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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 475002785
Report Date: 04/29/2022
Date Signed: 04/29/2022 11:21:21 AM


Document Has Been Signed on 04/29/2022 11:21 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, 520 COHASSET RD., STE. 170
CHICO, CA 95926



FACILITY NAME:GRENADA GARDENS SENIOR LIVING, LLCFACILITY NUMBER:
475002785
ADMINISTRATOR:BURSTEIN, NAFTALIFACILITY TYPE:
740
ADDRESS:424 HIGHWAY A-12TELEPHONE:
(530) 436-2514
CITY:GRENADASTATE: CAZIP CODE:
96038
CAPACITY:90CENSUS: DATE:
04/29/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Mike NaftaliTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Misty Valencia, Licensing Program Manager (LPM) Maribeth Senty, Regional Office Manager (ROM) Alycia Berryman, Legal Rep Joel Goodman and Administrator (Admin) Mike Naftali conducting a teams meeting regarding facility changes.

Administrator explained that he would like to have a restaurant on facility grounds. Plan is to have the restaurant separated from the facility itself. The following were discussed with Admin

Grenada Gardens Gigi’s Café

-There is no statutory or regulatory prohibition against operating a business such as this from the facility premises, however the facility has a pre-existing and primary legal responsibilities to residents and their representatives. There are terms to consider

-An RCFE licensee is required to maintain safe, healthful, and comfortable accommodations for residents of a facility (California Code of Regulations (CCR), Title 22, section 87468.1(a)(2)). Any potential impact a side business may have on the facility and its residents must be weighed against this standard. The side business may not curtail any other personal rights residents currently have

-As a result, an updated facility sketch that includes the café and a mapped out food route to residents must be submitted to the licensing agency as specified in CCR, Title 22, section 87208, Plan of Operation.

-As a result, an updated admissions agreement must be submitted to the licensing agency as specified in CCR, Title 22, section 87208, Plan of Operation.

SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Misty ValenciaTELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:
DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2022
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, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: GRENADA GARDENS SENIOR LIVING, LLC
FACILITY NUMBER: 475002785
VISIT DATE: 04/29/2022
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-No café staff may interact with residents. Staff may hand off food in warming area with no contact. The window has to be sealed off between café and facility.

-No café staff interactions with residents unless fingerprint cleared and associated to facility.

-In a scenario in which Gigi's Diner is a separate legal entity, the third party contractor exception for criminal record clearance may apply, as specified in HSC section 1569.17(b)(2)(C).

Team spoke regarding the following; There are a few important considerations for GG’s moving forward. Admin reported the following;

· Would the business cause a disruption in the residents' daily routine or cause confusion for residents?


No, it will stay separate, except all staff will be fingerprinted and associated-even for the café.
· How will the licensee ensure the quality of food is not significantly reduced in any way?
We have all the equipment here to assure all residents will have warm healthy options.
· What food quality and safety standards will Gigi's Diner follow?
We will also be licensed by the county for the café so we have to abide by county and state regulations.
· Since GG is proposing to convert their existing kitchen to a warming kitchen, how much functionality would the warming kitchen have?
Is will have the needed equipment to regulations and sustain food quality. There will be snacks, fruit, juice and coffee available 24/7 in the activities area.
· Is there a way to ensure that Gigi's Diner staff members who have contact with residents are vaccinated and boosted?
All staff who are hired for the restaurant will be treated as the facility hiring process and will be vaccinated/boosted.


Admin will provide documents to LPA by 05/06/2022
-Updated facility Sketch to include café, food route to residents
-Updated Plan of Operations
-Updated Admissions agreement.

There were no citations issued during today's visit. An exit interview was conducted.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Misty ValenciaTELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022
LIC809 (FAS) - (06/04)
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