Section 87112(a)(1)(A) Conditions for Forfeiture of a License

The requirements of this regulation were met as evidenced by interviews and observation; On 11/27/2023 Licensing Program Analyst (LPA) Brian Phillips spoke with the sister of the Licensee by telephone as the Licensee was unable to be contacted. LPA was told that the Licensee was not sure if they were going to close the facility or keep the License after the Licensee recovers from a serious illness. LPA was informed that there were no current residents in care at the facility. LPA explained the details of the Facility Closure procedure and that Community Care Licensing Division (CCLD) would need to hear about a closure directly from the Licensee in writing. The sister of the Licensee indicated that she would inform the Licensee.

Continued on 809-C

On 02/02/2024, LPA contacted the telephone number listed for the facility, but received no response and was unable to leave a message. LPA also sent an email to the email address listed for the facility stating that the LPA talked to Licensee’s sister by telephone on 11/27/2023 and was told that the Licensee was not sure if they were going to close or keep the facility license recovery from illness. LPA reminded Licensee in the email that LPA told Licensee’s sister on 11/27/2023 that if Licensee was to close the facility, then Licensing needs to hear about a closure directly from the Licensee in writing. LPA also provided information as to where Licensee can send the closure notice in writing to the CCLD Regional Office (RO).

On 02/02/2024, LPA contacted the sister of Licensee again and asked about the status of the facility as Licensee was unable to be contacted or communicated with by telephone or email. The sister of Licensee informed LPA that the facility had been closed since December 2023, and gave LPA the personal telephone number information for Licensee. On 02/02/2024, LPA contacted the Licensee at their personal telephone number not associated with the facility. According to the Licensee, the facility was indeed closed in December 2023, but the Licensee had not informed CCLD yet in any way. The Licensee indicated that the last resident in care at the facility had been moved to an equivalent facility on 11/17/2023. The Licensee indicated that they had read the email sent by LPA on 02/02/2024 and would send a notice of closure in writing to Community Care Licensing Division (CCLD) as well as sending the original copy of the facility License.

Additionally, the facility was overdue/not current on the payment of Licensing fees to CCLD. A report was run by CCLD on 03/13/2023 stating that the facility was overdue 121 days and over for partial or nonpayment of 2022 annual fee billed on 06/01/2022. LPA contacted Licensee by telephone and email on 04/14/2023, providing the documentation of overdue payment and information on how to pay annual fees. LPA additionally discussed the payment of overdue licensing fees in person with the Licensee on 08/08/2023. A report was run by CCLD on 12/11/2023 stating that the facility was overdue 91 to 120 days for partial or nonpayment of 2023 annual fee billed on 06/07/2023. Another report was run by CCLD on 01/08/2024 stating that the facility was overdue 121 days and over for partial or nonpayment of 2023 annual fee billed on 06/07/2023. Continued on 809-C

The following requirements are in the process of being met. Submission of a closure letter and surrender of the facility License. This is a closure due to the Licensee abandoning the facility. After telephone discussion with LPA on 02/02/2024, the Licensee has chosen to surrender the facility license. A written notification of the Certification of Non-Operation is in the process of being signed and remitted, along with the original license, to the Regional Office (RO) of CCLD Goleta. The license will be forfeited upon receipt of the signed Certification of Non-Operation or other written notification from the licensee indicating they are no longer in business. For this facility, the RO is required to conduct a case management inspection to verify that the facility is no longer in operation.

LPA noted no vehicles in the driveway of the facility, and no individuals in the front entryway or around the perimeter of the facility. LPA knocked multiple times and rang the doorbell, but there was no answer from within. LPA was able to observe from outside the facility that the entry way leads into a living room and kitchen, both of which appeared to be vacated. There are 2 side gates from the facility which are not delayed egress self-closing. There are 5 designated resident rooms in the facility, and 1 staff room in the facility. LPA was able to observe these rooms through the windows as LPA walked the perimeter of the facility. All rooms appeared empty/vacated with no furniture or signs of usage at all.

From observations through facility windows, and of the outside areas of the physical plant, LPA noticed that all outside electrical outlets had no plugs attached. The backyard itself appeared vacated except for a hose attached to an outdoor water outlet and a shed in the backyard which contained replacement roof tiles and outdoor maintenance items. LPA was not able to observe the inside of the garage of the facility, but from the rest of the observations the physical environment was clean, in good condition, and appeared vacant. Walls, windows, ceilings, floors and floor coverings, and doors were checked.

Due to there being no individuals at the facility at the time of the Facility Closure inspection, the report will be emailed to the Administrator for signature. Signature on file