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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331800103
Report Date: 03/15/2021
Date Signed: 03/15/2021 03:16:37 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:LEGEND GARDENSFACILITY NUMBER:
331800103
ADMINISTRATOR:PENDINGFACILITY TYPE:
740
ADDRESS:73685 CATALINA WAYTELEPHONE:
(760) 773-3115
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:96CENSUS: 37DATE:
03/15/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Carrie MacDonald, Community Resourses DirectorTIME COMPLETED:
12:00 PM
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Licensing Program Analysts (LPAs) Tricia Danielson and Yolanda Delgado arrived to the facility to conduct a case management visit in conjunction with a 10 day complaint investigation visit on this date to check on the health, safety, and welfare of clients in care. LPAs met with Community Resources Director (CRD) Carrie MacDonald and explained the purpose of the visit. LPAs were informed that thirty-seven (37) residents currently reside at this facility. There were eleven (11) staff on duty during the time of the visit.

During the visit, LPAs toured the inside and outside of the facility. LPAs assessed the available food supply and observed that the supply exceeds the requirement of a two (2) day supply of perishable foods and a seven (7) day supply of non-perishable foods. The food was observed to be of adequate quality and have proper nutritional value. LPAs tested water temperatures which were found to be within regulatory requirements. Smoke and carbon monoxide detectors were also observed to be in working order. LPAs toured resident rooms and observed the rooms to have adequate lighting, appropriate linens, and adequate personal storage space. Facility doorways and pathways were observed to be free from obstructions. The inside temperature was measured and was within regulatory requirements. LPAs interviewed six (6) residents and four (4) staff.

Based on the information obtained during today's visit, there are no immediate threats to the health, safety, and welfare of the residents in care. No deficiencies were cited during today's visit. An exit interview was conducted and a copy of this report was provided to CRD MacDonald.
SUPERVISOR'S NAME: Reyna LaceyTELEPHONE: (951) 836-3135
LICENSING EVALUATOR NAME: Tricia DanielsonTELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2021
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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