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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603081
Report Date: 11/15/2024
Date Signed: 11/15/2024 12:00:18 PM

Document Has Been Signed on 11/15/2024 12:00 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:MEADOWBROOK VILLAGE CHRISTIAN RETIREMENT COMMUNITYFACILITY NUMBER:
374603081
ADMINISTRATOR/
DIRECTOR:
MARK MEMMELAARFACILITY TYPE:
741
ADDRESS:100 HOLLAND GLENTELEPHONE:
(760) 746-2500
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY: 200TOTAL ENROLLED CHILDREN: 0CENSUS: 58DATE:
11/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Administrator, Mark MemmelaarTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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On 11/15/2024, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility for a required annual inspection. LPA met with Administrator, Mark Memmelaar who was informed of the purpose of the visit. The facility has fire clearance for 200 non-ambulatory elderly residents, of which 15 may be bedridden.

LPA toured the Continuing Care Retirement Community's interior and exterior with Administrator. LPA was informed the facility is made up of 120 apartments and 50 cottages available for independent and assisted living. The facility also has a separate building with 22 beds designated for memory care and 15 beds for skilled nursing. The memory care unit is approved for delayed egress and LPA observed it to be operational. LPA also observed several common areas for resident leisure including a library, game room, theater, beauty salon, large dining rooms, and a fitness center with an indoor in-ground pool and spa. The in-ground pool and spa require a keyed entry and facility staff grant residents access. Indoor and outdoor passage ways are free of obstruction. LPA observed fire alarm systems, carbon monoxide detectors, and charged fire extinguishers throughout the facility. Fire extinguishers were last serviced on 12/16/2023. The smoke alarm/carbon monoxide detector in a resident room was tested and LPA observed it to be operational. LPA toured the kitchen and observed the facility had more than two-day supply of perishable foods and seven-day non-perishable food items, which were stored in a safe and healthful manner. Interviews revealed kitchen staff accommodate residents’ dietary needs. Medications are secured in medication carts in wellness centers, only accessible to authorized personnel such as wellness nurses and/or medication technicians. LPA reviewed random resident files, which had updated Departmental required records. Facility sketches are posted throughout the facility and complaint information is posted by the main dining room. When asked, Administrator communicated there are no reports or reasons to believe any of the current residents have firearms or ammunition in the facility. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted and a copy of this report was reviewed and provided to Administrator.
Tricia DanielsonTELEPHONE: (951) 202-5067
Janette RomeroTELEPHONE: (951) 529-2930
DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
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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