374600566-8-24-2023-18-AS-CGOH-CUZ2P6-20230823173350

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374600566
Report Date: 08/23/2023
Date Signed: 08/24/2023 01:58:23 PM

Document Has Been Signed on 08/24/2023 01:58 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 AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	REDWOOD TERRACE		FACILITY NUMBER:	374600566
ADMINISTRATOR:	LEIF CAMERON		FACILITY TYPE:	741
ADDRESS:	710 WEST 13TH AVENUE		TELEPHONE:	(760) 747-4306
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92025
CAPACITY:	210	CENSUS: 156	DATE:	08/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:12 PM
MET WITH:	Brittany Eargle, Director of Wellness & Assisted Living		TIME COMPLETED:	05:34 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	On 08/23/23 at 12:12 p.m. Licensing Program Analyst (LPA) Cheryl Goodrich arrived to conduct an unannounced annual visit. LPA met with the Director of Wellness & Assisted Living, Brittany Eargle. The purpose of today’s visit is to inspect the facility to ensure that the facility is following California Code of Regulations, Title 22, Division 6. Facility is approved for two hundred and ten residents. The facility currently has 12 memory care residents, 41 assisted living residents and 103 independent living residents. Infection Control: The facility has an approved infection control plan and a surplus of supplies for infection control including but not limited to mask, gloves, gowns, first aid kit, cleaning supplies, protective eye equipment and cleaning supplies. Physical Plant and Environmental Safety: There are a total of 156 resident bedrooms with bathrooms, studio apartments with kitchenettes, a master kitchen, seating areas, office areas, outside seating areas with furniture for residents and staff, and a transportation vehicle. All rooms, seating areas, office areas, kitchen and dinning room areas are all clean and clear of obstruction. The resident bedrooms were clean and clear from obstruction. The resident’s rooms were complete and clean linens and bedding, a television, dresser, and closet space. The facility is equipped with fire extinguisher, carbon mosnoxide and smoke detectors and sprinkler system. Operational Requirements: The facility was staffed with 5 caregivers and other operational support staff . The facility meets the operational requirements for an has a RCFE-Continuing Care Retirement Community is current with fire clearance for the facility. The facility is equipped with a backup generator for the facility and memory care has it’s own backup generator. (Continued on LIC809-C)

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Cheryl Goodrich	TELEPHONE: 951-248-0308
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

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
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: REDWOOD TERRACE	FACILITY NUMBER: 374600566
	VISIT DATE: 08/23/2023

NARRATIVE

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(Continued from LIC809)

Personnel Records-Training: All have fingerprint clearances, current CPR/First Aid certification, Health screen and TB tests completed. All staff complete monthly in-service training and fire-drills and disaster training and job title specific online training.
Client Records-Incident Reports: The resident records are complete with pre-assessments, physician reports, admissions agreements, physician reports and orders, medication log, daily logs of the resident’s health condition, and additional medical assessments.
Client Rights-Information: The residents rights documentation is present. The resident records also contain needs assessment information for each resident.
Food Service: 7-day non-perishable and 2 day of perishable food supply was observed, and all food was properly stored and available to residents.
Health- Related Services: The caregivers at the facility are dispensing medications within the guidelines of the physician’s order and the regulations. The facility is documenting the date and time of the dispensing of medication for each resident.
Disaster Preparedness: The facility has a disaster plan and has posted the evacuation plan, visible for staff and residents in care. The last fire drill was completed 07/17/23. The facility has emergency supply of food and water.
Summary: Based on today's visit, no deficiencies were observed at this time. An exit interview was conducted with Director of Wellness & Assisted Living, Brittany Eargle and a copy of this report was printed Signature below confirms receipt of these rights.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Cheryl Goodrich	TELEPHONE: 951-248-0308
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

LIC809 (FAS) - (06/04)

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