Inspection Reports for Belmont Village Senior Living Burbank
455 E Angeleno Ave, Burbank, CA 91501, United States, CA, 91501
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Inspection Report
Annual Inspection
Census: 117
Capacity: 160
Deficiencies: 0
Jul 21, 2025
Visit Reason
The visit was an unannounced continuation of the required One Year annual inspection to evaluate compliance with licensing requirements.
Findings
The inspection found the facility to be clean, sanitary, and well-maintained with no deficiencies observed. Resident bedrooms, bathrooms, medication storage, resident and staff files, and staff areas were all in compliance with regulations.
Report Facts
Number of residents in Assisted Living: 90
Number of residents in Memory Care: 27
Number of public restrooms: 9
Hot water temperature range (°F): Measured between 105.9 and 117.6 degrees Fahrenheit
Number of resident records reviewed: 10
Number of staff files reviewed: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mary Jane Rodriguez | Executive Director | Met with Licensing Program Analyst during inspection and mentioned in report |
| Nadia Shahbazian | Licensing Program Analyst | Conducted the inspection and signed the report |
| Eva Miller | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 118
Capacity: 160
Deficiencies: 0
Jul 15, 2025
Visit Reason
An unannounced required one-year inspection was conducted to evaluate compliance with licensing requirements and regulatory standards.
Findings
The facility was observed to be clean, sanitary, and appropriately furnished with all required safety systems in place. The kitchen and common areas were well maintained and free of hazards. Due to time constraints, the annual inspection was not fully completed and will be finished at a later date.
Report Facts
Residents in assisted living: 91
Residents in memory care: 27
Fire extinguishers last serviced: Nov 7, 2024
Last emergency/disaster evacuation drill: Jun 28, 2025
Last fire/earthquake drill: Jun 28, 2025
Last fire inspection: Oct 30, 2024
Refrigerators in kitchen: 3
Perishable food supply: 2
Non-perishable food supply: 7
Laundry rooms: 3
Washers: 3
Dryers: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mary Jane Rodriguez | Executive Director | Met with Licensing Program Analysts during inspection and participated in facility tour |
| Nadia Shahbazian | Licensing Program Analyst | Conducted the inspection |
| Michael Cava | Licensing Program Analyst | Conducted the inspection |
| Eva Miller | Licensing Program Manager | Named in report header and signature section |
Inspection Report
Annual Inspection
Census: 120
Capacity: 160
Deficiencies: 0
Jul 24, 2024
Visit Reason
Unannounced case management Annual Continuation visit conducted to complete the required 1-year inspection initiated on 06/23/2024.
Findings
The Licensing Program Analyst toured the facility to ensure no health and safety hazards were present. Staff files were reviewed and found complete with appropriate criminal record clearances and documentation.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mary Jane Rodriguez | Executive Director | Met during the inspection and provided a copy of the report. |
| Diana Gevorgyan | Director of Resident Care Services | Met during the inspection and toured the facility with the Licensing Program Analyst. |
| Antonia Alvizar-Ettima | Licensing Program Analyst | Conducted the unannounced case management Annual Continuation visit. |
Inspection Report
Annual Inspection
Census: 125
Capacity: 160
Deficiencies: 0
Jun 23, 2024
Visit Reason
An unannounced Required One (1) year inspection visit was conducted to evaluate compliance with licensing regulations and ensure the facility meets health and safety standards.
Findings
The facility was found to be in compliance with Title 22 regulations, with no health or safety hazards observed during the physical plant tour. Medications, kitchen, dining, laundry, bedrooms, bathrooms, and common areas were all properly maintained and secured. Resident files reviewed appeared complete and updated. The visit was terminated early due to time constraints and will be completed later.
Report Facts
Residents in assisted living: 97
Residents in memory care: 28
Fire extinguisher last inspection date: Oct 18, 2023
Facility disaster drill last conducted: Jun 20, 2024
Fire inspection last performed: Apr 26, 2024
Food supply duration - perishable: 2
Food supply duration - non-perishable: 7
Hot water temperature range: 111.3
Hot water temperature range: 117.3
Residents' files reviewed: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mary Jane Rodriguez | Executive Director | Joined the inspection and was provided a copy of the report |
| Diana Gevorgyan | Director of Resident Care Services | Joined the inspection |
| David Aaron | Activity Program Coordinator | Met with Licensing Program Analyst at the start of the inspection |
| Antonia Alvizar-Ettima | Licensing Program Analyst | Conducted the inspection visit |
| Naira Margaryan | Licensing Program Manager | Named in the report header and footer |
Inspection Report
Complaint Investigation
Census: 127
Capacity: 160
Deficiencies: 2
Oct 25, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that staff did not prevent a resident from eloping and that the facility refused to provide the resident's requested records to the responsible party.
Findings
The investigation substantiated that staff failed to prevent resident #1 from eloping the facility, posing an immediate health and safety risk. Additionally, the facility did not provide the resident's records to the responsible party in a timely manner. Alarms on exit doors were operational but the main entrance alarm was disabled during daytime hours due to staff monitoring.
Complaint Details
The complaint was substantiated. Staff did not prevent resident #1 from eloping on 10/11/2023, and the facility refused to provide the resident's requested records to the responsible party in a timely manner.
Severity Breakdown
Type A: 1
Type B: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Licensee did not ensure trained staff in sufficient numbers to meet care and supervision requirements for residents who leave the facility unassisted, posing an immediate health and safety risk. | Type A |
| Licensee failed to provide residents prompt access to review and purchase photocopies of their records within two business days. | Type B |
Report Facts
Capacity: 160
Census: 127
Deficiencies cited: 2
Plan of Correction Due Dates: Type A deficiency due 10/26/2023, Type B deficiency due 11/01/2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Naira Margaryan | Licensing Program Manager | Conducted the complaint investigation and signed the report |
| Antonia Alvizar | Licensing Program Analyst | Conducted the complaint investigation and signed the report |
| Mary Jane Rodriguez | Senior Executive Director | Facility representative involved in the investigation |
| Richard Pyo | Director of Resident Care Services | Facility representative involved in the investigation |
Inspection Report
Complaint Investigation
Census: 131
Capacity: 160
Deficiencies: 1
Oct 13, 2022
Visit Reason
The visit was conducted as a case management investigation of a complaint dated 09/21/2022, which included a tour and inspection of food preparation and food storage facilities.
Findings
The inspection found multiple food items with expired dates in the facility's food storage, which were observed by the Licensing Program Analyst and Chef Manager. The expired items were disposed of during the visit.
Complaint Details
The investigation was triggered by a complaint dated 09/21/2022 regarding expired food items found during inspection.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to comply with General Food Service Requirements; many food items were found expired in storage. | Type A |
Report Facts
Facility Capacity: 160
Census: 131
Deficiency Count: 1
Plan of Correction Due Date: Oct 17, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mary Jane Rodriguez | Administrator | Met with during inspection and exit interview |
| Alberto Lopez | Licensing Program Analyst | Conducted inspection and investigation |
| Lisa Hicks | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Census: 131
Capacity: 160
Deficiencies: 0
Oct 13, 2022
Visit Reason
The inspection was conducted as an unannounced complaint investigation following a complaint received on 09/21/2022 alleging the facility provided spoiled food to residents.
Findings
The investigation found no preponderance of evidence to substantiate the allegations. Although many expired food items were found in storage, there was no evidence that expired or spoiled food was served to residents. Staff and most residents denied the allegations, and the alleged resident served expired milk was not on the facility roster.
Complaint Details
The complaint alleged the facility provided spoiled food and expired milk to residents. The allegations were unsubstantiated after investigation.
Report Facts
Capacity: 160
Census: 131
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mary Jane Rodriguez | Administrator | Met with Licensing Program Analyst during investigation and provided information about the allegations |
| Alberto Lopez | Licensing Program Analyst | Conducted the complaint investigation |
| Lisa Hicks | Licensing Program Manager | Oversaw the complaint investigation |
Inspection Report
Annual Inspection
Census: 133
Capacity: 160
Deficiencies: 4
Jun 7, 2022
Visit Reason
Licensing Program Analyst Alberto Lopez conducted an unannounced Required-1 year visit focusing on COVID-19 Infection Control Practices and compliance with Title 22 regulations.
Findings
The inspection found deficiencies related to hot water temperature exceeding regulatory limits, insufficient non-perishable food supplies for seven days, damaged window screens, and a non-flushing toilet in room 219. Plans of correction were submitted with due dates for each deficiency.
Severity Breakdown
Type A: 2
Type B: 2
Deficiencies (4)
| Description | Severity |
|---|---|
| Hot water temperature in multiple rooms exceeded the maximum allowed 120 degrees F or was below minimum, posing immediate health and safety risk. | Type A |
| Lack of seven-day supply of non-perishable foods on premises. | Type A |
| Three window screens were in disrepair, posing potential health, safety, or personal rights risk. | Type B |
| Toilet in room 219 was not flushing and in need of cleaning, posing potential health, safety, or personal rights risk. | Type B |
Report Facts
Census: 133
Total Capacity: 160
Hot water temperature: 122.9
Hot water temperature: 72
Hot water temperature: 121.7
Hot water temperature: 120.5
Hot water temperature: 120.9
Non-perishable food supply: 7
Perishable food supply: 2
Window screens in disrepair: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mary Jane Rodriguez | Administrator | Assisted with inspection and participated in exit interview |
| Alberto Lopez | Licensing Program Analyst | Conducted the inspection and authored the report |
| Stefanie Coronel | Licensing Program Manager | Supervisor overseeing the inspection |
| Andrew Zumbado | Food Manager | Observed lack of 7 day non-perishable food supplies |
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