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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425850140
Report Date: 09/23/2026
Date Signed: 09/23/2026 04:53:34 PM

Document Has Been Signed on 09/23/2026 04:53 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
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:MERRILL GARDENS AT SANTA MARIAFACILITY NUMBER:
425850140
ADMINISTRATOR/
DIRECTOR:		MICHAEL EASBEYFACILITY TYPE:
740
ADDRESS:1220 Suey RDTELEPHONE:
(805) 928-2662
CITY:Santa MariaSTATE: CAZIP CODE:
93454
CAPACITY: 330CENSUS: 206DATE:
09/23/2026
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:12 AM
MET WITH:Michael EasbeyTIME VISIT/
INSPECTION COMPLETED:
05:10 PM
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Licensing Program Analyst (LPA) Melisa Rankin arrived at 10:12 am to continue the 1-year required annual visit. LPA met with Michael Easbey, Administrator, and explained the purpose of the visit.

The following was inspected and noted during the annual visit:

Physical Plant & Environment Safety: During today’s visit LPA viewed the outdoor patio area between the larger Assisted Living communities, there was a gated pool area, and large patio areas for visiting, and events. LPA observed the dining room areas, the bistro areas that held snacks, coffee and plenty of areas for indoor visiting and events. No health and safety concerns were noted as LPA was escorted up elevators, down hallways, and through courtyards.

Food Service: LPA re-toured kitchen area for both Assisted Living communities to investigate areas noted as possible concerns during prior visit. Areas had been reviewed and items of concern were addressed. New processes for in taking produce are being implemented to ensure all food and kitchen areas are preserved. LPA discussed menu and special diets with administrator. Noted that facility uses outside vendor with a dietician to review and approve menu items. Residents in Assisted Living maintain their own dietary requirements, except for items being pureed if needed. Garden House Memory Care Community has caregivers who order residents foods to ensure they are within the physician prescribed dietary requirements.

Personnel Records & Training: The facility currently employs 122 full-time staff, and 1 administrator. Staff records are kept confidential. LPA reviewed 10 staff files; all files were completed with required hiring documentation. Additional certifications are being updated and will be provided to LPA once completed. Administrator Certificate expires 6/23/28. Staff have orientation training and annual training completed for various subjects/topics and hours for 2025 and 2026. Continue on 809-c

Kelly Burley
Melisa Rankin
DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2026
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: 09/23/2026
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Incidental Medical Services: During today’s visit LPA reviewed the Assisted Living Communities medication room. The facility uses an electronic Medication Administration Record (MAR) along with the Centrally Stored Medication and Destruct Records (CSMDR). LPA reviewed a sample of residents’ medications. LPA reviewed processes with medication technicians regarding intake of medications for new residents, documenting PRNs, recording residents who are out of the community or who refuse medications. Records reviewed were complete and questions were in line with regulation requirements.

Resident Records & Incident Reports: LPA reviewed 6 resident files in the Assisted Living Community for Physicians report, Pre-appraisals, Appraisals Needs and Services Plan, and Emergency and ID forms. The facility keeps separate files on each Assisted Living resident confidential. Facility does submit incident reports to the department when required. All files were complete.

Disaster Preparedness: During the visit on 9/22/26, LPA discussed the current emergency disaster forms with the administrator. Emergency supplies of water and generators were observed during the tour on 9/22/26. The facility conducts monthly drills; each month the drills are on a different shift to ensure all 3 shifts are covered over the quarter. Annual fire inspection report was provided, the City fire department inspected on 8/15/25. The facility is unsure of when the fire department will conduct a new review but will provide the report to the LPA when that inspection is completed.

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: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC809 (FAS) - (06/04)
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