Inspection
No deficiencies recorded in this report
COTTAGES OF LAKE BALBOA 1, THE
6724 GAVIOTA AVE, Lake Balboa CA 91406
6 bedsLatest official report Aug 14, 2025Licensed
Additional info
- Telephone
- (747) 264-1004
- Licensee
- COTTAGES OF LAKE BALBOA, INC., THE
- Administrator
- LEVI, JUSTIN
- Contact
- LEVI, JUSTIN
- License first date
- Sep 13, 2019
- License effective date
- Sep 13, 2019
- District office
- WOODLAND HILLS N.ASC · (818) 596-4334
- Regional office
- 29
- Clients served
- 935 - ELDERLY
Summary
The available records show 1 Type A and 3 Type B deficiencies for this facility.
- Most recent inspection
- Aug 14, 2025
- Most recent deficiency
- Mar 4, 2022
7 later reports, from Sep 1, 2022 through Aug 14, 2025, recorded no deficiencies, though the records do not say whether they were follow-ups.
What Type A and Type B mean
- Type A
- 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
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
At a glance
Counts cover the five-year public record. Typical figures are the median for the 1,564 Los Angeles County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 10 reports for this facility: 8 inspections, 2 complaint investigations, and 0 licensing or administrative records.
Those records contain 1 Type A and 3 Type B deficiencies.
2 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 8
- Recorded deficiencies
- 4
- Type A deficiencies
- 1
- Type B deficiencies
- 3
- Substantiated complaints
- 0
- Repeated topics
- 0
More than the typical 4
0 in the last 12 months
More than the typical 1
0 in the last 12 months
Most this size have none
0 in the last 12 months
Most this size have none
0 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
No inspection in the last 12 months, so a zero above means no record rather than a clean visit.
Repeated topics
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
No topic repeats in the last 36 months
No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
No deficiencies recorded in this report
Complaint
Allegations0 substantiated · 3 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportInspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
Resident rightsType B
- Official classification
- Type B
- Official code
- 87468.1
- Regulation authority
- CCR
What the official deficiency says
Personal Rights of Residents in All Facilities: (a)Residents in all residential care facilities for the elderly shall have all of the following personal rights: (8)To have their representatives regularly informed by by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This requirement was not met, evidenced by, based on information obtained R1 fell and staff did not notify R1's representative in timely a manner. This is a potential health and safety risk to residents in care.
Official plan of correction
Administrator and LPA discussed the plan of correction, that the facility will ensure that any incidents related to residents, all family or representatives will be notified in a timely manner, and will continue to submit SIRs to Licensing according to regulations. Training will be provided to all staff and documentation will be submitted to LPA by POC date.
Deadline recorded: Mar 25, 2022. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Mar 25, 2022
Correction not verified in available records
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(g)
- Regulation authority
- CCR
What the official deficiency says
Incidental Medical and Dental Care. (g) The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis..This requirement was not met, evidenced by, based on R1 fell at the facility and staff did not provide medical attention to R1.
Official plan of correction
Administrator will discuss with staff, the proper protocols when a resident is injured and when to contact emergency personnell, as wwhen needed. Training will be provided and documentation will be submitted to LPA by POC date.
Deadline recorded: Mar 25, 2022. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Mar 25, 2022
Correction not verified in available records
Complaint
Health conditions and treatmentsType A
- Official classification
- Type A
- Official code
- 87608
- Regulation authority
- CCR
What the official deficiency says
Postural Supports: (a) Based on the individual's preadmission appraisal..for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports maybe... used to achieve proper body position and balance...but not limited to, preventing a resident from falling out of bed..This requirement was not met, evidenced by, based on incident reports, the facility installed full bed rails to secure R1 in the bed (although R1 was not on hospice). and R1 sustained serious injuries. This is a potential health and safety risk to resident in care.
Official plan of correction
Administrator and LPA discussed during the visit, the plan of correction will be to continue to ensure that all residents who have bed rails, has proper documentation or a hospice care plan. Currently, there are (2) residents who are on hospice with proper documentation for bed rails. POC cleared during visit
Deadline recorded: Mar 4, 2022. A deadline is not proof that correction was completed.
Official record says corrected or clearedRecorded in report dated Mar 4, 2022
Plan of correction recorded
Correction deadline recordedDeadline Mar 4, 2022
Basic services and supervisionType B
- Official classification
- Type B
- Official code
- 87466
- Regulation authority
- CCR
What the official deficiency says
Observation of Resident: The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning...the licensee shall ensure that such changes are documented...This requirement was not met as evidenced by: during the investigation, the facility accepted and retained R1, when knowing R1 was a “high fall risk.” Because of the improper use of bed rails, the impact of the fall caused severe injuries to R1. This is a potential health and safety risk to residents in care.
Official plan of correction
Administrator and LPA discussed during the visit, the plan of correction will be to continue to ensure that all residents have current re-appraisals and needs and service plan, as well as current physician reports. Currently all residents documents are current and updated. POC cleared during visit.
Deadline recorded: Mar 4, 2022. A deadline is not proof that correction was completed.
Official record says corrected or clearedRecorded in report dated Mar 4, 2022
Plan of correction recorded
Correction deadline recordedDeadline Mar 4, 2022
Inspection
No deficiencies recorded in this report
Source and limits
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
Read the data methodology