197602414-4-6-2021-31-AS-CHAS-C2GP4T-20210427105940

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197602414
Report Date: 04/06/2021
Date Signed: 04/06/2021 03:15:06 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
03/29/2021 and conducted by Evaluator Wendell Smith

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20210329122220

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: 69	DATE:	04/06/2021
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Anchirriza Concebcion		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Air conditioner is too loud.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Wendell Smith conducted a subsequent complaint visit regarding 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 staff Anchirriza Concebcion.
It is alleged that the air conditioner was too loud and disturbed residents. LPA conducted interviews with residents and staff regarding this allegation. Interviews revealed that residents heard noises coming from the air conditioner and let facility staff know about it. Facility staff had additional padding put around the air conditioner unit and the noise has stopped. There was nothing wrong with the air conditioner. As soon as the facility was aware that the noise was disturbing residents they immediately fixed the issue. Based upon the information obtained through interviews this allegation is deemed Unsubstantiated at this time.
Exit Interview conducted. Copy of report emailed for signature.

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: 04/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2021

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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