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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425800837
Report Date: 12/21/2021
Date Signed: 12/21/2021 03:55:55 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:GARDEN COURT AT VILLA SANTA BARBARAFACILITY NUMBER:
425800837
ADMINISTRATOR:STEFANIA RADUFACILITY TYPE:
740
ADDRESS:227 E. ANAPAMU STREETTELEPHONE:
(805) 963-4428
CITY:SANTA BARBARASTATE: CAZIP CODE:
93101
CAPACITY:126CENSUS: DATE:
12/21/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Catherine Lee, AdministratorTIME COMPLETED:
03:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced Case Management visit at the facility. LPA met with Administrator Catherine Lee and announced the purpose of the visit.

Entrance interview conducted.

On 10/5/2021, CCL received notification via email from Administrator Diona “Stephanie” Radu that as of 10/6/2021, she has resigned and will no longer be the administrator at the facility. On 11/24/2021 at approximately 2:10 pm, LPA contacted the facility via telephone and requested a call back from a facility representative. At approximately 2:38 pm, LPA received a return call from William “Bill” Ferguson, Director of Operations who stated a new administrator will be starting at the facility on 11/29/2021.
At approximately 9:34 am on 12/10/2021, LPA received a telephone call from Catherine Lee who stated she is present at the facility and is now the administrator at the facility. Lee stated she began her on-site duties on 11/29/2021. LPA described the documents needed to designate Lee as the facility administrator. During the call, Lee stated the documents would be provided by 12/14/2021. To date, no documents have been received.
LPA reviewed the CCL Personnel Summary Report and noted Catherine Lee has been working in the facility since 11/29/2021, however, was not associated to the facility until 12/5/2021.
During today's visit, Lee stated her Administrative Certificate is not complete and needs approximately 20 Continuing Education Units (CEUs) to complete the certificate. LPA and Lee conducted a conference call with Carol Burnell, Vice-President, Operations, Capital Living and Sonida Senior Living. Burnell stated she will continue to be the designated representative.

Exit interview conducted. Report issued. Deficiencies cited. Civil penalty assessed. Appeal rights issued.

SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Kristin KontilisTELEPHONE: (805) 689-2787
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 BARBARA
FACILITY NUMBER: 425800837
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/22/2021
Section Cited

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87405(a) Administrator Qualifications & Duties: All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person…
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This requirement is not met as evidenced by: Based on interviews conducted, the licensee did not comply with the section cited above, as there was no designated Administrator for several weeks, which poses an immediate health and safety risk to residents in care.
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Type A
12/22/2021
Section Cited

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87355(e)(2) Criminal Record Clearance: (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c). This requirement is not met as evidenced by:
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Based on interviews and record review, the licensee did not comply with the section cited above and allowed 1 out of 1 individual to work at the facility prior to being associated to the facility from 11/29/2021 to 12/5/2021 which posed an immediate health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Kristin KontilisTELEPHONE: (805) 689-2787
LICENSING EVALUATOR SIGNATURE:
DATE: 12/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/21/2021
LIC809 (FAS) - (06/04)
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