374602832-1-19-2024-08-AS-AROS-CZMUYY-20240119150044

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374602832
Report Date: 01/19/2024
Date Signed: 01/19/2024 03:00:53 PM

Document Has Been Signed on 01/19/2024 03:00 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 VIDA DEL MAR		FACILITY NUMBER:	374602832
ADMINISTRATOR:	WEST, LAURA		FACILITY TYPE:	740
ADDRESS:	850 DEL MAR DOWNS RD		TELEPHONE:	(858) 755-1224
CITY:	SOLANA BEACH	STATE: CA	ZIP CODE:	92075
CAPACITY:	130	CENSUS:	DATE:	01/19/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	executive Director, West Laura		TIME COMPLETED:	03:10 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) Amy Rodgers, made an unannounced visit to conduct the required One-Year Inspection. LPA Rodgers was granted entry into the facility by Executive Director Laura West, after identifying herself and stating the purpose of the inspection. The facility serves one-hundred thirty non-ambulatory elderly residents, age 60 and above, of which eight may be bedridden on the first and second floor only. There is an approved Hospice Waiver for 15 residents. LPA was accompanied by Beatriz Teran, Director of Assisted Living and Santos Arroyo, Environmental Service Director during a tour of the facility, which was conducted inside and out and included a sample of resident units, the dining area, recreation rooms, and dinning areas. There is a fire signal system in place and the carbon monoxide detectors were operational. The last disaster drill was conducted on December 2023. Exterior and interior passageways were free from obstructions. According to Business Manager, Scottie Geno are no weapons and/or ammunition stored on the premises. Pull cords, sensor alerts that are connected with the emergency responses system are present in the facility. LPA Rodgers observed functionality of signal system. Resident's room temperatures were within a comfortable range. Each resident had clean and sufficient bed linens, towels, and washcloths. All residents’ rooms were equipped with required furnishings. Lighting was present in the bedrooms. Residents’ bathrooms were observed to be sanitary and operational. Toilets and showers were equipped with grab bars. Hot water temperature in residents’ bathrooms were compliant. [Continued on 809-C]

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024

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 VIDA DEL MAR	FACILITY NUMBER: 374602832
	VISIT DATE: 01/19/2024

NARRATIVE

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[Continued on 809]

Facility has a two-day supply of perishable and a seven-day supply of nonperishable food items. Food supply is replenished frequently by outside vendors. Food was observed to be properly stored and labeled. Food menus and activities schedule were posted. Chemicals and cleaning supplies were stored in a locked closet. Medication room is located on the first floor. The medication carts were locked and stored in the medication room. Medications were labeled and kept in compliance with label instructions.

LPAs interviewed multiple staff and clients. LPA reviewed multiple staff and client records/files. The interviews did not raise any significant licensing concerns. The reviewed files contained all required documents. LPA Rodgers also conducted a review of In-service training procedures. Confidential records were stored in locked areas. Licensee's staff also presented proof of current/active business liability insurance. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs.

An preliminary exit interview was conducted with Executive Director West. A final exit interview and a copy of this report and Licensee/Appeal Rights - LIC 9058 (rev. 01/16) were provided to Business Manager, Scottie Kay Geno, whose signature on this form acknowledges receipt of these documents.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024

LIC809 (FAS) - (06/04)

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