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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603136
Report Date: 03/18/2025
Date Signed: 03/18/2025 03:36:32 PM

Document Has Been Signed on 03/18/2025 03:36 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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:SAVANT OF BURBANK EASTFACILITY NUMBER:
198603136
ADMINISTRATOR/
DIRECTOR:		ACHARYA, NIRJARAFACILITY TYPE:
740
ADDRESS:1900 GRISMER AVETELEPHONE:
(818) 843-3141
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY: 100CENSUS: 93DATE:
03/18/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Imelda Villanueva - Administrator TIME VISIT/
INSPECTION COMPLETED:
12:17 PM
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Licensing Program Analysts (LPAs) Nadia Shahbazian and Raymond Comer conducted an unannounced site visit continuation of the required annual inspection conducted on 03/17/2025. LPAs met with Executive Director, Imelda Villanueva and explained the reason for the visit.

The following remaining inspection domains were observed, reviewed and inspected:

Bedrooms: LPA toured multiple resident bedrooms on both floors for safety, privacy, and comfort (Bedroom#’s 201, 203, 205, 223, 235, 240, 103, 105, 112, 118). The bedrooms were inspected and observed to maintain required furnishings and sufficient lightings, bed linens, and blankets. All bedrooms were observed to be clean and clear of obstructions. At 11:38am in room# 240, LPAs pulled the assistance cord; caregiver responded within 2 minutes.

Bathrooms were observed to be clean and sanitary with necessary supplies and required safety fixtures (grab bars, non-slip mats, anti-slip floor stripping). Hot water temperature measured between 112.3 °F. and 113.2°F; within the required range. At 2:01pm in bathroom# 118, LPAs pulled the assistance cord; caregiver responded within 5 minutes.

SURROUNDING GROUNDS: The passageways and entrance to the home was clear of obstruction. Facility has an outdoor patio and an indoor patio area, both areas were observed to be shaded, with tables with sufficient seating for the residents. Outdoor furniture observed to be in good condition. There are no bodies of water in the facility. The facility has cameras in common areas of the home; no cameras in resident rooms or bathrooms.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: SAVANT OF BURBANK EAST
FACILITY NUMBER: 198603136
VISIT DATE: 03/18/2025
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Laundry: Facility has two (2) laundry rooms, one (1) in each floor with total of four (4) washers and four (4) dryers. LPAs observed all the machines in functional capacity. Laundry detergents, cleaning agents and other toxins are secured in locked storages, inaccessible to residents.

Medications: Facility has a Wellness Room adjacent to the lobby, in which all medications are securely locked\inaccessible to residents. LPAs reviewed Medication Administration Records (MARs) for six (6) residents and compared them to the medication count and found no discrepancies. Multiple First Aid kits and the First Aid Manual were observed in the Wellness Room.

Resident records: All records were observed as locked and inaccessible to residents. A total of ten (10) resident files were reviewed for current IPP and/or Needs and Services plans, physician reports, and admission agreements. Resident records appeared to be complete and current.


Staff records: All records were observed as locked and inaccessible to residents. A total of six (6) Staff files were reviewed. Criminal record clearances were present, and Staff are associated to this facility. Staff records appear to be complete and current.

There were no immediate health and safety hazards observed at the time of this inspection. Exit interview conducted and a copy of this report was given to facility Administrator.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Nadia Shahbazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025
LIC809 (FAS) - (06/04)
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