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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803820
Report Date: 11/20/2023
Date Signed: 11/20/2023 03:48:15 PM

Document Has Been Signed on 11/20/2023 03:48 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:ENSO VILLAGE, A KENDAL AFFILIATEFACILITY NUMBER:
496803820
ADMINISTRATOR:JORDAN, ROSEMARYFACILITY TYPE:
741
ADDRESS:1801 BOXHEART DRIVETELEPHONE:
(925) 366-3414
CITY:HEALDSBURGSTATE: CAZIP CODE:
95448
CAPACITY: 82CENSUS: 0DATE:
11/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Administrator, Rosemary JordanTIME COMPLETED:
04:00 PM
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Licensing Program Analyst Bertozzi arrived unannounced to conduct a Case Management inspection and met with Administrator, Rosemary Jordan.

Facility has requested a change of capacity to add additional apartments as part of their second phase. All apartments are designated for residents who are independent. The facility does not plan to add apartments for residents in assisted living and memory care until their third phase.

LPA initiated a tour of the areas identified in Phase 2 around 2:00pm and observed the following: Areas identified during the 11/17/2023 visit as needing final construction have been completed. The facility has a Zendo that is part of Phase 2 but is not yet completed .Completion date is pending but building is locked to ensure resident safety until completed. LPA confirmed through observation that the exterior door from the Balance Room has been secured so individuals may not access the patio while it is still under construction.

Floors 2-4 have been approved by the local fire department to allow for 98 residents. The apartments are approved for non-ambulatory residents, however, the local fire department has specified that at this time, only ten non-ambulatory residents may reside on floors 2-4. A separate building identified as "The Meadows" has not yet been approved by the local fire district despite being part of Phase 2. The Meadows has a capacity of twenty independent residents and without that approval, the fire department has updated the fire safety inspection report to allow for 98 residents instead of the 118 requested by facility.

LPA and Administrator discussed the importance of maintaining safety while area is still under partial construction.

LPA will update capacity to allow for 98 independent residents in the main building, floors 1-4.
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Victoria Bertozzi
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2023
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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