197610706-6-7-2026-31-AS-NMAN-DW824T-20260721170426

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610706
Report Date: 06/07/2026
Date Signed: 06/07/2026 05:08:43 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
12/09/2025 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20251209161558

FACILITY NAME:	AZALEA HOUSE		FACILITY NUMBER:	197610706
ADMINISTRATOR:	HEWITT, AMBER		FACILITY TYPE:	740
ADDRESS:	1952 MAIDEN LANE		TELEPHONE:	(626) 239-9051
CITY:	ALTADENA	STATE: CA	ZIP CODE:	91001
CAPACITY:	6	CENSUS: 6	DATE:	06/07/2026
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Caregivers, Luis Mendez, Imen Moussa and Administrator, Amber Hewitt		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Staff illegally evicted a resident in care
Resident developed prohibited health condition while at the facility
Staff did not provide toileting assistance to the resident

INVESTIGATION FINDINGS:

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At 11:15a.m., Licensing Program Analyst (LPA) Antonia Alvizar- Ettima conducted an unannounced subsequent visit to complete an investigation and deliver findings of the above noted allegations. LPA met with Staff #1-#2 (S1-S2) and explained the reason for the visit. At approximately 11:30a.m. Administrator was contacted via-phone and later joined us.

During initial visit on 12/12/25 at 10:15am., LPA Alvizar- Ettima requested and received copies of the facility resident and staff rosters. At approximately 10:30a.m., LPA and House Manager conducted a physical plant walk-through. Between 11:00a.m. – 2:15p.m., LPA conducted interviews with the Adm., House Manager and staff #1 (S1). LPA asked questions relevant to the investigation. At about 2:45p.m. LPA received Resident #1 (R1’s) Identification Inf., Appraisal/Needs, Physician Report, Adm. Agreement, and other pertinent information.
On 06/02/26 LPA- Alvizar-Ettima reviewed Resident #1 (R1’s) records that Administrator provided.
Cont. on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2026

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-20251209161558

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: AZALEA HOUSE	FACILITY NUMBER: 197610706
	VISIT DATE: 06/07/2026

NARRATIVE

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Cont. from LIC 9099

During this visit at approximately 11:45a.m., LPA Alvizar- Ettima and Staff #1 conducted a physical plan tour and did not observe any immediate health and safety issues. Between 12:10a.m. – 1:30p.m. LPA interviewed two (2) residents and attempt to interview two (2) however due to their health condition it was unsuccessful. One (1) resident was asleep, and one (1) resident was out of the facility with family. Facility staff indicated that Resident #1 (R1) no longer resides in the facility.
1.) Staff illegally evicted a resident in care.
It was alleged that R1 was illegally evicted because R1 has a stage 3 bedsore and after being discharged from hospital Administrator did not want to allow the R1 to return to the facility. All R1’s belongs from the room needed to be removed so Administrator could rent it to someone else. Administrator denied the allegation and stated that R1 was hospitalized due to medical concerns and was not denied re-entry to the facility. Administrator also stated that the Home Health RN and R1’s Nurse Practitioner had documented as a stage 3 wound. Staff interviews corroborated the Administrator’s statement. Staff reported that R1 was transported to the hospital for treatment and they were unaware of any eviction or refusal to readmit R1. Resident interviewed did not report concerns regarding resident evictions and were unaware of any incident of a resident being removed from the facility. No written eviction notice was issued to R1. A review of R1’s file and other facility records did not reveal any information to support the allegation.

Based on interviews and documents review there is insufficient information to support the allegations. Therefore, the allegation is UNSUBSTANTIATED at this time.

2.) Resident developed prohibited health condition while at the facility.
It was alleged that Resident #1 (R1) had a possible stage 3 bedsore and needed to be transported to hospital. However, R1 was admitted with a stage 2 pressure injury prior to admission to the facility.
The Administrator and staff verified that at the time of admission resident had existing Stage 2 pressure injury. Staff provided assistance and reminders regarding repositioning and skin care to R1. However, R1 frequently refused assistance with repositioning and preferred to remain in bed for extended periods. Staff routinely encouraged repositioning and documented resident’s refusals. Other residents interviewed did not report concerns regarding the care provided by facility staff. A review of Internal Notes reflected that staff provided education and reminders regarding repositioning and skin integrity.
Cont. on LIC 9099-C

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20251209161558

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: AZALEA HOUSE	FACILITY NUMBER: 197610706
	VISIT DATE: 06/07/2026

NARRATIVE

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Cont. from LIC 9099-C

Overall investigation revealed that although R1 developed prohibited health condition (Stage 3 pressure injury) there is no sufficient information to verify that R1’s skin condition was changed due to neglect in care and supervision. Therefore, based on interviews and records review this allegation is deemed to be UNSUBSTANTIATED at this time.

3) Staff did not provide toileting assistance to the resident.

It was alleged that multiple times Resident#1 (R1) asked facility staff if they could use the bathroom and staff responded to R1 they are wearing a diaper and refused to take R1 to the bathroom. The Administrator and staff revealed that staff never refused bathroom assistance to R1. Staff routinely provided assistance with toileting and personal care. When paramedics were ready to transport R1 to the hospital R1 was reminded that they were wearing a diaper in case R1 needed to use it. Other Residents Interviewed did not expressed concerns regarding staffs care and supervision. LPA review of Internal Notes and other pertinent facility documentation did not reveal concerns regarding staff refusal to provide toileting assistance. During the visits, LPA observed staff present in resident care areas, appropriately supervising residents and responding to residents.

Based on interviews, observation and records reviewed, there is insufficient information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No immediate health and safety issues were noted.
Exit interview was conducted. Copy of report was provided.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2026

LIC9099 (FAS) - (06/04)

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