<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604533
Report Date: 04/20/2022
Date Signed: 04/20/2022 05:06:50 PM


Document Has Been Signed on 04/20/2022 05:06 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:SANTIANNA OAKMONT SIGNATURE LIVINGFACILITY NUMBER:
374604533
ADMINISTRATOR:THARP, CHRISTOPHERFACILITY TYPE:
740
ADDRESS:2560 FARADAY AVETELEPHONE:
(442) 325-8090
CITY:CARLSBADSTATE: CAZIP CODE:
92010
CAPACITY:226CENSUS: 0DATE:
04/20/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Executive Director, Christopher TharpTIME COMPLETED:
03:00 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
Licensing Program Analyst (LPA), Natasha Persaud conducted an announced Pre-Licensing/Component III inspection. LPA identified herself and explained the purpose of the visit with Executive Director, Christopher Tharp and Vice President of Operation, Tamara Fernandez to ensure Title 22 compliance. An initial application was received by the Department on 12/20/2021. The Applicant/Licensee requested to be licensed for a capacity of 226 Non-Ambulatory; of which 8 may be bedridden in memory care building on the first and second floors. Delayed egress approved in memory care building. Hospice waiver for 15 residents.

During today’s visit, LPA, accompanied by the applicant's representatives, toured the interior and exterior of the facility and inspected resident rooms, along with common areas. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Sinks and toilets were in working order. Hot water temperature measured between 106-118 degrees F in bathrooms for resident use.

The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and resident activities. The facility has locked areas for storage of medication and confidential resident and staff records. Pool was fenced and locked. Per the Executive Director, no firearms or ammunition will be stored at the facility. More than a 30 day supply of PPE along with an ample supply of emergency food and water. Signal system was operational. The facility fire clearance was granted on April 6, 2022 and reflects that the facility is approved for 226 elderly residents.

An exit interview was conducted with Executive Director, Christopher Tharp and a copy of this report, along with Licensee/Appeal Rights (LIC 9058 01/16), were provided to the Executive Director via electronic mail. An electronic read receipt confirmation was requested to be sent by the Applicant/Licensee upon receipt of the documents.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha PersaudTELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1