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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004192
Report Date: 06/15/2020
Date Signed: 06/15/2020 04:07:40 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
306004192
ADMINISTRATOR:MELCHOR DE LEONFACILITY TYPE:
740
ADDRESS:200 WEST WHITTIER BLVD.TELEPHONE:
(562) 691-1200
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:196CENSUS: 110DATE:
06/15/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:21 PM
MET WITH:Carol LeeTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Kimberly Lyman contacted the facility via telephone to commence a health and safety visit in conjunction with a complaint visit via telephone due to COVID-19 and pre-cautionary measures. LPA identified herself and discussed the purpose of the visit with Business Office Manager Carol Lee.

During the visit, LPA Lyman toured the facility via FaceTime. LPA observed all common areas in the facility. Due to Covid-19, residents are in their rooms and not in the common areas. LPA had to conclude the virtual visit due to poor connection for FaceTime.


An exit interview was conducted with Business Office Manager via telephone and a copy of this report was provided via email and an electronic email read receipt confirms receiving these documents.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2020
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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