374604294-5-29-2026-18-AS-JSRS-DUK36V-20260529175858

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374604294
Report Date: 05/29/2026
Date Signed: 05/29/2026 05:59:08 PM

Document Has Been Signed on 05/29/2026 05:59 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 NORTE		FACILITY NUMBER:	374604294
ADMINISTRATOR/ DIRECTOR:	FARISH, JOLENE		FACILITY TYPE:	740
ADDRESS:	1325 LAS VILLAS WAY		TELEPHONE:	(760) 741-1047
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92026
CAPACITY: 198		CENSUS: 180	DATE:	05/29/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Jolene Farish, Aministrator		TIME VISIT/ INSPECTION COMPLETED:	06:00 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	On 05/29/2026, Licensing Program Analyst (LPA) Jacqueline Shaw Ross arrived at the facility to conduct an annual required inspection. Upon arrival, LPA met with Administrator Jolene Farish and the purpose of the visit was explained. LPA toured the interior and exterior of the facility with the Administrator. During the inspection, LPA observed that the facility consists of three separate buildings designated for independent living, assisted living, and memory care services. The facility is licensed to serve 198 non-ambulatory residents, of whom 86 may be bedridden. The facility maintains an approved hospice waiver for 28 residents, at the time of the visit, 27 residents were receiving hospice services. LPA observed an in-ground swimming pool located on the premises that was properly gated and secured with a master lock. Outdoor shaded seating areas were available for resident use. Interior and exterior walkways were observed to be free of obstructions. Fire alarm systems, carbon monoxide detectors, and fire extinguishers were observed and verified as maintained, with fire extinguishers last serviced on 04/27/2026. The last fire drill was conducted on 05/06/2026. LPA inspected the kitchen, walk-in refrigerator, walk-in freeze, and dry food storage area, and observed food supplies to be stored in a safe and sanitary manner. The facility maintains the required two-day supply of perishable foods and seven-day supply of non-perishable foods. Resident interviews indicated that dietary needs are accommodated and that a variety of activities and outings are available to residents. LPA observed that medications and resident medical records were maintained in the wellness rooms. Medications were secured in locked medication carts and accessible only to authorized personnel, including nurses and medication technicians. Cleaning supplies and disinfectants were stored in a locked storage area inaccessible to residents. Kitchen knives and other sharp instruments were secured and inaccessible to residents. Continue on LIC 809-C...

NAME OF LICENSING PROGRAM MANAGER: Rikesha Stamps
NAME OF LICENSING PROGRAM ANALYST: Jacqueline Shaw Ross
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/29/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: LAS VILLAS DEL NORTE	FACILITY NUMBER: 374604294
	VISIT DATE: 05/29/2026

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LPA toured a sample of resident rooms and rooms were observed to be clean, organized, and free of odors. LPA also reviewed a sample of resident and staff records. Records reviewed were complete, current, and contained all required documentation.

During today's inspection, LPA observed no health or safety concerns therefore no deficiencies were cited. An exit interview was conducted, and a copy of this report was reviewed with and provided to Jolene Farish, Administrator.

NAME OF LICENSING PROGRAM MANAGER: Rikesha Stamps
NAME OF LICENSING PROGRAM ANALYST: Jacqueline Shaw Ross
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/29/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026

LIC809 (FAS) - (06/04)

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