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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421702848
Report Date: 04/26/2022
Date Signed: 04/26/2022 05:32:37 PM

Document Has Been Signed on 04/26/2022 05:32 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:COVENANT LIVING AT THE SAMARKANDFACILITY NUMBER:
421702848
ADMINISTRATOR:LAURIE SMALLFACILITY TYPE:
741
ADDRESS:2550 TREASURE DRIVETELEPHONE:
(805) 687-0701
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY: 379CENSUS: 349DATE:
04/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Jennifer Leggett, Associate Executive DirectorTIME COMPLETED:
05:30 PM
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced continuance of an Annual Inspection and Infection Control Inspection visit to the facility. LPA continued the annual visit due from the inspection conducted on 4/25/2022. Upon arrival LPA met with Karen Harris, Human Resources Director and Jennifer Leggett, Associate Executive Director and explained the purpose for the visit.
The facility is a 16-acre Residential Care Facility for the Elderly (RCFE) Continuing Care Retirement Community. It consists of Independent Living, Assisted Living, and Memory Care. The skilled nursing facility is not within Community Care Licensing Division’s jurisdiction. The Independent Living section has approximately 218 private residential apartments. The Assisted Living unit has approximately 36 residential apartments. The Memory Care unit consists of a secure unit with approximately 16 apartments.
Resident’s activities address the “eight dimensions of holistic wellness”. These activities include but are not limited to fitness programming, life-long learning, art classes, religious studies, book clubs, technology education, spiritual programming, inter-generational opportunities with students in local schools, music appreciation and participation, outdoor games such as bocce ball, corn toss, ping pong; a Residents’ Counsel, and scenic drives to museums, parks, and cultural centers.
There are four dining areas and eateries on the campus. The outdoor area consists of a 25-meter swimming pool with a jacuzzi in a locked fenced area, a gym, fitness studio, putting green, walking paths, botanical garden, coy pond, and shaded sitting areas conducive for outdoor visitations.
The administrative offices consist of a two-story building with Sales & Marketing, Human Resources, Transportation, a bank, Director of Philanthropy, Business Office Specialist, financial facilitator, Covenant Trust Representative, Resident Life Director, and Office of Executive Director and Associate Executive Director.
A health and safety tour of the campus was conducted from 4:30 pm to 5:05 pm.

Exit interview conducted. Deficiencies noted were addressed in a Case Management report on 4/26/2022. Report issued via email.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2022
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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