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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600816
Report Date: 10/09/2023
Date Signed: 11/16/2023 08:47:01 AM


Document Has Been Signed on 11/16/2023 08:47 AM - It Cannot Be Edited

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:ROWNTREE GARDENSFACILITY NUMBER:
300600816
ADMINISTRATOR:CLAUDIA LUSCA-BORCSAFACILITY TYPE:
741
ADDRESS:12151 DALE STREETTELEPHONE:
(714) 530-9100
CITY:STANTONSTATE: CAZIP CODE:
90680
CAPACITY:280CENSUS: DATE:
10/09/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
12:32 PM
MET WITH:Randy BrownTIME COMPLETED:
12:33 PM
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Office visit to discuss Stipulation and compliance requirements with Randy Brown and Allison Nakatomi.
· CDSS reviewed the proposed disclosure language and is working with CFH’s attorney, Pam Kaufmann, on required revisions.
· CFH is required to submit the escrow reports quarterly.
· CFH is required to include a signed attestation that there were no life care contracts entered for each reporting period.
· CFH is required to submit its Financial Plan (Plan) (1793.13(a)(2). CDSS expects to receive the Plan no later than 60 days of the date.
· CFH will be required to continue submitted financial statements and occupancy reports. These are required to be submitted quarterly (based on CFH’s fiscal year).
CFH’s action taken to comply with Stipulation:
· CDSS approves Gary Johnson to serve on CFH’s Board.
· CDSS approves the change naming Ann Hablitzel as the Board Chair to separate the roles and ensure and there are no overlapping responsibilities do with the Chief Executive Officer (Randy Brown).
· CDSS approves the proposed financial consultant, MHS Consulting (Jeremy Kauffman), to identify implementable strategies to improve the CFH’s performance and provide quarterly reports to CFH and the Department regarding CFH’s financial operations.
· CFH has submitted a proposed Continuing Care Contract (Type B/
36-Month Amortization) to the Department for its review and approval. The Department has reviewed this contract and found that it does not conflict with the Continuing Care Statutes.
· CFH has submitted a revised Escrow Agreement to the Department for its review and approval. The Department has reviewed this agreement and found that it complies with the terms in the Stipulation.
SUPERVISOR'S NAME: Kathryn HernandezTELEPHONE: (916) 651-7902
LICENSING EVALUATOR NAME: Allison NakatomiTELEPHONE: (916) 531-5336
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2023
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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