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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004192
Report Date: 11/17/2020
Date Signed: 11/17/2020 10:50:24 AM

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:CHIN SHUN LEE LIAUFACILITY TYPE:
740
ADDRESS:200 WEST WHITTIER BLVD.TELEPHONE:
(562) 691-1200
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:196CENSUS: DATE:
11/17/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Carol LeeTIME COMPLETED:
10:45 AM
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Licensing Program Analysts (LPA) Ruth Martinez conducted an unannounced Case Management tele-visit for the purpose of a health and safety check via FaceTime due to COVID-19 Pandemic and precautionary measures. LPA explained the reason for today's visit and conducted a virtual tour of the inside of the facility, common areas, and kitchen along with Carol Lee, Administrator and observed the following:

LPA observed there was 1 receptionist in the main entrance of the facility. LPA observed 2 caregivers on each of 3 floors (wearing masks), 4 med techs (wearing masks), 3 activity directors (wearing masks), 3 housekeepers (wearing masks), and 5 kitchen staff (wearing masks), along with other staff. LPA observed no locked resident doors on 2nd or 3rd floor memory care. LPA observed activities being conducted at the time of visit. LPA observed residents in common areas of the facility socializing and watching television. LPA observed that food storage areas were clean and organized. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. LPA observed hallways and walkways were free of obstruction.

There were no health and safety concerns observed in the areas inspected. Based on the observations made during today’s visit, no deficiencies are being cited per Title 22, Division 6 of the California Code of Regulations.

An exit interview was conducted with Administrator. This report will be emailed and an electronic email read receipt confirms receipt of the report. Administrator agrees to sign the report and email it back to LPA.
SUPERVISOR'S NAME: Marina StanicTELEPHONE: (714) 703-2851
LICENSING EVALUATOR NAME: Ruth MartinezTELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2020
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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