/20/26, at 9:40am, LPA Saucedo conducted a physical tour, interviewed staff and residents.

LIC 9099C-continued

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

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-20251223171146

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: 05/20/2026

NARRATIVE

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Regarding the allegation: Staff did not prevent a physical altercation between residents in care. It is being alleged that two (2) residents were involved in a fight in the dining hall and there was no staff present. During LPA's interview with Resident #1 (R1), R1 was asked what happened and R1 stated, "I don't remember anything." LPA asked were any staff present and R1 stated, "no." During LPA's interview with Resident #2 (R2), R2 stated, "they did not remember what happened that day." LPA asked R2 if there was any staff present during the incident and R2 stated, "no." LPA interviewed two (2) staff that were present the day of the fight and they confirmed that there were no staff present during the fight in the dining hall. Staff #1 (S1) confirmed that while they were passing by they heard a loud noise and when they looked over R1 was already on the floor. Staff #2 (S2) confirmed they responded to give R1 and R2 medical attention if they needed any but the fight had already occurred when they went to the dining hall so they did not observe anything. S2 also remembers there was no other staff present because it was a weekend day. LPA confirmed that the incident was a Sunday-12/14/25. LPA interviewed fourteen (14) other residents and out of the fourteen (14) residents two (2) remember the incident involving R1 and R2. Both residents that were present for the fight stated, "R2 pushed R1, R1 then fell hitting their head and when R1 got up they went towards R2 with a butter knife." LPA asked the two (2) residents that remember the incident if there were any staff present and they both stated, "no." The twelve (12) other residents that were interviewed did not recall the incident between R1 and R2. Therefore, based on the 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 Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20251223171146

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: 05/20/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/03/2026 Section Cited CCR 87468.2(a)(4)	1 2 3 4 5 6 7	(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the...personal rights:(4)To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers...This requirement is not met by:	1 2 3 4 5 6 7	The Administrator/Licensee shall conduct an in-service training to all staff regarding care and supervision of all residents. POC 06/03/26
	8 9 10 11 12 13 14	Based on LPA's interviews, the licensee/administrator did not comply with the section cited above by providing R1 and R2 the care and supervision they need which posed a potential Health, Safety, or Personal Rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC9099 (FAS) - (06/04)

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