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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 405850034
Report Date: 02/22/2024
Date Signed: 02/23/2024 09:53:14 AM


Document Has Been Signed on 02/23/2024 09:53 AM - 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364



FACILITY NAME:AVILA SENIOR LIVING AT DOWNTOWN SLOFACILITY NUMBER:
405850034
ADMINISTRATOR:DARLENE MARKHAMFACILITY TYPE:
740
ADDRESS:475 MARSH STTELEPHONE:
(805) 541-4222
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93401
CAPACITY:100CENSUS: 48DATE:
02/22/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Darlene MarkhamTIME COMPLETED:
03:30 PM
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Licensing Program Analyst conducted a Plan of Correction visit to the facility above. LPA met with Darlene Markham Administrator and explained the purpose of the visit.

LPA De Leon determined the following:

Apt 118 is currently being worked on the should be finished by next week.

Storage room drainage issue has not been completed.

Apt 202 work has not been completed.

Atrium Peeling paint and paint bubble has not been fixed, Skylight leaks have been fixed.

The roof leaks over Apt 202-205 have not been completed.

The rotted wood trim on the outside of the building has not been fixed.

Exit interview conducted, daily civil penalties have been assessed on original complaint visit, copy of report and appeal rights emailed to Administrator.
SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De LeonTELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2024
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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