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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602987
Report Date: 03/23/2023
Date Signed: 03/23/2023 01:49:47 PM


Document Has Been Signed on 03/23/2023 01:49 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) 488-3830
CITY:LA HABRA HEIGHTSSTATE: CAZIP CODE:
90631
CAPACITY:6CENSUS: 6DATE:
03/23/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Jesse Quezada (Administrator)TIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Kruz Long conducted a Case Management visit for the purpose of a capacity change. Upon arrival, LPA met with Jesse Quezada (Administrator) and who assisted with the visit.

During today's visit, LPA toured the facility with Jesse Quezada and observed the facility to be in good repair. Replacement of all Resident bedroom doors are complete and increase of capacity change from 6 to 9 Resident was granted on 03/20/23 via Fire Safety Inspection.

Exit interview conducted and a copy of this report provided to Jesse Quezada.
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Kruz LongTELEPHONE: (323) 383-8117
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2023
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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