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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486800368
Report Date: 09/17/2021
Date Signed: 09/17/2021 12:38:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:PARADISE VALLEY ESTATESFACILITY NUMBER:
486800368
ADMINISTRATOR:PEGGY HUSTONFACILITY TYPE:
741
ADDRESS:2600 ESTATES DRIVETELEPHONE:
(707) 432-1100
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:603CENSUS: 491DATE:
09/17/2021
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Peggy Huston, Chief Operating Officer and RCFE Administrator TIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Karina Canela arrived at Paradise Valley Estates on 09/17/2021 for the purpose of an on-site case management inspection regarding a request of an increase in capacity submitted to Community Care Licensing. LPA was screened for COVID-19 prior to entering the facility. LPA met with Peggy Huston, Chief Operating Officer and RCFE Administrator; Terry Tumpane, Vice President of Healthcare Operations; and Roger Breeding, Capital Construction Director of The Ridge. All staff wore masks during today's inspection. The facility has requested an increase of their total capacity from 603 to 743 through the new development of The Ridge. On 09/14/2021, The Fairfield Fire Department granted a fire clearance approval of 223 non-ambulatory, for a total capacity of 743. Facility sketch has been updated to reflect the additional space for residents.
The Ridge (10 acres) of 78 units in total includes: 70 independent living units (20 cottages and 50 villa apartments) and 3 community buildings (Oak room, Creekside Café, and Classroom Center).
LPA toured and inspected the Oak room (the main dining), Creekside Café (includes the U.S. mail room, game room, resident store, and wellness art studio), Classroom Center (available TV and projector screens). All exits were observed free from obstruction. A sample amount of cottages and villa apartments were toured and inspected. LPA observed evacuation chairs in stairwells, emergency pull switches in resident bedrooms and bathrooms, fire-proof ceilings in apartment garages, fire extinguishers in hallways, and hardwired combination smoke and carbon monoxide detectors. LPA tested hot water temperatures, which were between regulation of 105°F to 120°F.
LPA observed bulldozers, construction trucks, and construction crew who were finishing landscaping and final touches. The facility agrees to ensure the area is supervised and closed off to residents until landscaping/construction trucks exit the premises. LPA observed signs posted for resident notification and safety of the closed off entrance to the Ridge. Peggy Huston stated all staff cleaning of grounds and buildings will be completed on 09/21/2021. Residents are expected to begin move-in on 09/28/2021.
Community Care Licensing has approved the increase in capacity effective 09/17/2021.
No deficiencies cited during today's inspection.
Exit interview conducted with Peggy Huston, Chief Operating Officer and RCFE Administrator, whose signature on this report confirms receipt.
SUPERVISOR'S NAME: Hope DeBenedettiTELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Karina CanelaTELEPHONE: 707-588-5054
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
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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