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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421700160
Report Date: 10/12/2021
Date Signed: 10/12/2021 03:19:27 PM

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:CASA DORINDAFACILITY NUMBER:
421700160
ADMINISTRATOR:BRIAN MCCAGUEFACILITY TYPE:
741
ADDRESS:300 HOT SPRINGS RD.TELEPHONE:
(805) 969-8011
CITY:SANTA BARBARASTATE: CAZIP CODE:
93108
CAPACITY:325CENSUS: 322DATE:
10/12/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Brian McCague, AdministratorTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) K. Kontilis conducted an unannounced onsite one-year infection control annual visit to the above-named facility. LPA met with Brian McCague, Administrator and explained the purpose of the visit.
Entrance interview conducted.
The facility has submitted a Mitigation Plan to the Department. The Personal Care section of the facility consists of Assisted Living residents. There are 38 apartments in the Personal Care section. There is an entry station at the main entrance. Upon entry, staff, visitors, and residents who have returned from an outing are required to sign-in, complete a symptom questionnaire, and have a temperature screening at least once a day. All documentation is kept in log books located in the Nurse’s station on the second floor and near the lobby on the first floor. The entry station has PPE gear, hand sanitizer, disinfecting wipes, and a thermometer.
LPA toured facility with Administrator. This facility is licensed for 325 residents, 30 of the 48 acres of the property are buildings consisting of residents’ apartments, dining areas, library, game room, music room, Pacific room, a life enrichment building (arts and craft studios and health and fitness studios) and outdoor common spaces and patios. The facility license includes independent living and assisted living at this time.
The independent living area has 228 apartments. Independent living includes villas, cottages, and apartments. There is one outdoor pool surrounded with a locked gate and fully fenced. The pool is located on the southwest corner of the property near the Medical Center (Skilled Nursing facility).
A tour of the physical environment and accommodations were assessed, and the following was noted: LPA observed the required posting of the complaint poster, bill of rights and Resident’s Rights.
Exit interview conducted. No deficiencies noted. No citations issued. Copy of report issued via email.
SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Kristin KontilisTELEPHONE: (805) 689-2787
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
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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