<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336425030
Report Date: 11/18/2021
Date Signed: 11/18/2021 02:14:13 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:AVATAR RETIREMENT HOMEFACILITY NUMBER:
336425030
ADMINISTRATOR:JAMAL ALKAWASSFACILITY TYPE:
740
ADDRESS:44645 SAN ONOFRE AVENUETELEPHONE:
(760) 340-5191
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:6CENSUS: 6DATE:
11/18/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Yolanda Alkawass - LicenseeTIME COMPLETED:
02:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Crystal Colvin and Venus Mixon conducted an unannounced case management visit in order to increase the capacity per licensee request. LPAs met with Licensee Yolanda Alkawass and explained the purpose of the visit.

Licensee requested for a capacity increase from 6 residents to 10 residents, which includes an increase from 0 bedridden to 2 bedridden, and all residents able to be non-ambulatory. A Fire Clearance was approved on 11/3/21 for 8 non-ambulatory residents and 2 bedridden residents, for a total of 10 residents. Facility sketch on file shows sufficient square footage in the facility and activity rooms to accommodate the requested capacity. LPAs discussed the facility sketch with Licensee as well as the proposed changes to the capacity of the residential building. Resident bedrooms #2 & #3 have been approved for bedridden residents, and LPAs confirmed that both bedrooms have an exit to the outside of the facility, as well as a walk-in shower in the private bathrooms. LPAs Colvin and Mixon toured the interior/exterior of the residential building and visually inspected the resident bedrooms. LPAs confirmed that all identified shared rooms are large enough to accommodate the required furniture for two residents without inhibiting movement into and throughout the rooms. LPAs additionally confirmed that there are sufficient bathrooms in the facility to meet Title 22 requirements for ratio of residents to bathrooms, as every bedroom has a private bathroom.

The physical plant is ready for increase in capacity. LPA Colvin has notified the Licensee of final capacity increase approval. LPA Colvin further advised the Licensee that the new license will follow in the mail after capacity increase visit. Licensee had additional questions about converting a staff room to a resident bedroom. LPA Colvin could not locate the room (which is behind the kitchen) on the facility sketch, so LPA Colvin advised the Licensee to request blueprints from the City of Palm Desert to confirm it is permitted.

An exit interview was conducted where this report was discussed and a copy was provided to Licensee Yolanda Alkawass.
SUPERVISOR'S NAME: Joel EsquivelTELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal ColvinTELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1