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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425802137
Report Date: 06/07/2022
Date Signed: 06/09/2022 11:14:59 AM

Document Has Been Signed on 06/09/2022 11:14 AM - 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:SANTA BARBARA CRISIS RESIDENTIALFACILITY NUMBER:
425802137
ADMINISTRATOR:SUZANNE MENDEZ, LVNFACILITY TYPE:
772
ADDRESS:66 S. SAN ANTONIO ROADTELEPHONE:
(805) 947-5175
CITY:SANTA BARBARASTATE: CAZIP CODE:
93110
CAPACITY: 10CENSUS: 5DATE:
06/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Suzanne Mendez, AdministratorTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced on-site one-year Infection Control Inspection to the above-named facility. LPA met with Suzanne Mendez, Administrator and explained the purpose of the visit.
LPA conducted a physical tour of the facility. The facility has submitted a Mitigation Plan to the Department. The facility has an entry station at the front of the building. Upon arrival, there were 5 resident guests, five staff members present, and one Administrator present.
Upon entry, visitors and residents who are returning from an outing are required to sign-in, complete a symptom questionnaire, and have a temperature screening. Staff enter through the staff office and are COVID screened prior to entering the main floor of the facility. All documentation is kept on a clipboard and filed on a daily basis. The entry station has PPE gear, hand sanitizer, and disinfecting wipes along with a thermometer.
The facility is a Social Rehabilitation Center. The Licensee is a service provider for Santa Barbara County contract providing recovery care and healing services to individuals in Santa Barbara County communities. The facility operation is located in a county-owned building. The program allows resident guests to access well-being programs, as well as community, recreational, and educational opportunities. The program allows clients experiencing mental health crisis to enter the program voluntarily with a high-level of support and supervision. Program resources include Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy (DBT), medication support, Wellness Recovery Action Planning (WRAP), empowerment training, prevocational and employment training, peer support, and dual-recovery services.
The facility is a smoke-free environment. The facility is located in a residential area approximately one mile from businesses such as eateries and shopping areas.
LPA toured the facility. The facility is clean, safe, sanitary, and in good repair. The entrance into the facility is a welcome area that leads into the common area with exercise equipment, couches, chairs, coffee table, and a television. The dining area consists of tables and chairs for family style dining. The outside common area has patio tables with umbrellas and seating areas conducive for visitations.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2022
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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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: SANTA BARBARA CRISIS RESIDENTIAL
FACILITY NUMBER: 425802137
VISIT DATE: 06/07/2022
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 Program signage and required posters are distributed throughout the dining area, common area, and hallway. The common area serves as the location for program activities, group sessions, and relaxation/free time. The facility has an office suite off the common area.
The kitchen area is a locked area and consists of a refrigerator, a sink, cooking area equipped with a stove, oven, and microwave. There is a counter-top area and open window where food is served to resident guests. Sharps are kept in the kitchen in a locked drawer with no access to resident guests. A log is kept in the drawer and use of the sharps is logged for each meal preparation by Recovery Coaches (staff) per shift. LPA observed a 2-day supply of perishable food items and a 7-day supply of non-perishables.
The Clinician’s office is used for making phone calls, training sessions, private sessions, and private face-to-face meetings. A computer is available for client use in the dining area. There are personal rights’ posters throughout the areas of the building.
Breakfast, lunch, and dinner are served to the resident guests. Snacks are openly available in a common refrigerator located in the dining area.
Centrally stored medications are kept in the Health Office. Medications were checked for sufficient storage and proper safety measures. Resident guests will be assisted with self-administration of medications as needed. A First Aid kit is kept in the Health Office.
Disinfectants, cleaning solutions, and poisons are kept in locked cabinets and are inaccessible to the resident guests. The facility has one functioning carbon monoxide detector and three fire extinguishers with an inspection date of December 21, 2021. The facility has a hard-wired fire alarm system that sounds off directly to the local fire department if pulled or if it senses a fire.
There are ten (10) private bedrooms and four (4) communal bathrooms available to the resident guests.
All staff have received a criminal background clearance and are associated to the facility.
Exit interview conducted. No citations issued. A copy of the report has been issued via email.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022
LIC809 (FAS) - (06/04)
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