425850140-9-23-2026-29-AS-MRAN-DY7N7G-20260923101244

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 425850140
Report Date: 09/22/2026
Date Signed: 09/23/2026 10:13:53 AM

Document Has Been Signed on 09/23/2026 10:13 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME:	MERRILL GARDENS AT SANTA MARIA		FACILITY NUMBER:	425850140
ADMINISTRATOR/ DIRECTOR:	MICHAEL EASBEY		FACILITY TYPE:	740
ADDRESS:	1220 Suey RD		TELEPHONE:	(805) 928-2662
CITY:	Santa Maria	STATE: CA	ZIP CODE:	93454
CAPACITY: 330		CENSUS: 206	DATE:	09/22/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:32 AM
MET WITH:	Michael Easbey		TIME VISIT/ INSPECTION COMPLETED:	05:02 PM

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Licensing Program Analyst (LPA) Melisa Rankin arrived at 9:32 am for the 1-year required annual visit. LPA met with Michael Easbey, Administrator, and explained the purpose of the visit.

A tour of the Memory Care Community named Garden House was done. A tour of the Assisted Living Kitchens was conducted, and as well as an emergency supply storage shed. The following was inspected and noted during the annual visit:

Physical Plant & Environment Safety: The fire extinguishers were last charged and inspected on September 4^th and 10^th of 2025, they are scheduled to be inspected again on 9/28/26, all extinguishers viewed on the first floor and in the Garden House Community were charged. LPA tested 4 carbon monoxide detectors, two in the memory care units and two in the assisted living common areas. LPA toured 7 resident rooms in the memory care communities and observed that rooms were tidy, concern of flooring starting to bubble up in one restroom was discussed and maintenance inspected during visit, scheduled for total replacement on 9/23/26. Toilet, hand washing and bathing facilities observed are operational and secure grab bars are present. The showers have non-skid flooring. The pathways are clear of any obstructions. Facility areas viewed are well lit for safety and residents’ comfort. All communities have sufficient space inside and outside for activities and visiting. There are currently 26 residents in Garden House and 180 residents in the Assisted Living Community, total capacity of 206.

Facility has six laundry rooms for residents use in the Assisted Living Communities including one laundry area with industrial washers and dryers for staff use. Each Garden House has its own laundry facility. Review and discussion of the industrial laundry appliances was done, which included the Maintenance Director, facility will be addressing some areas of routing appliance maintenance needs. Continue on 809-C

Kelly Burley
Melisa Rankin
	DATE: 09/22/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: MERRILL GARDENS AT SANTA MARIA	FACILITY NUMBER: 425850140
	VISIT DATE: 09/22/2026

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Food Service: Each Garden House Community has their own full kitchen; however, meals are brought from the main kitchen to the Garden House Community. The facility has two kitchens in the Assisted Living Communities, during the tour LPA observed one walk-in refrigerator, two dry storage areas, one free standing refrigerator, and a walk-in freezer, food in areas was covered and marked with opened or received dates. Additional information to be added during next visit report.

Residents with Special Health Needs: The facility does accept dementia residents. The facility has delayed egress on the front doors of each of the three Garden Houses for memory care. Facilities staffing ratio for Garden Houses are two caregivers and a floating medication tech during waking hours to 12 residents. The Memory Care Community utilize Montessori methods to encourage residents to participate in daily activities, purposeful tasks, and engage in their home community.

Incidental Medical Services: LPA discussed the medication process with the Garden House Director and a medication technician. Facility has random medication audits done in house as well as quarterly the Pharmacy does a review of all medication carts, and annual their headquarters will conduct a detailed review.

Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on 12/1/26. The facility is approved for a capacity of 330 residents. The fire clearance is granted for 330 non-ambulatory of which 20 may be bedridden.

Resident Records & Incident Reports: During today’s visit of the Garden House Communities, LPA reviewed 4 resident files for signed, Physicians report, Pre-appraisals, Appraisals Needs and Services Plan, and Emergency and ID forms. The facility keeps separate files on each Garden House resident confidential. Facility does submit incident reports to the department when required.

LPA will need to return at a later date to complete annual review.

Exit interview conducted and copy of report printed for Administrator.

NAME OF LICENSING PROGRAM MANAGER: Kelly Burley
NAME OF LICENSING PROGRAM ANALYST: Melisa Rankin
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/22/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

LIC809 (FAS) - (06/04)

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