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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004192
Report Date: 10/20/2020
Date Signed: 10/20/2020 10:45:19 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:MELCHOR DE LEONFACILITY TYPE:
740
ADDRESS:200 WEST WHITTIER BLVD.TELEPHONE:
(562) 691-1200
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:196CENSUS: 100DATE:
10/20/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Carol Lee, AdministratorTIME COMPLETED:
11:00 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Ruth Martinez and Sean Haddad are conducting this case management visit for the purpose of a health and safety check. LPAs arrived at facility and were greeted at the door by receptionist and granted entry. LPAs were informed Administrator had not yet arrived at the facility. LPAs met with Care Coordinator Erick Merino Vargas and explained the reason for today’s visit. Administrator Carol Lee arrived at a later time and met with LPA Martinez.

Upon entry LPAs observed there was one receptionist in the main entrance of the facility. During the case management visit LPAs took a tour of the inside of the facility, restrooms, and common areas. LPAs observed there was the two caregivers on each floor, two med techs, six kitchen staff and two activities coordinators. LPAs observed that the meal prepared appeared of good quality and storage areas organized. LPAs inspected food supply adequate amount was observed to be within regulations. The facility has a two-day supply of perishables and seven-day supply of non-perishable food is available as required by regulations. LPAs observed renovations in room 339R. LPAs observed hallways and walkways were free of obstruction. There are no health and safety concerns observed in the facility.

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.

This report was reviewed with Administrator and a copy of this LIC809 was provided to the facility.
SUPERVISOR'S NAME: Marina StanicTELEPHONE: (714) 703-2851
LICENSING EVALUATOR NAME: Ruth MartinezTELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2020
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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