197610442-7-3-2026-31-AS-TAGD-DVSPEU-20260708111542

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610442
Report Date: 07/03/2026
Date Signed: 07/03/2026 02:15:28 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
04/27/2026 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20260427092547

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: 173	DATE:	07/03/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Stephanie Oden		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff refused to provide medication to resident in care.
Staff spoke inappropriately to residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to investigate the above allegations. LPA met with Stephanie Oden and explained the reason for the visit.

--- Staff refused to provide medication to resident in care.

It was alleged that Staff #1 (S1) refused to give medication to Resident #2 (R2). To investigate the allegation LPA requested documents at around 10:00a.m., interviewed four (4) staff from 11:00a.m. to 1:00p.m., and interviewed one (1) resident from 1:00p.m. to 2:00p.m. On May 14, 2026, LPA Gina Saucedo interviewed two (2) residents and three (3) staff from around 12:30p.m. to 2:30p.m. On July 3, 2026, LPA interviewed sixteen (16) residents. A review of the Department’s records revealed no incident reports involving R2 regarding any medication refusal.

(CONT. on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260427092547

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: 07/03/2026

NARRATIVE

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A review of R2’s Medication Administration Records indicates that all medication were given as prescribed, with exceptions for surgery and community outings. A review of the Physician’s Report states R2 is able to communicate needs, independently able to administer and store own medications with assistance. A review of R2’s Service Plan states R2 is independent and needs reminders for other activities of daily living. During interviews, Staff #1 (S1) stated they give all residents their medications as prescribed and never refuse to give residents their medications. One (1) out of four (4) staff stated they overheard S1 refusing to give R2 their medication. All other staff stated they are not aware. During interviews, Resident #1 (R1) stated they witnessed S1 refuse to give R2 their medications. All residents, including R2, stated all medications are given as prescribed.

Based on interviews and record review, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

--- Staff spoke inappropriately to residents in care.

It was alleged that S1 yelled at and threatened to call Immigration and Customs Enforcement (I.C.E.) on R1 and R2. To investigate the allegation LPA requested documents at around 10:00a.m., interviewed four (4) staff from 11:00a.m. to 1:00p.m., and interviewed one (1) resident from 1:00p.m. to 2:00p.m. On May 14, 2026, LPA Gina Saucedo interviewed two (2) residents and three (3) staff from around 12:30p.m. to 2:30p.m. On July 3, 2026, LPA interviewed an sixteen (16) residents. A review of the Department’s records revealed no incident reports involving R1 regarding any altercation between staff and residents. A review of the Physician’s Report states R2 is able to communicate needs, able to leave facility unassisted, ambulatory, independently able to transfer and able to administer and store own medications with assistance. A review of R2’s Service Plan states R2 is independent, reminders only/prepare items for bathing, and standby assistance and reminders for other activities of daily living. A review of the Physician’s Report states R1 is not confused, able to follow instructions, able to communicate needs and able to leave facility unassisted. During interviews, two (2) out of four (4) staff stated they witnessed S1 being rude to R2 and not treating them with respect and dignity. All other staff, including S1, stated they treat all residents with respect and dignity. During interviews, R2 stated there are two (2) staff that tell them to take their clothes off quickly, and they can’t because they have a medical condition. R2 could not identify which staff. S1 is a MedTech and does not bathe residents.
(CONT. on LIC9099-C)

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260427092547

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: 07/03/2026

NARRATIVE

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R1 stated S1 does not want R1 and R2 to be friends and hang out in R1’s room. R1 added that S1 yells at R2 and threatens to call I.C.E. on us. All other residents stated they are treated with respect and dignity.

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 and a copy of the report was issued.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2026

LIC9099 (FAS) - (06/04)

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