331881459-9-29-2023-18-AS-JARA-CW5PUW-20230929113812

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 331881459
Report Date: 09/29/2023
Date Signed: 09/29/2023 11:38:16 AM

Document Has Been Signed on 09/29/2023 11:38 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	CARLOTTA, THE		FACILITY NUMBER:	331881459
ADMINISTRATOR:	BOWIE, MOLLY		FACILITY TYPE:	741
ADDRESS:	41-505 CARLOTTA DRIVE		TELEPHONE:	(760) 346-5420
CITY:	PALM DESERT	STATE: CA	ZIP CODE:	92211
CAPACITY:	250	CENSUS: 207	DATE:	09/29/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Executive Director, Molly Bowie		TIME COMPLETED:	11:45 AM

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On 9/29/2023, Licensing Program Analyst (LPA) Janira Arreola, conducted an announced visit to the facility in order to conduct a prelicensing inspection. LPA met with Executive Director, Molly Bowie, who was informed of the purpose of the visit. LPA conducted a walk through of the facility and reviewed submitted application documents.

The applicant WELL OAK CCRC TENANT LLC; OAKMONT ET AL is seeking a change for an residential care facility for the elderly continuing care retirement community with a capacity of 250, ages 60 and above.

The facility obtained an approved fire clearance on 7/6/2023 for 240 non-ambulatory of which 10 may be bedridden from Office of the Riverside County Fire Marshall. LPA observed studios 404, 405, 411-416, 432, and 433 approved for bedridden residents. The current administrator credentials were reviewed and meet licensing requirements with expiration date of 1/23/2025.

The facility is a 2 story building with 2 separate "casitas". Total 258 bedroom, 267 bathrooms are licensed. Required documents are posted in public view and in common areas. Resident bedrooms and bathrooms possessed working utilities and were in good repair.

LPA observed required furniture, extra linens and bath towels. Emergency supplies such as fire extinguisher, first aide kit, AED, emergency food and water supply were present. Emergency shut off is located on facility sketch with emergency exit routes. Resident medications will be stored and locked in medication rooms. Safety precautions are taken with grab bars, hall night lights. Facility has call buttons for resident to call for assistance. The facility has pools and hot tub which were observed to be gated and locked. No firearms are being kept in the facility.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira Arreola	TELEPHONE: 951-248-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2023

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: CARLOTTA, THE	FACILITY NUMBER: 331881459
	VISIT DATE: 09/29/2023

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The facility kitchen was observed to be equipped with enough pots, pans, cooking utensils, plates, and cups. The kitchen had the required perishable and non-perishable food items. Separate areas are observed for food preparation and sanitization. The laundry room functional, and the facility possesses cleaning supplies to conduct regular cleaning of the facility which will be kept locked and located in housekeeping closets.

The smoke alarms and carbon monoxide detectors were found in working condition. The dining room and outdoor space has ample room to accommodate residents. LPA observed the facility has activities for clients to engage in. The hot water temperature was recorded in a resident room at 106.3F, and land line was is operational at (760-346-7710). No health or safety issues were observed during the time of the visit.

An exit interview was conducted were this report was reviewed and provided to Executive Director, Molly Bowie.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira Arreola	TELEPHONE: 951-248-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2023

LIC809 (FAS) - (06/04)

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