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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425801937
Report Date: 02/05/2025
Date Signed: 02/05/2025 03:11:47 PM

Document Has Been Signed on 02/05/2025 03:11 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:MARAVILLAFACILITY NUMBER:
425801937
ADMINISTRATOR/
DIRECTOR:
GRANDE, RUTH EFACILITY TYPE:
740
ADDRESS:5486 CALLE REALTELEPHONE:
(805) 967-1965
CITY:SANTA BARBARASTATE: CAZIP CODE:
93111
CAPACITY: 131CENSUS: 117DATE:
02/05/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:28 AM
MET WITH:Ruth Grande, Administrator & Anna Munoz, Dir of ALTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced Annual Inspection to the above-named facility. LPA was greeted by Anna Munoz, Director of Assisted Living and explained the purpose of the visit. Ruth Grande, Administrator participated in the inspection at approximately 2:45 PM.
Entrance interview conducted.
The facility is a three-story Residential Care Facility for the Elderly (RCFE) with a hospice waiver for 20. Currently, there are 21 residents with a dementia diagnosis, 18 residents on hospice and 7 residents on oxygen. There are no bedridden residents at this time.
A tour of the physical environment and accommodations were assessed, and the following was noted: LPA observed the required posting of the complaint poster and Resident’s Rights. LPA inspected the facility for fire safety and other hazards.
The facility entrance consists of a large lobby, a concierge desk for check-in, and a hallway at the right of the lobby leading to the administration offices. Immediately past the concierge’s desk is a stairway that leads to the residential area.
Residents participate independently in live entertainment and music, worship support, exercise activities, card games, lectures, Resident Council Townhall meetings, Bingo, art, reading club, pet therapy, arts and crafts, and outings to parks, restaurants, shopping excursions, museums, theatre events, and other local attractions.
The fire extinguishers were charged and last serviced on 12/9/2024. LPA observed elevators are in good working order.
LPA observed the kitchen and dining area were clean and sanitary. LPA observed a sufficient amount of perishables for two days and non-perishables for seven days for all residents in care.
Residents’ files were reviewed. LPA noted that on file for each resident was the following: Admission Agreements, Medical Assessments, Identification and Emergency information, Appraisals/Needs Service Plan, and Health Screenings.
Due to time restraints, LPA will return at a later date to continue the annual inspection.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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