Facility Evaluation Report

On 08/22/24, Licensing Program Analyst (LPA) Ernand Dabuet conducted a Case Management visit at this facility. LPA met with designated administrator Evangeline Agatep who allowed for the entry in this facility. LPA informed Agatep the purpose of the visit is to conduct a health and safety check.

Investigation revealed the following: LPA conducted a tour of the entire facility. During the inspection, LPA observed the following: (4) bedrooms (2) bathroom, kitchen, living room, den, patio, and garage LPA observed all (5) residents residing at this home requiring assistance with assisted daily living (ADLs) This property address is licensed to Santa Fe Home III #198602162. According to Residential Lease Agreement (dated: 05/24/24), Santa Fe Home III lost control of the property effective 06/04/24. The Residential Lease Agreement contract had Ace Elderly Homes, Inc. under contract effective 06/05/24. Ace Elderly Homes, Inc. submitted an Application for A Community Care Facility LIC 200 on 07/02/24 to Central Applications Bureau, which is still under consideration.

Based on the Department’s observation and interviews conducted, the preponderance of evidence standard has been met, therefore the allegation of “Unlicensed Care is Being Provided" is found to be: "Substantiated".

You are hereby issued a Notice of Operation in Violation of the Law letter. You are to cease operation or submit an application to the CCLD Senior Care Office on or before 09/06/24 or relocate the resident to a licensed assisted living facility. If you fail to: cease operation or relocate the resident a civil penalty will be assessed. Failure to comply will result in civil penalties of $200 per day until a completed application is submitted, operations cease, or written verification from a licensed mental health professional or residents are relocated.