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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604294
Report Date: 04/12/2024
Date Signed: 04/12/2024 02:47:42 PM


Document Has Been Signed on 04/12/2024 02:47 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:LAS VILLAS DEL NORTEFACILITY NUMBER:
374604294
ADMINISTRATOR:FARISH, JOLENEFACILITY TYPE:
740
ADDRESS:1325 LAS VILLAS WAYTELEPHONE:
(760) 741-1047
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY:198CENSUS: 168DATE:
04/12/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Administrator, Jolene FarishTIME COMPLETED:
03:00 PM
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On 4/12/2024, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility for a required annual inspection. LPA met with Administrator, Jolene Farish who was informed of the purpose of the visit.
LPA toured the facility’s interior and exterior with Administrator Farish. During the tour, LPA observed the facility is made up of three (3) buildings, which are designated for independent living, assisted living, and memory care. The facility is licensed for 198 non-ambulatory residents of which 86 may be bedridden. The facility has an approved hospice waiver for 28 residents and LPA was informed the facility currently has 10 residents receiving hospice services. The facility has an in-ground pool on the premises that is properly gated and secured with a master lock. Outside shaded seating is also available for resident use. Indoor and outdoor passageways are free of obstruction. LPA observed fire alarm systems, carbon monoxide detectors, and charged fire extinguishers serviced on 3/13/2024. LPA toured the kitchen, walk-in refrigerator and dry food storage room and observed food was stored in a safe and healthful manner. The facility met Departmental requirements for a 2-day supply of perishable foods and 7-day supply of non-perishable food items. Resident interviews revealed kitchen staff accommodate residents’ dietary needs and there are several activities and outings available for resident leisure. Medications and residents’ medical files are stored in wellness rooms. Medications are secured in medication carts, only accessible to authorized personnel such as facility nurses and medication technicians. Cleaning solutions and disinfectants are secured in a storage closet. Knives and sharp instruments are stored in the kitchen, inaccessible to the residents. The facility is in the process of removing hallway carpets and adding new flooring. During today’s visit, LPA did not issue any deficiencies. An exit interview was conducted, and a copy of this report was reviewed and provided to Administrator Farish.

There are no health and safety concerns observed as identified on the non-compliance conference held on 10/20/2023

SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette RomeroTELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2024
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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