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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881372
Report Date: 02/15/2023
Date Signed: 02/15/2023 04:18:09 PM


Document Has Been Signed on 02/15/2023 04:18 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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:SEGOVIA OF PALM DESERTFACILITY NUMBER:
331881372
ADMINISTRATOR:BARTON, ROBERTFACILITY TYPE:
741
ADDRESS:39905 VIA SCENATELEPHONE:
(760) 674-3200
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:182CENSUS: 133DATE:
02/15/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Executive Director, Robert BartonTIME COMPLETED:
04:25 PM
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Licensing Program Analyst (LPA) Janira Arreola, conducted an announced visit for the purpose of conducting the prelicensing visit. LPA met with Executive Director, Robert Barton who was informed of the purpose of the visit. The applicant is seeking a change of ownership where the ownership is changing to Oakmont Management group. The population served is elderly ages 60 and over and will be licensed as a continuing care retirement community. The capacity will be for (182) residents.

LPA conducted a walk through of the interior and exterior of the facility. The building is a (2) story building with main building and seperate cottages. Total amount of rooms amounts to 121. The fire clearance conducted by Office of the Riverside County Fire Marshall was approved for (177) non-ambulatory and (5) bedridden residents. LPA observed the residents bedrooms which had the appropriate furniture such as bed, dresser, closet space, light, and chair. The facility has first aid kit with required items, and emergency equipment in garage storage area. The facility kitchen has enough pots and pans, cooking utensils, plates and cups for all residents. The kitchen had the appropriate food items for the capacity of the facility. LPA observed the bathrooms in the facility to have hand hygiene supplies. The laundry room was observed be functional, and the facility possesses cleaning supplies to conduct regular cleaning of the facility. The smoke alarms and carbon monoxide detectors were found to be in operating condition. The dining room has enough seating for all residents with dining area, private dining, bistro and casual dining area, The outdoor space has enough seating to accommodate residents with a shaded areas. The hot water temperature was recorded at 116.9F, and the land line was observed to be operational.

No firearms are being kept in the facility. LPA observed facility pool and spa had locked gates. Kitchen knifes will be kept in designated facility kitchen inaccessible to residents. The medications were observed to be locked in the facility medications room.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira ArreolaTELEPHONE: 951-248-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SEGOVIA OF PALM DESERT
FACILITY NUMBER: 331881372
VISIT DATE: 02/15/2023
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The facility will need to make the following corrections:
  • Obtain items detailed in Title 22 section 87307(a) (3)(C). The applicant will submit proof of purchase as soon as possible to proceed in licensure process.

Component III orientation was conducted during the visit with the applicant. An exit interview was conducted were this report was reviewed and provided to Executive Director, Robert Barton.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira ArreolaTELEPHONE: 951-248-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023
LIC809 (FAS) - (06/04)
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