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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425850001
Report Date: 02/25/2022
Date Signed: 02/25/2022 03:35:18 PM


Document Has Been Signed on 02/25/2022 03:35 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:VILLA ALAMARFACILITY NUMBER:
425850001
ADMINISTRATOR:LEICHTER, MITCHFACILITY TYPE:
740
ADDRESS:45 E ALAMAR AVETELEPHONE:
(805) 682-9345
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY:43CENSUS: 26DATE:
02/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Corinne Satterthwaite, Wellness NurseTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) K. Kontilis conducted an unannounced Annual Required visit and Infection Control Inspection of the facility. LPA arrived at approximately 12:55 pm and was greeted by Corinne Satterthwaite, Wellness Director and Yesenia Leon, Resident Services Director and explained the purpose of the visit. Administrator Mitch Leichter was not available at the time of the visit.

Entrance interview conducted:
There are currently twenty-six (26) Residents residing in the facility. The facility is a one-story facility to Residents with a dementia diagnosis and/or requiring assistance with daily living needs. There are eleven residents currently on hospice.
LPA conducted a tour of the facility and discussed Infection Control procedures with Staff Satterthwaite and Leon.
Due to time restraints, LPA will return at a later date to conclude the annual inspection.
Exit interview conducted. No deficiencies noted. Copy of report sent via email.
SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Kristin KontilisTELEPHONE: (805) 689-2787
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022
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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