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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603137
Report Date: 02/24/2026
Date Signed: 02/24/2026 05:28:32 PM

Document Has Been Signed on 02/24/2026 05:28 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 WESTFACILITY NUMBER:
198603137
ADMINISTRATOR/
DIRECTOR:		VALDEZ, SILVIAFACILITY TYPE:
740
ADDRESS:1911 GRISMER AVETELEPHONE:
(818) 295-2727
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY: 100CENSUS: 99DATE:
02/24/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Silvia Valdez-Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On 02/24/2026, at 9:00 am Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced required annual inspection. LPA met with Executive Director - Silvia Valdez and explained the reason for the visit. Facility is licensed as a two-story building. Fire clearance approved for one hundred (100) non-ambulatory residents; ten (10) of whom may be bedridden. Hospice waiver is approved for thirty (30) residents.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools. From 11:10am to 1:20pm, LPA along with the Executive Director, conducted a tour of the physical plant and observed the following:

The Screening/Reception area is located immediately upon entrance. Required postings were displayed at the reception area. Facility’s main door is the primary entry/exit access. The facility has five (5) delayed egress exit doors. Facility has one elevator. LPA observed an evacuation chair atop of one (1) of the three (3) stairwells.

COMMON AREAS: Facility is a two-story building; there are four common area bathrooms, in both floors. The first floor has two lobbies, a television room, dining room, hair salon and outside and an inside patio areas. In the hair salon, LPA observed a foldable weight station, used to weight residents and lockers for staff use. Second floor has an activity room. Common area floors and hallways were clean and without obstructions, all furnishings were observed to be clean and in good condition. Multiple dual smoke/carbon monoxide detectors are installed, hardwired, and interconnected throughout the facility. Multiple fire extinguishers were observed throughout both floors and all the fire extinguishers were last inspected on 05/08/2025 by Delta Fire Company, which is privately owned. Delta Fire Company conducts quarterly smoke/carbon monoxide detector and fire alarm testing, the last test was conducted on December 2025

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NAME OF LICENSING PROGRAM MANAGER: Mary G Flores
NAME OF LICENSING PROGRAM ANALYST: Nadia Shahbazian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 WEST
FACILITY NUMBER: 198603137
VISIT DATE: 02/24/2026
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The facility has cameras in common areas of the home. In addition facility offers telephone access and wi-fi access to residents in care. There are three stairwells and one elevator in the building; evacuation chairs were observed atop each stairwell. Roof is inaccessible to residents. Evacuation routes are clearly labelled and posted throughout the facility.

SURROUNDING GROUNDS: The passageways and entrance to the home was clear of obstruction. Facility has an outdoor patio and an indoor patio area. LPA observed two sets of patio furniture with two umbrellas, in each patio. There are no bodies of water in the facility.

KITCHEN: Facility has a commercial kitchen which is kept locked and inaccessible to residents. LPA observed an adequate supply of perishable foods for two (2) days, and non-perishable food supply for seven (7) days, which were stored in the refrigerator, freezer, and pantry. Food was properly labeled and stored. Emergency food is stored in a separate walk-in pantry. Sharps are stored in the kitchen; inaccessible to residents. LPA observed records of special dietary needs and weekly menu in the kitchen.

BEDROOMS: LPA toured multiple resident bedrooms on both floors. All bedrooms were inspected and observed to maintain required furnishings and sufficient lightings, bed linens, and comforters. At 12:19pm in room# 224, LPA pulled the assistance cord; caregiver responded within 2 minutes; at 12:39pm in room# 112 LPA pulled the assistance cord; 2 caregivers responded within 2 minutes.

BATHROOMS: All bathrooms were observed to be clean and sanitary with necessary supplies and required safety fixtures (grab bars, non-slip mats). Hot water temperature measured between 108.5° F. and 113.2° F; within the required range. At 12:14pm in bathroom# 226, LPA pulled the assistance cord; caregiver responded within 1 minute.

LAUNDRY ROOMS: There are two laundry rooms, one on each floor, with two washers and two dryers in each room. Chemicals and detergents were stored in a locked room near the laundry room, inaccessible to residents.

STAFF RECORDS: All records are kept online, yet there are also files, stored and locked in the Business Office. A total of eleven (11) staff files were reviewed. Training, criminal record clearances were present, and staff are associated to this facility. Staff records appear to be complete and current.


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NAME OF LICENSING PROGRAM MANAGER: Mary G Flores
NAME OF LICENSING PROGRAM ANALYST: Nadia Shahbazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2026
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 WEST
FACILITY NUMBER: 198603137
VISIT DATE: 02/24/2026
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MEDICATIONS: Facility has a Wellness Room behind the front desk, in which all medications are securely locked, inaccessible to residents. LPA observed new medications being accounted for and being logged to the system. LPA reviewed Medication Administration Records (MARs) for nine (9) 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: A total of ten (10) resident files were reviewed for the following reports but not limited to: Appraisals, physician's reports, and admission agreements. Resident records appeared to be complete and current.

In addition to the plant tour, LPA reviewed the facility's liability insurance, infection control plan, and disaster plan. Records were complete and up-to-date. Facility conducts quarterly Fire Disaster/Elopement and Emergency drills, the last drill was conducted on 01/03/2026.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies observed during the visit.

Exit Interview Conducted / A Copy of the Report provided to Administrator.

NAME OF LICENSING PROGRAM MANAGER: Mary G Flores
NAME OF LICENSING PROGRAM ANALYST: Nadia Shahbazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2026
LIC809 (FAS) - (06/04)
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