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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603136
Report Date: 12/19/2022
Date Signed: 12/19/2022 03:33:48 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, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/09/2022 and conducted by Evaluator Glenn Trueman
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20221209154741
FACILITY NAME:BURBANK SENIOR VILLA EASTFACILITY NUMBER:
198603136
ADMINISTRATOR:ACHARYA, NIRJARAFACILITY TYPE:
740
ADDRESS:1900 GRISMER AVETELEPHONE:
(818) 843-3141
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY:100CENSUS: 93DATE:
12/19/2022
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Marili Barajas Business ManagerTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff increased rates without a proper notice.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Glenn Trueman conducted an unannounced complaint investigation visit regarding the above allegation. LPA met with Marili Barajas Business Manager and explained the reason for the visit.
Shortly thereafter Administrator Nirjara Acharya arrived.
The investigation consisted of the following: LPA requested staff/resident roster. LPA interviewed resident #1(R1),#2(R2),#3(R3),#4(R4),#5(R5), and #6 (R6) from 1:30 PM to 2:30 PM.
LPA interviewed Marili Barajas Business Manager at 1:15 PM and Administrator at 3:00 PM.
The investigation revealed the following: Regarding allegation: Based on interviews conducted and information gathered 6 of 6 residents interviewed stated they received over a month ago a letter from the facility regarding a cost of living increase. Stated they received it in a timely manner. 5 of 6 residents stated they understood that SSA and SSI would be increased and why in turn their rent would increase.
Staff interviewed stated that a letter was sent to residents on 11/22/2022 which stated the new rental amount would be $1324.82. Staff stated rent last year was $1211.77.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Wei Siew HoTELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Glenn TruemanTELEPHONE: (323) 981-1652
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 28-AS-20221209154741
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: BURBANK SENIOR VILLA EAST
FACILITY NUMBER: 198603136
VISIT DATE: 12/19/2022
NARRATIVE
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Facility provided documentation regarding SSI/SSP Rates which show an increase in SSI to $914 and $578.82 for SSP totaling $1492 for the resident.
Previous year (2022) total was $1365.
2023 Total $1492-1324 rent= $168 to the resident
2022 Total $1365- 1211= $154 to the resident
Staff stated that based on above figures there was no extra taken from resident, but actually a little more back.
Administrator stated that they were notified of the change in SSI rates at the same time the letter went out to the residents.
Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are Unsubstantiated.
SUPERVISOR'S NAME: Wei Siew HoTELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Glenn TruemanTELEPHONE: (323) 981-1652
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2