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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880942
Report Date: 09/09/2024
Date Signed: 09/09/2024 02:04:53 PM

Document Has Been Signed on 09/09/2024 02:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:PARADISE ON PICOFACILITY NUMBER:
331880942
ADMINISTRATOR/
DIRECTOR:		SCOGGINS, STEPHAN MCCLAINFACILITY TYPE:
740
ADDRESS:303 WEST PICO ROADTELEPHONE:
(760) 699-8433
CITY:PALM SPRINGSSTATE: CAZIP CODE:
92262
CAPACITY: 6CENSUS: 0DATE:
09/09/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:02 AM
MET WITH:Stephan Mcclain ScogginsTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
NARRATIVE
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On September 09, 2024, Community Care Licensing (CCLD) held an informal meeting conducted in the Riverside Adult and Senior Care Regional Office. In attendance was Licensing Program Manager (LPM) Rikesha Stamps, Licensing Program Analyst (LPA) Abdoulaye Zerbo, and Licensee Stephan Mcclain Scoggins. The purpose of the meeting is to discuss the facility’s plan of operation, hours of operation, advertisement of the facility, and the intent to implement a new program.

During today’s meeting Licensee Stephan Mcclain Scoggins confirmed with CCLD he has not accepted any residents since becoming licensed in 2020 and would like to maintain his license. Licensee confirmed that he does live out of state from June 1st through September 30th and is in state October 1st through May 30th. Licensee informed LPM and LPA of his intent to operate on a seasonal basis known as “Snowbirds,” individuals who move from cooler to warmer climates. Licensee assured LPM and LPA that he has not implemented this process but is interested in submitting a request for consideration for seasonal operations. However Licensee is aware to abide by his current existing plan of operations approved by the department in 2020. Licensee did confirm he is advertising the property as an Airbnb, during this meeting Licensee was informed of Title 22 regulations Advertisement and License Number and False Claims. Licensee agreed to remove the Airbnb advertisement.

According to the licensee it was unknown to him that he had made any errors, Licensee confirmed he is aware of the Title 22 Regulations due to him being an approved vendor trainer (Esteem Production Corporation).

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: PARADISE ON PICO
FACILITY NUMBER: 331880942
VISIT DATE: 09/09/2024
NARRATIVE
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Licensee was provided resources from the CCLD transparency website and was encouraged to adhere to the Title 22 Regulations on maintaining substantial compliance. Licensee intent is to submit a written draft of a revised plan of operation for the department to review and consider for seasonal operations.

A deficiency was cited under the California Code of Regulations Title 22 for False Claims, Licensee is advertising as both a License board and care and Airbnb rental.

An exit interview was conducted with Licensee Stephan Mcclain Scoggins who was provided a copy of this report along with copies of the LIC809C, LIC809D, and appeal rights.

SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/09/2024 02:04 PM - It Cannot Be Edited


Created By: Abdoulaye Zerbo On 09/09/2024 at 11:12 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: PARADISE ON PICO
FACILITY NUMBER: 331880942

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2024
Section Cited
CCR
87207

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87207 False Claims No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement was not met, as evidenced by: Based on record review Licensee is advertising as both a License board and care and Airbnb rental. This poses a potential threat to the health, safety and personal rights of the residents in care.
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Poc, Licensee agreed to remove the Airbnb advertisement and will email proof of approval to LPA Zerbo at
Abdoulaye.Zerbo@dss.ca.gov.




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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Rikesha Stamps
LICENSING EVALUATOR NAME:Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2024


LIC809 (FAS) - (06/04)
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