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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610442
Report Date: 06/16/2026
Date Signed: 06/16/2026 01:49:49 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
06/08/2026 and conducted by Evaluator Gina Saucedo
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20260608102458
FACILITY NAME:LEISURE VALE ASSISTED LIVINGFACILITY NUMBER:
197610442
ADMINISTRATOR:STEPHANIE ODENFACILITY TYPE:
740
ADDRESS:413 E. CYPRESS STREETTELEPHONE:
(818) 244-2323
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:199CENSUS: 160DATE:
06/16/2026
UNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Stephanie Oden, AdministratorTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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Staff mishandled a resident's medication(s).
INVESTIGATION FINDINGS:
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On 06/16/26, at 8:05am, 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 06/09/26, Licensing Program Analyst (LPA) Jose Tan conducted the initial, complaint visit. On 06/16/26, at 8:15am, LPA Saucedo conducted a physical tour and interviewed staff.

LIC 9099C-continued
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
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 2
Control Number 31-AS-20260608102458
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: 06/16/2026
NARRATIVE
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Regarding the allegation: Staff mishandled a resident's medication(s). It is being alleged that resident #1 (R1) wants to administer their own insulin. During LPA's interview with three (3) staff it was confirmed that R1 is legally blind and has Motor Impairment/Paralysis. During LPA's interview with three (3) out of three (3) staff it was determined that R1 is to be given their insulin by a skilled professional. R1 cannot administer their own insulin because of their vision and motor impairment. LPA obtained R1's medication list where R1 is to receive their insulin three (3) times under the skin subcutaneously. Furthermore, one (1) of the vocational licensed nurse tried to administer the insulin to R1 and R1 did not want to be touched and R1 then refused their insulin twice in one (1) day. Let it be noted, R1 is not currently in the facility and remains in the hospital. Furthermore, LPA spoke to one (1) of the hospital staff and R1 is being administered their medication including their insulin by medical staff. LPA received R1's Medical Assessment and Resident Appraisal where it confirms that R1 needs assistance with medication management including needing assistance with administering their own injections and Max assistance with medication. Therefore, based on the staff interviews and pertinent documents obtained the allegation(s) is UNSUBSTANTIATED at this time.

An exit interview was conducted, no citation(s) were issued for the above allegation(s), and a copy of this report was given to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
LIC9099 (FAS) - (06/04)
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