405850354-8-18-2023-29-AS-DCHZ-CUTT43-20230818142315

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 405850354
Report Date: 08/18/2023
Date Signed: 08/18/2023 02:24:02 PM

Document Has Been Signed on 08/18/2023 02:24 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 GARDENS		FACILITY NUMBER:	405850354
ADMINISTRATOR:	CASTANIAGA, JANELYN		FACILITY TYPE:	740
ADDRESS:	9385 SANTA CLARA RD.		TELEPHONE:	(805) 464-2098
CITY:	ATASCADERO	STATE: CA	ZIP CODE:	93422
CAPACITY: 6		CENSUS: 0	DATE:	08/18/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Janelyn Castaniega, Applicant		TIME COMPLETED:	02:35 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 8/18/23 at 1:00 pm, Licensing Program Analyst (LPA) Chavez conducted a follow-up pre-licensing visit to the facility noted above to inspect the items needing further action from the original pre-license inspection on 7/27/23. LPA met with Janelyn Castaniaga, Applicant. At 1:05 pm, LPA conducted a physical plant tour with the applicant. In the original report, it was noted that double-occupancy resident bedrooms (3) had only one chair. Applicant has placed an additional chair in each resident room. Resident room #1 was missing two (2) chests of drawers, room #2 was missing one chest of drawers, and room #3 was missing two dressers. Applicant has placed two dressers in each resident bedroom. Room #2 had a closet with two doors with one door opening fully, the other did not open fully making it difficult for residents to access the closet. Applicant has removed the doors and placed curtains at the closet entrance. Resident beds were missing mattress pads. Applicant has added mattress pads to resident beds. The screen on the sliding glass door at the back of the house by the dining room was difficult to open/close, the handle was broken, and the screen had a tear of approximately 6 inches. Applicant has repaired the door. The hot water temperatures in resident bathrooms previously exceeded the range of 105 F to 120 F degrees. Applicant has adjusted the temperatures. LPA measured the temperatures today at 105.1 F and 110.1 F. degrees. The facility did not have a locked cabinet or room for resident and staff records and resident medications. Applicant has placed file cabinets in the dining room near the front entrance containing staff and resident records as well as medications with locks on the cabinets. The first aid supplies were complete, however, the kit was not stored in a secure area. Applicant has placed the kit in the locked laundry room. The stove had on/off knobs, and the kitchen was accessible to residents in care. Applicant has closed-off one entrance to the kitchen and placed a gate and lock on the second entrance. The refrigerator was recorded at 46 F. Applicant has adjusted the temperature. LPA observed a temperature of 31 F degrees. Continued on 809-C.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Darlene Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2023

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

FACILITY NAME: VILLA GARDENS	FACILITY NUMBER: 405850354
	VISIT DATE: 08/18/2023

NARRATIVE

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The kitchen trash can had a lid, however, it did not fully close. Applicant replaced it with a fully functioning lid on the trash can. The facility floors had dirt and particles. Applicant has cleaned the floors. LPA observed sufficiently cleaned flooring. There were no alarms on exterior doors. Applicant added the alarms. LPA opened all exterior doors and alarms worked properly. The emergency exiting plans/sketch were not posted in hallways and at the entrance. Applicant has posted these, and LPA observed them posted at entrance, hallway near resident bedrooms and in each resident bedroom. The emergency telephone numbers and non-discrimination statement were not posted in a common area. LPA observed the postings on the wall across from the kitchen toward the garage. Ramps leading from resident bedrooms (3) have approximately a 3-inch space on each side where residents could fall/trip. Additionally, there is a ramp leading from the deck outside the resident rooms to the backyard which has the same 3-inch gap. Applicant has placed handrails on each side of the bedroom ramps and a handrail on one side of the ramp leading to the backyard deck. There are two pedestrian gates on the east and west side of the property which did not have self-locking latches and automatic closing mechanisms. The gate on the east side had a chain and lock on it. Applicant has added latches and self-closing mechanisms so that residents can open gates from inside the property and gates will close when released. The facility has a 3-foot tall fence around the eastside deck with an open space of approximately 15 feet between the end of the fence and the garage. There is a step down from the deck onto an uneven surface which could be a hazard to residents. Applicant has enclosed the area with a 3-foot tall fence and unlocked gate. There is a 3-car garage with two vehicle entrance doors. The 1-car garage does not have a door opener and can be opened from the outside. Toxic items and tools are stored in the garage. Applicant has secured the door from the inside. All items needing correction from the 7/27/23 inspection have been completed.

Exit interview conducted and report given.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Darlene Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2023

LIC809 (FAS) - (06/04)

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