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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610032
Report Date: 06/18/2025
Date Signed: 06/18/2025 12:12:20 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
06/17/2025 and conducted by Evaluator Angelica Segovia
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20250617093103
FACILITY NAME:LEISURE GARDEN SENIOR ASSISTED LIVING FACILITYFACILITY NUMBER:
197610032
ADMINISTRATOR:CRYSTAL BARRIENTOSFACILITY TYPE:
740
ADDRESS:44523 15TH STREET WESTTELEPHONE:
(661) 941-4578
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:157CENSUS: 120DATE:
06/18/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Crystal Barrientos- AdministratorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility has not properly disposed of hazardous items
INVESTIGATION FINDINGS:
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On 6/18/2025 at approximately 10:30 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced initial complaint visit to the facility to investigate the above allegation(s). LPA was greeted by the Administrator, Crystal Barrientos and stated the reason for their visit was to gather information, conduct interviews and deliver findings for this complaint.

To investigate the allegation(s) at 10:30 AM, LPA requested census, resident and staff roster. At approximately 11:00 AM, LPA conducted a physical plant tour, to ensure the health and safety of the residents. Between 10:30 AM – 12:00 PM, LPA conducted interviews with four (4) staff members (S1-S4).


(continue to LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
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-20250617093103
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 GARDEN SENIOR ASSISTED LIVING FACILITY
FACILITY NUMBER: 197610032
VISIT DATE: 06/18/2025
NARRATIVE
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Regarding the allegation: Facility has not properly disposed of hazardous items. It was alleged that the facility is not properly disposing of hazardous material. To investigate the allegation, LPA interviewed four (4) staff members. Interview with all four (4) staff revealed that all hazardous materials are disposed of properly within sealed trash bags inside of the trash barrels located outside of the facility. Interview with S4 confirmed that the trash barrels have lids and must be maintained closed after trash is disposed. All four (4) staff confirmed that the trash along with any hazardous materials are picked up weekly. During LPA’s physical tour, LPA observed facility staff carts supplied with trash bags to dispose of materials. LPA observed the outside trash barrels to be closed with the appropriate lids. LPA observed there to be no hazardous materials such as but not limited to: mask, disposable leak pads, and/or diapers left unsecured within the facilities premises. All trash was observed to be within trash bags inside of the facilities trash barrels. LPA observed two (2) other facilities adjacent one on each side with their own trash bins. LPA observed one (1) out of the two (2) adjacent facilities to have their trash bin open without a lid. LPA’s record review of the past week’s weather forecast for the surrounding area showcased wind speeds ranging from 13 mph-21 mph.

Furthermore, based on LPA’s interviews, observations and record review there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No immediate health and safety issues observed during the day of the visit. Exit interview conducted and a copy of this report was provided to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC9099 (FAS) - (06/04)
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