374600637-2-13-2024-08-AS-JBAD-D2EVVG-20240213154619

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374600637
Report Date: 02/13/2024
Date Signed: 02/13/2024 03:46:27 PM

Document Has Been Signed on 02/13/2024 03:46 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME:	LA COSTA GLEN CARLSBAD		FACILITY NUMBER:	374600637
ADMINISTRATOR:	KEARNAGHAN, KRISTEN		FACILITY TYPE:	741
ADDRESS:	1950 SILVERLEAF CIRCLE		TELEPHONE:	(760) 704-1000
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92009
CAPACITY:	1233	CENSUS: 808	DATE:	02/13/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Executive Director Kristen Kearnaghan, Assistant Executive Director Ivy Holmes		TIME COMPLETED:	03:50 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) Juliana Barfield and Amy Rodgers conducted an unannounced Required One Year visit to ensure substantial compliance with Title 22 regulations. This facility is co-licensed as a Continuing Care Retirement Community (CCRC) for up to 1233 elderly residents, all of whom may be non-ambulatory. LPA was met by Assistant Executive Director Ivy Holmes and discussed the purpose of the visit. LPAs were then joined by Executive Director Kristen Kearnaghan. LPAs toured the Independent living areas and briefly spoke with residents and staff. Pathways were free of obstruction and slip hazards. There is an outdoor pool securely fenced and an indoor pool and coy pond that are only accessible to independent residents. Smoke and carbon monoxide alarms are hard-wired to a central location. Hot water temperatures was compliant in resident bathrooms, which had grab bars for resident use. LPA inspected two facility kitchens and food storage and observed a minimum of seven (7) days of nonperishable foods and a minimum of two (2) days of perishable foods. Cleaning solutions are stored away from areas that also store kitchen utensils, equipment and/or food. Medication is centrally stored and secured in locked medication rooms.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Juliana Barfield	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024

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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: LA COSTA GLEN CARLSBAD	FACILITY NUMBER: 374600637
	VISIT DATE: 02/13/2024

NARRATIVE

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Staff have current 1st Aid training and Safety Department staff are EMTs. Resident records sampled had a Physician's Report and Admission Agreement, along with current Needs and Services plans.

No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted and a copy of this report along with Licensee/Appeal Rights (LIC9058 03/22) were provided to Executive Director Kristen Kearnaghan.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Juliana Barfield	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024

LIC809 (FAS) - (06/04)

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