197609362-1-6-2023-28-AS-NMAN-CN7TCK-20230118133654

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609362
Report Date: 01/06/2023
Date Signed: 01/06/2023 05:30:45 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/27/2022 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 28-AS-20221227144823

FACILITY NAME:	HEIGHTS AT BURBANK, THE		FACILITY NUMBER:	197609362
ADMINISTRATOR:	DAWN SMITH		FACILITY TYPE:	740
ADDRESS:	2721 WILLOW STREET		TELEPHONE:	(818) 954-9500
CITY:	BURBANK	STATE: CA	ZIP CODE:	91505
CAPACITY:	130	CENSUS: 87	DATE:	01/06/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Dawn Smith - Executive Director		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility heater unit is in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced complaint visit at this facility to investigate the above allegation. LPA met with Executive Director Dawn Smith and explained the reason for the visit.

LPA conducted physical plant tour at 1:10 PM, requested copies of facility documents at 1:30 PM and interviewed staff and resident between 1:30 PM to 2:30 PM. It was alleged that the Air conditioning/Heater Unit (AC/H) makes noise and blows cool air instead of heat. LPA's observation through testing AC/H unit revealed that the unit is working properly and appeared to be new. LPA's interview with Resident #1 (R1) at 1:30 PM also revealed that the air conditioning was replaced recently which was confirmed with LPA's interview with the maintenance director at 2:00 PM, adding that it was a brand new unit. LPA's physical plant tour also revealed that the facility has four (4) brand new AC/H units in the Maintenance Director's office if in case any AC/H breakdown as apartments have the same AC/H unit. Based on the information gathered during this visit, the allegation is deemed unsubstantiated at this time. Exit interview conducted. Copy of this report issued.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alex Estrada	TELEPHONE: (818) 596-4364
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

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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