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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603266
Report Date: 01/10/2025
Date Signed: 01/10/2025 02:54:59 PM

Document Has Been Signed on 01/10/2025 02:54 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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:SILVERADO SENIOR LIVING-BEVERLY PLACEFACILITY NUMBER:
198603266
ADMINISTRATOR/
DIRECTOR:		GIUNTO,TAYLOR L.FACILITY TYPE:
740
ADDRESS:330 N. HAYWORTH AVETELEPHONE:
(323) 852-9200
CITY:LOS ANGELESSTATE: CAZIP CODE:
90048
CAPACITY: 256CENSUS: 111DATE:
01/10/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Patrice O'Grady & Stephanie Brynjolfson TIME VISIT/
INSPECTION COMPLETED:
03:03 PM
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Licensing Program Analyst (LPA) Ernand Dabuet made an unannounced case management visit regarding the relocation of (45) residents of Silverado Senior Living—Calabasas #197609117 to the facility listed above due to mandatory evacuation orders from Fire Advisory. LPA met with Executive Directors from both facilities, Patrice O'Grady and Stephanie Brynjolfson, and explained the purpose of the visit.

LPA conducted a health and safety check during the visit, and no concerns were observed. LPA reviewed and obtained resident and staff rosters for both facilities.

Per an interview with Executive Director Patrice O'Grady, (45) residents have been relocated to Silverado Senior-Beverly Place. The facility has sufficient beds, hygiene supplies, bedding, and linens, and everyone has a designated private or shared room with bathrooms in each room.

The dining room is large enough to accommodate all residents on the first and second floors. The kitchen has sufficient two-day perishable and seven-day non-perishable food supplies. Medications, MARs, and resident's files of Silverado Senior Living-Calabasas are available electronically. The medicines have been transferred to Silverado Senior-Beverly Place and stored in locked cabinets. (LPA) inspected emergency food and water supplies. LPA observed that the facility has sufficient 30-day Personal Protective Equipment and incontinent supplies. Brynjolfson confirmed that the facility has backup generators.

There are (22) ambulatory and (23) non-ambulatory residents transferred from Silverado Senior- Calabasas. There are (32) who use assistive devices, and (43) who require assistance with incontinence care. LPA inspected rooms #242, #246, #317, and #331 and found to be in compliance with Title 22 regulations.

The Licensee stated that both facilities use the same vendors, pharmacy, and home health agencies, which allows them to provide the same level of continued care for the residents.
(Evaluation Report continues LIC 809-C)
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: SILVERADO SENIOR LIVING-BEVERLY PLACE
FACILITY NUMBER: 198603266
VISIT DATE: 01/10/2025
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There is sufficient staffing available to provide care for residents of both facilities. It has been verified that routine Fire Inspection and Disaster Drills were last tested on 12/15/24. O'Grady confirmed that all families and responsible parties of Silverado Senior-Calabasas residents have been notified about the relocation either via calls or emails. O'Grady confirmed that residents from Siliverado Senior-Calabasas were health screened prior to the relocation.

An exit interview was conducted, and Executive Directors Brynjolfson and O'Grady were provided with a copy of this report.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
LIC809 (FAS) - (06/04)
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