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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425800837
Report Date: 05/31/2022
Date Signed: 05/31/2022 05:01:42 PM


Document Has Been Signed on 05/31/2022 05:01 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:GARDEN COURT AT VILLA SANTA BARBARAFACILITY NUMBER:
425800837
ADMINISTRATOR:KAROLYN SORENSONFACILITY TYPE:
740
ADDRESS:227 E. ANAPAMU STREETTELEPHONE:
(805) 963-4428
CITY:SANTA BARBARASTATE: CAZIP CODE:
93101
CAPACITY:126CENSUS: 66DATE:
05/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Rick Olds, AdministratorTIME COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced Annual Inspection and Infection Control Inspection visit to the facility. Upon arrival LPA met with Rick Olds, Administrator and explained the purpose for the visit. A health and safety tour of the facility was conducted from 1:10 pm to 1:45 pm.
The facility is a Residential Care Facility for the Elderly (RCFE). It consists of Assisted Living and Independent Living Residents. There are approximately 126 resident rooms. Currently, there are 2 residents on hospice. Activities are available to the residents on an ‘at will’ basis. Activities include physical exercise, mental crunches, billiard tables, movie night, live music entertainment, religious study groups, a book club, transportation to appointments, outings, and local eateries, and scenic tours to beaches and parks,
The ground level consists of entrance into the facility into the main lobby, a common area, a dining area, theatre room, billiard room, beauty salon, a library, a laundry room, and administrative offices. There is a private patio in front of the facility with access from the dining area. Private parking is connected into the facility at the back of facility.
Floor #1 consists of residents’ rooms, medication room, a wellness center with the nurses’ station, employee staff room, and an exercise room. Floor #2 consists of residents’ rooms.
A balcony is available for residents through an elevator. The balcony has covered and uncovered seating areas with outdoor benches and tables. The balcony area is conducive for visitation area for residents and guests.
LPA observed the kitchen is sufficiently stocked with 2-days of perishables and 7-days of non-perishables.
LPA observed 10 fire extinguishers serviced between October 26, 2021 and January 2022. Smoke alarms are hard wired and will alert the local fire department in the event of a fire.
Due to time restraints, LPA will return to the facility at a later date.

Exit interview conducted, 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: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022
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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