374600799-5-29-2024-08-AS-MGCO-D5R99M-20240529231034

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374600799
Report Date: 05/29/2024
Date Signed: 05/29/2024 11:13:10 PM

Document Has Been Signed on 05/29/2024 11:13 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:	CARLSBAD BY THE SEA		FACILITY NUMBER:	374600799
ADMINISTRATOR:	DIGERNESS, PAULA		FACILITY TYPE:	741
ADDRESS:	2855 CARLSBAD BLVD.		TELEPHONE:	(760) 492-3359
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	224	CENSUS: 199	DATE:	05/29/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Executive Director, Paula Digerness		TIME COMPLETED:	05:25 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 Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Annual visit. LPA met with Executive Director, Paula Digerness and we discussed the purpose of the visit. Digerness is the certified administrator for the facility, and her Administrator's Certificate expires on June 17, 2025. The facility file was reviewed before the visit. According to the facility’s license, the community serves residents over age 60. 208 residents may be non-ambulatory. The property includes three (3) buildings, at 2807 Ocean Street, at 201 Grand Avenue, and the Main Building located at 2855 Carlsbad Blvd. A waiver is approved for five (5) hospice residents. Currently, there is only one (1) resident under hospice care living in assisted living. The facility was assessed by touring it inside and out. LPA inspected for compliance with safety, maintenance, and operational requirements. LPA interviewed staff, and residents in assisted and independent living. LPA briefly interacted with residents in care. All facility staff records reviewed by the LPA had a current criminal record clearance. Digerness stated there are no firearms stored on the premises. There were two areas available for dining, the meals are prepared in the main dining area for all residents living in the property. There were at least two (2) days of perishable food, and at least seven (7) days of non-perishable food present, all safely stored in the kitchen inspected. Cooking/dining equipment and utensils were present. The kitchen and dining areas were clean, organized, and free from bad odors. Fresh fruit and vegetables were observed to be of good quality. There was a facility pool, and LPA toured the area with Executive Assistant, Page Kerr. A key fob restricted access to the pool and the four (4) doors were secured during the LPA's visit. Today's inspection consisted of parts within each of the three buildings. LPA inspected the nursing station; resident records and medication were observed to be secured and locked as required. Per staff, the hot water temperature was measured by maintenance once a week. (continue at LIC809C)

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

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: CARLSBAD BY THE SEA	FACILITY NUMBER: 374600799
	VISIT DATE: 05/29/2024

NARRATIVE

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(Continue from LIC809)

LPA observed smoke alarms present in each room. The appliances in the resident rooms were in working order. Each room observed was clean, sanitary, and in good operating condition. Temperature in the residents' rooms was controlled by each resident. It was also observed pull cords in each of the residents' rooms. All bathrooms inspected had grab bars installed in the shower areas. However, there was one bathroom observed that did not have grab bars by the toilet. LPA provided technical advice regarding grab bars by the toilets.

Cleaning supplies for the housekeeping staff were secured in the housekeeping closet. The signal system was tested in the presence of staff; staff responded in less than one (1) minute. Some of the residents also utilize a pendant that can be worn to request staff assistance in emergencies. Per resident interviews, staff responded to the pendant in less than 5 – 10 minutes.

Medications were labeled, as required, and stored in locked areas. LPA observed several medication carts that were locked and secured. In independent living, all residents keep their medications in their apartments. Keys to the medication were kept and controlled by appropriate staff with responsibility for medication management for assisted living.

LPA interviewed staff and reviewed multiple staff and resident records/files. LPA interviews did not raise any licensing concerns. The files that LPA reviewed contained the required documents. Confidential records were stored in locked areas.

Facility staff conducted emergency drills in April 2024, LPA verified that emergency drills were conducted at least quarterly in some cases every two (2) months. Fire drills were conducted each month. The facility updated its disaster and emergency preparedness plan was updated on April 15, 2024. Liability insurance was current until January 1, 2025. Staff had current basic first aid and basic CPR certificates on file. Required training was current and complete for all staff records reviewed. All required postings were observed to be prominently displayed in common areas of the facility. All fire extinguishers were serviced in April 2024.

No Violations were observed during today's visit. An exit interview was conducted with the Executive Director, Digerness, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

LIC809 (FAS) - (06/04)

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