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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331800103
Report Date: 12/01/2021
Date Signed: 12/01/2021 11:25:33 AM

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: 31DATE:
12/01/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Carrie MacDonald, Community Relations DirectorTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Jesse Gardner made an unannounced visit to conduct a health, safety, and welfare check of the residents in care at the facility.

Upon arrival, LPA met with Community Relations Director Carrie MacDonald, and explained the purpose of the visit. At the time of the visit, there were thirty-one (31) residents, and nine (9) staff, including a chef. LPA observed the facility's utilities to be in working order, and no concerns were noted.

During the visit, LPA toured the inside and outside of the facility. LPA assessed the food supply and concluded that the facility exceeds the required (7) days non-perishable, (2) days perishable food requirement.

LPA met with Lead Medical Technician and reviewed resident medications. Medical Tech reported no issues with obtaining the required medications for residents.

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 Ms. MacDonald.
SUPERVISOR'S NAME: Reyna LaceyTELEPHONE: (951) 248-0341
LICENSING EVALUATOR NAME: Jesse GardnerTELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021
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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