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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608477
Report Date: 10/08/2021
Date Signed: 10/08/2021 03:54:56 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:SUNRISE ASSISTED LIVING OF STUDIO CITYFACILITY NUMBER:
197608477
ADMINISTRATOR:SHAHIN TAGHIZADEHFACILITY TYPE:
740
ADDRESS:4610 COLDWATER CANYONTELEPHONE:
(818) 505-8484
CITY:STUDIO CITYSTATE: CAZIP CODE:
91604
CAPACITY:121CENSUS: DATE:
10/08/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Sean TaghizadehTIME COMPLETED:
04:00 PM
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On 10/08/2021 at 1:45PM, Licensing Program Analysts (LPA) Tuesday Cabinness and Nicholas Reed met with Administrator Sean Taghizadeh for an unannounced annual inspection.

Infection Control: LPAs entered at the main entrance and waited for the receptionist. Receptionist took the LPAs' temperatures, provided hand sanitizer and a mask. She also requested the LPAs sign the visitors’ log and note any COVID-19 symptoms. LPAs observed proper signage at the front door. LPAs also witnessed the protocol applied to staff, maintenance workers, and residents.

LPAs and Administrator reviewed the facility mitigation plan (approved on 01/20/2021) to make sure the facility was following current infection control recommendations. Administrator verified the facility's testing regimen of twice weekly after a reported positive case. Administrator also showed proof of staff training records, resident and staff temperature logs, testing dates, and test results. Administrator stated that a resident who tests positive for COVID-19 uses their private room for isolation. Staff don and doff PPE to provide care for the resident.

Administrator and LPA Reed toured the inside of the facility. LPA observed hand sanitizer and COVID-19 related signage throughout the facility. LPA observed a public restroom with ample soap, paper towels, and a trash can with a tight fitting lid and a foot pedal to open the lid. Administrator and LPA toured a resident room with two sinks, hand sanitizer, paper towels, and trash can with tight fitting lid. Administrator showed one of several PPE storage rooms with N95 masks, surgical masks, gowns, gloves, and face shields.

SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: SUNRISE ASSISTED LIVING OF STUDIO CITY
FACILITY NUMBER: 197608477
VISIT DATE: 10/08/2021
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Administrator noted at least a month's supply of medication for each resident. All new employee hires require proof of vaccination. New residents are properly screened and provided a negative COVID test prior to entering the facility. Residents and staff are screened at the front when returning from outings. Staff are notified of sick leave policies. The facility is aware to report any changes with residents and staff to Licensing and their LPA, pertaining to positive COVID-19 cases.

Exit interview conducted with Administrator.

A copy of this report will be emailed to administrator at StudioCity.ED@sunriseseniorliving.com

SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021
LIC809 (FAS) - (06/04)
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