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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610442
Report Date: 09/24/2025
Date Signed: 09/24/2025 03:29:07 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.ASC, 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
09/18/2025 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20250918094556
FACILITY NAME:LEISURE VALE ASSISTED LIVINGFACILITY NUMBER:
197610442
ADMINISTRATOR:ANGELA SMITHFACILITY TYPE:
740
ADDRESS:413 E. CYPRESS STREETTELEPHONE:
(818) 244-2323
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:199CENSUS: 170DATE:
09/24/2025
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Nilda MercadoTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Staff did not seek medical attention to resident
INVESTIGATION FINDINGS:
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At approximately 10:45 a.m. on 09/24/25 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with staff and disclosed the reason for the visit.

Regarding the allegation "Staff did not seek medical attention to resident" it was alleged Resident #1 (R1) had low blood sugar on the evening of 09/16/25 and did not receive staff assistance. To investigate the allegation, LPA interviewed staff and residents between 10:50 a.m. and 2:00 p.m. today, conducted a record review of pertinent records, including but not limited to an admission agreement, medical assessment, care plan, and staff and client rosters at 11:00 a.m., and toured the facility inside and out at 11:30 a.m. Interview with R1 at approximately 11:45 a.m. today revealed they were okay and free from pain. R1 stated they were asleep when Staff #1 (S1) checked on them. S1 later told R1 that they saw R1 with their eyes fluttering and looking uncomfortable. Although R1 was fine, R1 was concerned with S1’s report. R1 noted that S1 assisted them with medications as usual, and R1 received all necessary medications and medical attention.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2025
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-20250918094556
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: LEISURE VALE ASSISTED LIVING
FACILITY NUMBER: 197610442
VISIT DATE: 09/24/2025
NARRATIVE
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Telephonic interview with S1 at 2:00 p.m. today confirmed R1 received assistance with all necessary medications and their blood sugar level returned to normal shortly thereafter. S1 further stated that R1 reported no pain or discomfort to S1 at the time or afterwards. Interviews with four (04) out of four (04) other staff revealed staff have properly attended to R1’s medical needs. Record review of R1’s preplacement appraisal revealed they required assistance with preparing their medications. Review of R1’s medical assessment revealed they were able to communicate their needs, perform their own glucose testing, and administer their own medications. Based on interviews and record review, facility staff provided appropriate medical attention to R1 in a timely manner. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health or safety concerns were observed during today’s visit.

Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2