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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602987
Report Date: 01/23/2023
Date Signed: 01/23/2023 03:00:41 PM


Document Has Been Signed on 01/23/2023 03:00 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754



FACILITY NAME:HEIGHTS INN, THEFACILITY NUMBER:
198602987
ADMINISTRATOR:QUEZADA, JESSEFACILITY TYPE:
740
ADDRESS:2400 PANCHOY PLTELEPHONE:
(562) 536-8860
CITY:LA HABRA HEIGHTSSTATE: CAZIP CODE:
90631
CAPACITY:6CENSUS: 4DATE:
01/23/2023
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Jesse Quezada (Administrator)TIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Kruz Long conducted a Case Management visit for a Health and Safety check. LPA met with Jesse Quezada and explained the purpose of the visit.

During today's visit, LPA toured the facility with Jesse Quezada and observed the facility to be clean and in good repair. All outdoor and indoor passageways is kept free of obstruction. Nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days were observed. There is running water in all bathrooms. LPA did not observed any immediate health and safety concerns during today's visit.

Exit interview conducted with Jesse Quezada and a copy of this report provided.
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Kruz LongTELEPHONE: (323) 383-8117
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2023
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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