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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603136
Report Date: 06/25/2024
Date Signed: 06/25/2024 01:23:21 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/19/2024 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20240619115048
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:
06/25/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Imelda VillanuevaTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not safeguard resident’s personal belongings
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Tuesday Cabiness conducted the initial complaint visit, and met with Administrator Imelda Villanueva, who was informed the reason of the visit.

It was alleged that staff does not safeguard resident’s personal belongings. During the visit, from 1030am to 130pm, LPA conducted a physical plant inspection, conducted interviews and reviewed resident and facility documents. From the information obtained, resident # 1 (R1) complained to staff that their personal belongings were missing, and could not identify the resident that allegedly took the items. Staff interviewed residents and (R1), as well as checked facility cameras in the common areas. Cameras revealed, no-one but staff were entering the room. Facility conducted an internal investigation, which revealed,( R1) giving conflicting statements pertaining to the items that were alleged to be stolen. LPA interviewed (R1), and the items reported missing, were not consistent what was reported to facility staff. Therefore, based on interviews, there is insufficient evidence to prove the allegation, and it’s Unsubstantiated at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy AgardTELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Tuesday CabinessTELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2024
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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