197602414-2-19-2021-31-AS-CHAS-BZDUTV-20210323155235

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197602414
Report Date: 02/19/2021
Date Signed: 02/19/2021 01:38:23 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
01/19/2021 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20210119111413

FACILITY NAME:	BROOKDALE NORTH TARZANA		FACILITY NUMBER:	197602414
ADMINISTRATOR:	DAVIS, DINA		FACILITY TYPE:	740
ADDRESS:	5711 RESEDA BLVD		TELEPHONE:	(818) 996-2022
CITY:	TARZANA	STATE: CA	ZIP CODE:	91356
CAPACITY:	135	CENSUS: 74	DATE:	02/19/2021
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Susan Wilson, Dina Davis		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Facility staff is not properly disposing of their solid waste.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Wendell Smith initiated a complaint investigation for the allegation listed above. Due to the situation surrounding the Corona virus Disease 2019 (COVID-19) and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Susan Wilson and Dina Davis.

Regarding the allegation above LPA previously conducted a telephonic visit on 1/21/21 about the allegation above. It is alleged that the facility is not properly disposing of their trash and that it gets out into the neighborhood where the facility is located. LPA was notified that the Department of Public Health had gone out to investigate this allegation. LPA received a copy of the report which was dated 1/22/21. It was noted that observation showed that all trash bags were tied closed and trash is picked up daily. It was also noted that no trash was observed from the facility on adjacent properties. LPA also interviewed the administrator regarding this allegation. Based on the information obtained through interviews and reports received this allegation is deemed Unsubstantiated at this time. Exit Interview conducted. Copy of report issued.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell Smith	TELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2021

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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