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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191221839
Report Date: 12/19/2023
Date Signed: 12/19/2023 05:36:41 PM


Document Has Been Signed on 12/19/2023 05:36 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364



FACILITY NAME:BROADVIEW RESIDENTIAL CARE CENTERFACILITY NUMBER:
191221839
ADMINISTRATOR:BETSY K DAVISFACILITY TYPE:
740
ADDRESS:535 WEST BROADWAYTELEPHONE:
(818) 246-4951
CITY:GLENDALESTATE: CAZIP CODE:
91204
CAPACITY:180CENSUS: 69DATE:
12/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:28 PM
MET WITH:Betsy Davis, AdministratorTIME COMPLETED:
05:35 PM
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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced required one year annual inspection. LPA met with Administrator Betsy Davis and explained the purpose of the visit.

LPA Valenzuela conducted a physical plant tour of the facility. The facility is a two-story building. Areas inspected: the front lobby, dining area, activity spaces / common lounge areas, medication room, storage/ disaster rooms, resident common restrooms, laundry room, outside gardens, residents bedrooms and kitchen area. LPA observed that the facility does not have a large body of water, small fountains were observed and were secured and fenced. All indoor and outdoor passageways were free of obstruction. There is only one entrance being utilized at the facility.

LPA toured randomly selected resident bedrooms. All bedrooms were clean and furnished with required furniture. The resident's bathrooms were observed to be clean, operational and equipped with grab bars and non-skid mats. Common resident restrooms were observed. The hot water temperature was tested and measured 115 degrees Fahrenheit. Smoke detectors are present throughout the facility and in resident bedrooms. Fire extinguishers were last serviced on May of 2023 . Oxygen monoxide detectors were observed to be operable. Fire alarms are hardwired throughout the facility.



The kitchen was inspected. LPA observed all kitchen equipment to be clean and in working condition. LPA observed sufficient supply of perishable and non-perishable foods, food menu was posted and no foods were expired. Common areas were observed clean and properly furnished. LPA observed the centrally stored medication area to be locked and inaccessible to residents. The first aid kit was complete.

Exit interview conducted and a copy of the report was issued.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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