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PC - Item 3C - Modification 14-01 and Zone Varience 14-01 at 9025 Guess Street E M ° A 9 a ROSEMEAD PLANNING COMMISSION STAFF REPORT CIVIC PRIDE *11* 7/,•Moi r".. RATED 14y9 TO: THE HONORABLE CHAIR AND MEMBERS OF THE ROSEMEAD PLANNING COMMISSION FROM: PLANNING DIVISION DATE: MARCH 16, 2015 SUBJECT MODIFICATION 14-01 AND ZONE VARIANCE 14-01 9025 GUESS STREET Summary Zosimo and Nelia Pascasio submitted a Modification application requesting to expand their existing adult care facility (Rosemead Villa) and a Zone Variance application requesting to deviate from the required number of parking spaces. The subject property is located at 9025 Guess Street, in the R-1 (Single-family Residence) zone. On May 5, 2014, the Planning Commission conducted a duly noticed public hearing for Modification 14-01 and Zone Variance 14-01. Due to insufficient information on how the Department of Social Services (DSS) regulates the Rosemead Villa business operation and neighboring resident complaints, the Planning Commission continued the public hearing to a date uncertain. The Planning Commission staff report and meeting minutes are included in this report as Exhibits "C" and "D", respectively. Environmental Determination: Section 15309 of the California Environmental Quality Act (CEQA) guidelines exempts projects that consist of inspections to check for the performance of an operation, or for quality, health, or safety of a project. Accordingly, Modification 14-01 and Zone Variance 14-01 are classified as a Class 9 Categorical Exemption pursuant to Section 15309 of CEQA guidelines. Staff Recommendation It is recommended that the Planning Commission ADOPT Resolution No. 14-07 with findings (Exhibit "A"), and APPROVE Modification 14-01 and Zone Variance 14-01, subject to the twenty-three (23) conditions outlined in Attachment "A" attached hereto. Property History and Description The subject site is located on a single parcel of land totaling 17,500 square feet of area. According to Assessor Records, the property was originally developed as a single- family residence in 1924. Additional detached buildings were constructed in 1925 and I Planning Commission Meeting March 16. 2015 Page 2 of 17 1929. The use of the site was converted into a small nursing home facility in 1944, under the Los Angeles County jurisdiction prior to the City's incorporation. On December 26, 1956, the Los Angeles County Board of Supervisors approved Zone Exception Number 2612 permitting a 26-bed nursing home facility. When new owners acquired the business, the City required the new property owners to obtain a Conditional Use Permit as required by code for the operation of an adult care facility. Subsequently, Conditional Use Permit 96-677 was approved by the Rosemead Planning Commission on August 19, 1996, subject to conditions of approval outlined in Planning Commission Resolution number 96-43. The decision was later upheld by the Rosemead City Council on September 10, 1996 (approved under CC Resolution number 96-42), after an appeal was filed, permitting the operation of a 22-bed residential care facility subject to specific conditions of approval. {riir..7.44 4 is -. _ - t Front Elevation Site & Surrounding Land Uses The project site is designated in the General Plan as Residential and is zoned R-1 (Single-family Residential). The site is surrounded by the following land uses: North: General Plan: Commercial Zoning: CBD-D (Central Business District with a Design Overlay) Land Use: Commercial Planning Commission Meeting March 16, 2015 Page 3 of 17 South: General Plan: Low Density Residential Zoning: R-1 (Single-family Residential) Land Use: Residential East: General Plan: Low Density Residential Zoning: R-1 (Single-family Residential) Land Use: Residential West: General Plan: High Density and Low Density Residential Zoning: R-3 (Medium Multiple Residential) and R-1 (Single-family Residential) Land Use: Residential ADMINISTRATIVE ANALYSIS Continuance of Public Hearing The Planning Commission continued this public hearing due to several concerns. On May 21 , 2014, staff sent a letter to the applicants (attached as Exhibit "E') outlining all the concerns that were raised at the Planning Commission meeting on May 5, 2014. In response to staff's letter, the applicants responded and submitted supported documents (attached as Exhibit "F") to the City on August 28, 2014. The current status of the concerns is included below. Planning Commission Concerns Status A copy of all Department of Social Services (DSS) state requirements and responsibilities that Title 22 does not provide staffing ratios, parking govern the facility requirements and operation standards, bedroom size requirements, ratio of requirements of an ARF. Specific code residents to restrooms. or minimum standards for regulations should be highlighted to provide dining area (see orange tab in Exhibit "F" for answers to the Planning Commission's concerns details). In addition. staff has spoken to Leah regarding staffing ratios, parking standards, Theophile, Community Care Licensing for DSS, bedroom size requirements, ratio of residents to who stated that DSS does not have specific number of restrooms. minimum standards for requirements for these items. dining area, and any quality of life measures. On August 25, 2014, the applicants called and sent a letter to DSS requesting annual inspection reports for the last three years (see pink tab in Copies of your DSS annual review reports for the Exhibit "F" for details). On November 3. 2014, last three years. If DSS has not completed annual DSS sent staff an email with the most current review within the past three years, request an annual inspection report for "Rosemead Villa" inspection and submit a copy of the inspection facility, dated August 9, 2011 (attached as Exhibit report. This report will be included as supporting G"). Based on the departments computer documentation for the proposed expansion. generated list "Rosemead Villa" facility is not required to be visited annually at this time. A "5 year inspection visit is required and will be conducted by August of 2016. Planning Commission Meeting March 16, 2015 Page 4 of 17 On August 25, 2014, the applicants submitted the required applications to DSS (see purple tab in A summary of Rosemead Villas application Exhibit "F" for details). The Community Care requirements from DSS for the expansion. Licensing Department of DSS will review, process, and approve the application once the City approves the project. The applicants submitted the Rosemead Villa Submit a narrative describing how the facility Program Design, which has been approved by the operates. Community Care Licensing (see tan tab in Exhibit "F" for details). On November 24, 2014, the applicants obtained a fence permit and installed a block wall along the west and east property boundary lines to provide The neighboring residents expressed concern screening from the neighboring properties. On about safety (residents loitering in the street), March 9. 2015. a building permit was obtained to noise (especially during nighttime hours), and replace 12 windows with dual-pane glass windows public nuisance disturbances (such as littering of to minimize noise impacts of the facility. The cigarette butts. shopping carts being left in the applicants have revised the site plan to re-locate public-right-of-way. etc.). the smoking area to the rear of the building. . In addition, the applicants submitted a Neighborhood Complaint Procedures Form (see yellow tab in Exhibit"F" for details). The revised site plan, dated February 12, 2015 Designating outdoor recreational areas on the site (Exhibit "B"). illustrates that the applicants are plan in order to demonstrate that the facility proposing two gazebos, outdoor furniture, and a provides "quality of life" for the residents. basketball court to provide "quality of life" for their residents. The applicant has submitted Rosemead Villa's Admissions Policy, which includes pre-placement appraisal screening applications for residents (see Resident Screening red tab in Exhibit "F" for details). They indicated they will incorporate the screening of residents for any convictions. parole, or probation for misdemeanors or felony involving a crime or violence or any sexual offense. Administrator will make sure the facility is safe Property Nuisances and well maintained at all times. A condition of approval has been incorporated in the Conditions of Approval (Attachment "A"). In the event that residents of the facility would like to Facility residents may not obtain a State of obtain a State of California driver's license, the California driver's license. project shall be reviewed by the Planning Commission through modification applications and a new parking study will be required. Modification 14-01 and Zone Variance 14-01 The applicants have submitted a Modification application requesting to modify their existing Conditional Use Permit in order to expand the existing adult care facility and a Planning Commission Meeting March 16.2015 Page 5 of 17 Zone Variance application requesting to deviate from the required number of parking spaces. Rosemead Municipal Code (RMC) Section 17.112.020(8) permits the operation of care facility in any zone upon the approval of a conditional use permit. RMC Section 17.108 permits the granting of a variance when practical difficulties or unnecessary hardships occur. Architectural Plan The property is developed with three detached buildings, as shown in the architectural plans dated February 12, 2015 (Exhibit "B"). Building "A" totals 2,027 square feet of area and is comprised of seven (7) bedrooms, two (2) bathrooms and one living room. Building "B" totals 1,218 square feet of area and is comprised of three (3) bedrooms, one (1) bathroom, a kitchen, and a dining room. Building "D" totals 778 and is comprised of two (2) bedrooms, one (1) bathroom, and a laundry room. The applicants are proposing to construct a new detached 596 square foot building (Building "C") at the rear of the property. Building "B" will consist of two (2) bedrooms, two (2) bathrooms, one (1) office and a storage room. The proposed building meets all development standards. The new building will be stuccoed finished in a white stucco color with composition roof shingles. Business Operations Rosemead Villa is an Adult Residential Care Facility. The facility provides 24-hour non- medical care for adults, 18 through 59 years of age. The clients at Rosemead Villa are ambulatory adults who are mentally disabled. According to the applicants, the facility operates with a total of three (3) employees during the day; two (2) employees and one (1) facility administrator. The facility operates with one (1) employee during the evening hours (from 11:00 p.m. to 7:00 a.m.) The facility currently operates with a maximum of twenty-two (22) beds. The applicants are requesting permission to add six (6) new beds for a total of twenty-eight (28) beds for the facility. Parking and Zone Variance The buildings are located approximately thirty-two (32) feet from the front property line. The parking area is accessed from two (2) separate driveways along Guess Street. According to the site plan, seven (7) parking spaces are provided for the facility (one (1) ADA and six (6) standard stalls). RMC Section 17.84.050 requires that land uses involving hospitals, convalescent homes and homes for the aged shall provide one (1) parking space per patient bed. Based on these requirements, a total of twenty-eight (28) parking spaces are required for the operation of this adult care facility. Based on the code requirements, the center would be deficient by twenty-one (21) parking spaces. To address the parking deficiency, the applicants had a parking study completed to determine the onsite parking demand for the facility. The parking study conducted by Planning Commission Meeting March 16,2015 Page 6 of 17 Abratique & Associates, Inc. (Exhibit "H"), compared similar land uses to residential care facilities, as there are no direct land uses that exactly correlate to residential care facilities. The study analyzed assisted living facilities and nursing home land uses and compared them to residential care facilities. Residential care facilities differ from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. This facility provides 24-hour direct care (supervision) for ambulatory adults in a non-medical capacity. The facility operates with a limited staff level and no direct medical care (doctors or nurses) is provided onsite to the patients. The facility patients do not have California Drivers Licenses and they do not drive personal vehicles. Because the residential facility operates with a small staff, the actual demand for parking spaces is less than a standard nursing home or an assisted living facility. Abratique & Associates, Inc. conducted a parking count for the site. According to the parking count data, the peak weekday parking demand occurred during both the morning and the afternoon when there were two (2) occupied parking spaces. The peak Saturday parking demand occurred in the afternoon with two (2) occupied parking spaces. The parking study utilized the existing peak parking demand rate of 0.1 vehicles per bed to determine that the facility would result in a parking demand of three (3) spaces for the expanded facility. The parking study concluded that the existing seven (7) parking spaces can be expected to adequately serve the proposed project. Based on the findings of the parking study, the applicants submitted an application for a Zone Variance requesting to deviate from the required number of parking spaces for the facility. The parking study was reviewed by the City's Traffic Consultant and was deemed acceptable. Public Safety The City of Rosemead Public Safety Center and Chief of Police have reviewed this request and have indicated concern with the facility expansion. According to the Chief of Police, the subject site has had a significant number of "calls for service" within the past two years. However, according to the Chief of Police, the majority of these calls dealt with medical responses, mental patient disturbances, and missing person's reports. According to the Chief of Police, most of the "calls for service" were for non- violent issues. The City's Code Enforcement has had two (2) calls for service over the past two years. These calls resulted from citizen complaints but no code violations were documented. MUNICIPAL CODE REQUIREMENTS Conditional Use Permit 96-677 was approved by the Rosemead Planning Commission on August 19, 1996, subject to conditions of approval outlined in Resolution 96-43 and the decision was upheld by the Rosemead City Council on September 10, 1996 (CC Resolution 96-42) after an appeal was filed. Planning Commission Meeting March 16. 2015 Page 7 of 17 Rosemead Municipal Code (RMC) Section 17.112.020(8) permits the operation of care facility in any zone upon the approval of a conditional use permit. Chapter 17.112 does not contain standards for the modification of a Conditional Use Permit, therefore, City staff has applied the same standards to the proposed project for a modification that were applied to the original Conditional Use Permit application. A. The project is essential and desirable to the public convenience or welfare. The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of adding eight (8) additional patient beds. The facility will continue to serve a need that is considered essential to the disabled community. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. B. The project is in harmony with the elements and objectives of the General Plan and Zoning Codes. The property is located in the R-1 (Single-family Residential) zone and is designated as Residential in the City's General Plan. The use of the site is permitted upon the granting of Conditional Use Permit. The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and a Conditional Use Permit was granted by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of adding eight (8) additional patient beds. C. The project will not be detrimental to the surrounding properties. The facility is licensed and monitored by the State of California for ambulatory and non-ambulatory adults as a non-medical facility. The facility provides 24- hour care and supervision for the patients. To address neighboring resident complaints, the applicants have installed new perimeter fencing along the east and west property line where no fencing has been installed. The applicants have also obtained building permits to remove and replace 12 existing windows with dual-pane windows to minimize noise impacts to adjacent neighbors. In addition, the applicants have relocated the smoking area to the rear of the building. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. An applicant must obtain a Zone Variance in order to operate with less than the required number of parking spaces. Section 17.108.020 sets criteria required for granting such a variance. If one of these criteria cannot be met, then the variance may not be granted. These criteria require that the granting of a variance will not: Planning Commission Meeting March 16. 2015 Page 8 of 17 A. Constitute a grant of special privilege inconsistent with the limitations upon other properties in the vicinity; The adult care facility differs from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. This facility provides 24-hour supervision for ambulatory adults in a non-medical capacity. As a result, the facility operates with a limited staff level as direct medical care is not provided onsite to the patients. The facility patients do not have a California Driver's License and do not drive personal vehicles. The adult care facility operates with a small staff, which reduces the actual demand for parking spaces. A parking study was conducted to determine the existing parking demand for the facility and the parking demand for the expanded facility. The parking study utilized the existing peak parking demand rate to determine the parking demand for the expanded facility. The anticipated parking demand for the expanded facility is three (3) spaces. The parking study concluded that the existing seven (7) parking spaces can be expected to adequately serve the proposed project. The parking variance would not grant a special privileged inconsistent with the limitations upon the other properties in the vicinity and zone as the actual parking demand for this facility is lower than a standard nursing home or assisted care facility. B. Be materially detrimental to the public health or welfare or be injurious to the property or improvements in such zone or vicinity: The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of the addition of eight (8) patient beds. To address neighboring resident complaints, the applicants have installed new perimeter fencing along the east and west property line where no fencing has been installed. The applicants have also obtained building permits to remove and replace 12 existing windows with dual-pane windows to minimize noise impacts to adjacent neighbors. In addition, the applicants have relocated the smoking area to the rear of the building. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. The granting of such variance will not be materially detrimental to the public health or welfare or injurious to the property or improvements in such zone or vicinity in which the subject property is located. C. Adversely affect the comprehensive General Plan; and The property is designated as Residential in the General Plan. The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The facility has operated in the same capacity since 1996. The adult care facility Planning Commission Meeting March 16, 2015 Page 9 of 17 will continue to operate in the same manner with the exception of the addition of eight (8) patient beds. Therefore, the granting of the parking variance will not adversely impact the General Plan. D. That because of special circumstances, the strict enforcement of the code would deprive the subject property of privileges enjoyed by other properties in the vicinity under identical zone classifications. Strict application of the zoning ordinance would require twenty-eight (28) onsite parking spaces for the facility. The adult care facility differs from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. The adult care facility operates with a small staff, which reduces the actual demand for parking spaces. A parking study determined that the facility could accommodate the expansion adequately. Therefore, approval of a Zone Variance allowing the adult care facility to expand is reasonable. PUBLIC NOTICE PROCESS This item has been noticed through the regular agenda notification process, which includes a 300' radius public hearing notice to forty-one (41) property owners, publication in the Rosemead Reader, and postings of the notice at the five (5) public locations and on the subject site. Prepared . • Submitted by: • - 'LLAa Lily T. Valenzuela Michelle Ramirez Associate Planner Community Development Director EXHIBITS: A. Planning Commission Resolution 14-07 with Attachment"A" (Conditions of Approval) B. Site Plan and Floor Plan C. Planning Commission Staff Report. dated May 5. 2014 D. Planning Commission Meeting Minutes. dated May 5, 2014 E. Staff's Comment Letter, dated May 21. 2014 F. Applicant's Response Packet G. Email from DSS, dated November 3, 2014 H. Parking Study dated October 1. 2013 I. Assessor Parcel Map (APN:8594-008-036) Planning Commission Meeting March 16.2015 Page 10 of 17 EXHIBIT "A" PC RESOLUTION 14-07 A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF ROSEMEAD, COUNTY OF LOS ANGELES, STATE OF CALIFORNIA APPROVING MODIFICATION 14-01 FOR THE EXPANSION OF AN EXISTING ADULT CARE FACILITY AND ZONE VARIANCE 14-01 REQUESTING TO DEVIATE FROM THE REQUIRED NUMBER OF PARKING SPACES LOCATED AT 9025 GUESS STREET, IN THE R-1 (SINGLE FAMILY RESIDENTIAL) ZONE. (APN: 8594-008-036) WHEREAS, on February 27, 2014, Zosimo and Nelia Pascasio submitted a Modification application requesting to modify existing Conditional Use Permit 96-677 in order to expand the adult care facility and a Zone Variance application requesting to deviate from the required number of parking spaces located at 9025 Guess Street; and WHEREAS, 9025 Guess Street is located in the R-1 (Single Family Residential) zone; and WHEREAS, Section 17.112.020(6) of the Rosemead Municipal Code permits the operation of education institutions in any zone upon the granting of a Conditional Use Permit; and WHEREAS, Sections 65800 & 65900 of the California Government Code and Sections 17.112. 010 and 17.108.020 of the Rosemead Municipal Code authorize the Planning Commission to approve, conditionally approve, or deny Conditional Use Permit and Zone Variance applications; and WHEREAS, Section 17.112.010 of the Rosemead Municipal Code specifies the criteria by which a Conditional Use Permit may be granted; and WHEREAS, an applicant must obtain a Zone Variance in order to create a development that does not meet the minimum standards. Section 17.108.020 sets criteria required for granting such a variance. If one of these criteria cannot be met then the variance may not be granted; and WHEREAS, on May 5, 2014, the Planning Commission held a duly noticed and advertised public hearing to receive oral and written testimony relative to Modification 14-01 and Zone Variance 14-01. Based on the testimonies, the Planning Commission continued the public hearing to a date uncertain; and WHEREAS, on March 5, 2015, forty-one (41) notices were sent to property owners within a 300-foot radius from the subject property, in addition to notices posted in five (5) public locations, on-site, and in the Rosemead Reader, specifying the Planning Commission Meeting March 16, 2015 Page 11 of 17 availability of the application, plus the date, time, and location of the public hearing for Modification 14-01 and Zone Variance 14-01; and WHEREAS, on March 16, 2015, the Planning Commission held a duly noticed and advertised public hearing to receive oral and written testimony relative to Modification 14-01 and Zone Variance 14-01; and WHEREAS, the Rosemead Planning Commission has sufficiently considered all testimony presented to them in order to make the following determination. NOW, THEREFORE, BE IT RESOLVED by the Planning Commission of the City of Rosemead as follows: SECTION 1. The Planning Commission HEREBY DETERMINES that Modification 14-01 and Zone Variance 14-01 is classified as a Class 9 Categorical Exemption pursuant to Section 15309 of California Environmental Quality Act (CEQA) guidelines. Section 15309 of the CEQA guidelines exempts projects that consist of inspections to check for the performance of an operation, or for quality, health, or safety of a project. SECTION 2. The Planning Commission HEREBY FINDS AND DETERMINES that facts do exist to justify approving Modification 14-01 according the criteria of Chapter 17.112.010 of the Rosemead Municipal Code as follows: A. The project is essential and desirable to the public convenience or welfare. FINDINGS: The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of adding eight (8) additional patient beds. The facility will continue to serve a need that is considered essential to the disabled community. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. B. The project is in harmony with the elements and objectives of the General Plan and Zoning Codes. FINDINGS: The property is located in the R-1 (Single Family Residential) zone and is designated as Residential in the City's General Plan. The use of the site is permitted upon the granting of Conditional Use Permit. The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and a Conditional Use Permit was granted by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of adding eight (8) additional patient beds. Planning Commission Meeting March 16, 2015 Page 12 of 17 C. The project will not be detrimental to the surroundings properties. FINDINGS: The facility is licensed and monitored by the State of California for ambulatory and non-ambulatory adults as a non-medical facility. The facility provides 24-hour care and supervision for the patients. To address neighboring resident complaints, the applicants have installed new perimeter fencing along the east and west property line where no fencing has been installed. The applicants have also obtained building permits to remove and replace 12 existing windows with dual-pane windows to minimize noise impacts to adjacent neighbors. In addition, the applicants have relocated the smoking area to the rear of the building. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. SECTION 3. The Planning Commission HEREBY APPROVES Zone Variance 14-07 granting a deviation from the required number of parking spaces. A. Constitute a grant of special privilege inconsistent with the limitations upon other properties in the vicinity; FINDINGS: The adult care facility differs from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. This facility provides 24-hour supervision for ambulatory adults in a non- medical capacity. As a result, the facility operates with a limited staff level as direct medical care is not provided onsite to the patients. The facility patients do not have a California Driver's License and do not drive personal vehicles. The adult care facility operates with a small staff, which reduces the actual demand for parking spaces. A parking study was conducted to determine the existing parking demand for the facility and the parking demand for the expanded facility. The parking study utilized the existing peak parking demand rate to determine the parking demand for the expanded facility. The anticipated parking demand for the expanded facility is three (3) spaces. The parking study concluded that the existing seven (7) parking spaces can be expected to adequately serve the proposed project. The parking variance would not grant a special privileged inconsistent with the limitations upon the other properties in the vicinity and zone as the actual parking demand for this facility is lower than a standard nursing home or assisted care facility. B. Be materially detrimental to the public health or welfare or injurious to the property or improvements in such zone or vicinity; FINDINGS: The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of the addition of eight (8) patient beds. To address neighboring resident complaints, the applicants have installed new perimeter fencing along the east and west property line where no fencing has been installed. The applicants have also obtained building permits to remove and replace 12 existing windows with dual-pane • I Planning Commission Meeting March 16,2015 Page 13 of 17 windows to minimize noise impacts to adjacent neighbors. In addition, the applicants have relocated the smoking area to the rear of the building. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. The granting of such variance will not be materially detrimental to the public health or welfare or injurious to the property or improvements in such zone or vicinity in which the subject property is located. C. Adversely affect the comprehensive General Plan: and FINDINGS: The property is designated as Residential in the General Plan. The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The facility has operated in the same capacity since 1996. The adult care facility will continue to operate in the same manner with the exception of the addition of eight (8) patient beds. Therefore, the granting of the parking variance will not adversely impact the General Plan. D. That because of special circumstances, the strict enforcement of the code would deprive the subject property of privileges enjoyed by other properties in the vicinity under identical zone classifications. FINDINGS: Strict application of the zoning ordinance would require twenty-eight (28) onsite parking spaces for the facility. The adult care facility differs from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. The adult care facility operates with a small staff, which reduces the actual demand for parking spaces. A parking study determined that the facility could accommodate the expansion adequately. Therefore, approval of a Zone Variance allowing the adult care facility to expand is reasonable. SECTION 4. The Planning Commission HEREBY APPROVES Modification 14- 01 for the expansion of an existing adult care facility and Zone Variance 14-01 granting a deviation from the required number of parking spaces, located at 9025 Guess Street, and subject to the conditions listed in Attachment "A" attached hereto and incorporated herein by reference. SECTION 5. This action shall become final and effective ten (10) days after this decision by the Planning Commission, unless within such time a written appeal is filed with the City Clerk for consideration by the Rosemead City Council as provided in Rosemead Municipal Code Section 17.160.040 —Appeals of Decisions. Planning Commission Meeting March 16, 2015 Page 14 of 17 SECTION 6. This resolution is the result of an action taken by the Planning Commission on March 16, 2015, by the following vote: YES: NO: ABSENT: ABSTAIN: SECTION 7. The Secretary shall certify to the adoption of this resolution and shall transmit copies of same to the applicant and the Rosemead City Clerk. PASSED, APPROVED and ADOPTED this 16th day of March. 2015. Nancy Eng, Chair CERTIFICATION I hereby certify that the foregoing is a true copy of a resolution adopted by the Planning Commission of the City of Rosemead at its regular meeting, held on the 16th day of March, 2015, by the following vote: YES: NO: ABSENT: ABSTAIN: Michelle Ramirez, Secretary APPROVED AS TO FORM: Gregory M. Murphy, Planning Commission Attorney Burke, Williams & Sorensen, LLP Planning Commission Meeting March 16,2015 Page 15 of 17 ATTACHMENT "A" (PLANNING COMMISSION RESOLUTION 14-07) MODIFICATION 14-01 AND ZONE VARIANCE 14-01 9025 GUESS STREET (APN: 8594-008-036) CONDITIONS OF APPROVAL March 16, 2015 1. Modification 14-01 is approved for the expansion of an adult care facility and Zone Variance 14-01 is approved for the deviation from the required number of parking spaces in accordance with the plans marked Exhibit "B", dated February 12, 2015. Any revisions to the approved plans must be resubmitted for the review and approval of the Planning Division. 2. Approval of Modification 14-01 and Zone Variance 14-01 shall not take effect for any purpose until the applicant has filed with the City of Rosemead a notarized affidavit stating that he/she is aware of and accepts all of the conditions of approval as set forth in the letter of approval and this list of conditions within ten (10) days from the Planning Commission approval date. 3. Approval of Modification 14-01 and Zone Variance 14-01 are approved for a period of six (6) months from the date of adoption of Planning Commission Resolution 14-07. The applicant shall commence the proposed use or request an extension within 30-calendar days prior to expiration. The six (6) months initial approval period shall be effective from the Planning Commission approval date. For the purpose of this petition, project commencement shall be defined as beginning the permitting process with the Planning Division and Building and Safety Division so long as the project is not abandoned. If Modification 14-01 and Zone Variance 14-01 have been unused, abandoned, or discontinued for a period of six (6) months, it shall become null and void. 4. Modification 14-01 and Zone Variance 14-01 is granted or approved with the City and its Planning Commission and City Council retaining and reserving the right and jurisdiction to review and to modify Modification 14-01 and Zone Variance 14-01 , including the conditions of approval, based on changed circumstances. Changed circumstances include, but are not limited to, the modification of the use, a change in scope, emphasis, size, or nature of the use, or the expansion, alteration, reconfiguration, or change of use. This reservation of right to review is in addition to, and not in lieu of, the right of the City, its Planning Commission, and City Council to review and revoke or modify any permit granted or approved under the Rosemead Municipal Code for any violations of the conditions imposed on Modification 14-01 and Zone Variance 14-01. Planning Commission Meeting March 16, 2015 Page 16 of 17 5. The applicant shall defend, indemnify, and hold harmless the City of Rosemead or its agents, officers, and employees from any claim, action, or proceeding against the City of Rosemead or its agents, officers, or employees to attack, set side, void, or annul, an approval of the Planning Commission and/or City Council concerning the project, which action is brought within the time period provided by law. 6. The onsite public hearing notice posting shall be removed by the end of the 10- day appeal period of Modification 14-01 and Zone Variance 14-01 . 7. The Planning Commission hereby authorizes the Planning Division to make or approve minor modifications to the approved plans where necessary. 8. The following conditions must be complied with to the satisfaction of the Planning Division prior to final approval of the associated plans, building permits, occupancy permits, or any other appropriate request. 9. The applicant shall comply with all Federal, State, and local laws relative to the approved use including the requirements of the Planning, Building, Fire, Sheriff, and County Health Departments. Prior to submittal to the Planning, Building, Fire, Sheriff, and Health Departments for any approvals related to this application, the applicant shall submit a revised and correct site plan to the Planning Division, which shall be subject to Division review and approval. 10. No portion of the lot, outside of the building, shall be used for storage of any type, unless designated and approved by the Planning Division. 11. The numbers of the address sign shall be at least 6" tall with a minimum character width of 3/4", contrasting in color and easily visible at driver's level from the street. Materials, colors, location, and size of such address numbers shall be approved by the Planning Division, prior to installation. 12. Occupancy will not be granted until all improvements required by this approval have been completed, inspected, and approved by the appropriate department(s). 13. The site shall be maintained in a graffiti-free state. Any new graffiti shall be removed within twenty-four (24) hours. A 24-hour Graffiti Hotline can be called at (626) 569-2345 for assistance. 14. The site shall be maintained in a clean, weed and litter free state in accordance with the Rosemead Municipal Code, which pertains to the storage, accumulation, collection, and disposal of garbage, rubbish, trash, and debris. All trash containers shall be stored in the appropriate trash enclosure at all times. All trash, rubbish, and garbage receptacles shall be regularly cleaned, inspected, Planning Commission Meeting March 16. 2015 Page 17 of 17 and maintained in a clean, safe, and sanitary condition. The trash enclosure doors shall be closed at all times. 15. The parking area, including handicapped spaces, shall be paved, and re-striped periodically to City standards to the satisfaction of the Planning Division. In accordance with Rosemead Municipal Code, all designated parking spaces shall be double-striped and have wheel stops. Such striping shall be maintained in a clear, visible, and orderly manner. 16. All landscape planters onsite shall be rehabilitated and maintained at all times. 17. Adequate lighting shall be provided in the parking area where deemed appropriate by the Planning Division. All exterior lighting shall be directed away from adjacent properties. 18. All roof top appurtenances and equipment shall be adequately screened from view of the public right of way. 19. All driveway entrances and exits shall remain open and unobstructed at all times. 20. The facility shall not exceed a maximum of twenty-eight (28) patient beds at any given time. 21. The facility shall provide adequate level of supervision for the patients at all times. 22. The facility residents may not obtain a State of California driver's license. In the event that residents of the facility would like to obtain a State of California driver's license, the project shall be reviewed by the Planning Commission through modification applications and a new parking study will be required. 23. Violations of the conditions of approval may result in citation and/or initiation of revocation proceedings. 1 1 f M F ° 5 ' o ROSEMEAD PLANNING COMMISSION � STAFF REPORT CIVIC PRIDE 1 V1ill:117it ""m RA7ER 10 TO: THE HONORABLE CHAIRMAN AND MEMBERS OF THE ROSEMEAD PLANNING COMMISSION FROM: PLANNING DIVISION DATE: MAY 5, 2014 SUBJECT MODIFICATION 14-01 AND ZONE VARIANCE 14-01 9025 GUESS STREET Summary Zosimo and Neila Pascasia submitted a Modification application requesting to expand their existing adult care facility and a Zone Variance application requesting to deviate from the required number of parking stalls. The subject property is located at 9025 Guess Street, in the R-1 (Single Family Residence) zone. Environmental Determination: Section 15309 of the California Environmental Quality Act (CEQA) guidelines exempts projects that consist of inspections to check for the performance of an operation, or for quality, health. or safety of a project. Accordingly, Modification 14-01 and Zone Variance 14-0'. are classified as a Class 9 Categorical Exemption pursuant to Section 15309 of CEQA guidelines. Staff Recommendation Based on the analysis and findings contained in this report, it is recommended that the Planning Commission ADOPT Resolution No. 14-07 with findings (Exhibit "A"), and APPROVE Modification 14-01 and Zone Variance 14-01, subject to twenty-two (22) conditions outlined in Exhibit "B" attached hereto. Property History and Description The subject site is located on a single parcel of land totaling 17,500 square feet of area. According to Assessor Records, the property was originally developed as a single family residence in 1924. Additional detached buildings were constructed in 1925 and 1929. The use of the site was converted into a small nursing home facility in 1944, under the Los Angeles County jurisdiction prior to the City's incorporation. On December 26, 1956, the Los Angeles County Board of Supervisors approved Zone Exception Number 2612 permitting a 26-bed nursing home facility. When new owners acquired the business, the City required the new property owners to obtain a Conditional Use Permit EXHIBIT "C" Planning Commission Meeting May 5,2014 Page 2 of 16 as required by code for the operation of an adult care facility. Subsequently, Conditional Use Permit 96-677 was approved by the Rosemead Planning Commission on August 19, 1996, subject to conditions of approval outlined in Planning Commission Resolution number 96-43. The decision was later upheld by the Rosemead City Council on September 10, 1996 (approved under CC Resolution number 96-42), after an appeal was filed, permitting the operation of a 22-bed residential care facility subject to specific conditions of approval. • • • • • } - not-t7 Front Elevation Site & Surrounding Land Uses The project site is designated in the General Plan as Residential and is zoned R-1 (Single Family Residential). The site is surrounded by the following land uses: North: General Ran. Commercial Zoning: CBD-D (Central Business District with a Design Overlay) Land Use: Office Building South: General Plan: Low Density Residential Zoning: R-1 (Single Family Residential) Land Use: Single Family Residence Planning Commission Meeting May 5,2014 Page 3 of 16 East: General Plan: Low Density Residential Zoning: R-1 (Single Family Residential) Land Use• Single Family Residence West: General Plan: High Density and Low Density Residential Zoning. R-3 and R-1 (Medium Multiple Residential and Single Family Residential) Land Use: Apartments and Single Family Residence ADMINISTRATIVE ANALYSIS The applicants have submitted a Modification application requesting to modify their existing Conditional Use Permit in order to expand the existing adult care facility and a Zone Variance application requesting to deviate from the required number of parking stalls. Rosemead Municipal Code (RMC) Section 17.112.020(8) permits the operation of care facility in any zone upon the approval of a conditional use permit. RMC Section 17.108 permits the granting of a variance when practical difficulties or unnecessary hardships occur. Architectural Plan The property is developed with three detached buildings, as shown in the architectural plans dated April 7, 2014 (Exhibit "C"). Building 'A" totals 2,027 square feet of area and is comprised of seven (7) bedrooms, two (2) bathrooms and one living room. Building "B" totals 1,218 square feet of area and is comprised of three (3) bedrooms, one (1) bathroom, a kitchen, and a dining room. The third detached building (listed as Building °D" on the site plan) totals 778 square feet of area. Building "D" is comprised of two (2) bedrooms, one (1) bathroom, and a laundry room. The applicant is proposing to construct a detached 596 square foot building at the rear of the property. This new building will consist of two (2) bedrooms, two (2) bathrooms, one (1) office and a storage room. The proposed building meets all development standards. The new building will be stuccoed finished in a white stucco color with composition roof shingles. Business Operations Rosemead Villa is an Adult Residential Care Facility. The facility provides 24-hour non- medical care for adults, 18 through 59 years of age. The clients at Rosemead Villa are ambulatory adults who are mentally disabled. According to the applicant, the facility operates with a total of three (3) employees during the day; two (2) employees and one (1) facility administrator. The facility operates with one (1) employee during the evening hours (from 11:00 p.m. to 7:00 a.m.) The facility currently operates with a maximum of twenty-two (22) beds. The applicants are requesting permission to add six (6) new beds for a total of twenty-eight (28) beds for the facility. • Planning Commission Meeting May 5,2014 Page 4 of 16 Parking and Zone Variance The buildings are located approximately thirty-two (32) feet from the front property line. The parking area is accessed from two (2) separate driveways along Guess Street. According to the site plan, seven (7) parking stalls are provided for the facility (one (1) ADA and six (6) standard stalls). RMG Section 17.84.050 requires that land uses involving hospitals, convalescent homes and homes for the aged shall provide one (1) parking stalls per patient bed. Based on these requirements, a total of twenty-eight (28) parking spaces are required for the operation of this adult care facility. Based on the code requirements, the center would be deficient by twenty-one (21) parking spaces. To address the parking deficiency, the applicant had a parking study completed to determine the onsite parking demand for the facility. The parking study conducted by Abratique & Associates, Inc. (Exhibit "E"), compared similar land uses to residential care facilities, as there are no direct land uses that exactly correlate to residential care facilities. The study analyzed assisted living facilities and nursing home land uses and compared them to residential care facilities. Residential care facilities differ from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. This facility provides 24-hour direct care (supervision), for ambulatory adults in a non-medical capacity. The facility operates with a limited staff level and no direct medical care (doctors or nurses) is provided onsite to the patients. The facility patients do not have California Drivers Licenses and they do not drive personal vehicles. Because the residential facility operates with a small staff, the actual demand for parking spaces is less than a standard nursing home or an assisted living facility. Abratique & Associates, Inc. conducted a parking count for the site. According to the parking count data, the peak weekday parking demand occurred during both the morning and the afternoon when there were two (2) occupied parking spaces. The peak Saturday parking demand occurred in the afternoon with two (2) occupied parking spaces. The parking study utilized the existing peak parking demand rate of 0.1 vehicles per bed to determine that the facility would result in a parking demand of three (3) spaces for the expanded facility. The parking study concluded that the existing seven (7) parking spaces can be expected to adequately serve the proposed project. Based on the findings of the parking study, the applicant submitted an application for a Zone Variance requesting a code exemption from the required number of parking spaces for the facility. The parking study was reviewed by the City's Traffic Consultant and was deemed acceptable. Public Safety The City of Rosemead Public Safety Center and Chief of Police have reviewed this request and have indicated concern with the facility expansion. According to the Chief Planning Commission Meeting May 6,2014 Page 5 of 16 of Police, the subject site has had a significant number of "calls for service" within the past two years. However. according to the Chief of Police, the majority of these calls dealt with medical responses, mental patient disturbances, and missing person's reports. According to the Chief of Police, most of the "calls for service" were for non- violent issues. The City's Code Enforcement has had two (2) calls for service over the past two years. These calls resulted from citizen complaints but no code violations were documented. MUNICIPAL CODE REQUIREMENTS Conditional Use Permit 96-677 was approved by the Rosemead Planning Commission on August 19, 1996, subject to conditions of approval outlined in Resolution 96-43 and the decision was upheld by the Rosemead City Council on September 10, 1996 (CC Resolution 96-42) after an appeal was filed. Rosemead Municipal Code (RMC) Section 17.112.020(8) permits the operation of care facility in any zone upon the approval of a conditional use permit. Chapter 17.112 does not contain standards for the modification of a CUP. therefore, City staff has applied the same standards to the proposed project for a modification that were applied to the original CUP application. • The project is essential and desirable to the public convenience or welfare. The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of adding eight (8) additional patient beds. The facility will continue to serve a need that is considered essential to the disabled community. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. • The project is in harmony with the elements and objectives of the General Plan and Zoning Codes. The use of the site is permitted upon the granting of conditional use permit. The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and a Conditional Use Permit was granted by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of adding eight (8) additional patient beds. The property is located in the R-1 (Single Family Residential) zone and is designated as Residential in the City's General Plan. • The project will not be detrimental to the surrounding properties. The facility is licensed and monitored by the State of California for ambulatory and non-ambulatory adults as a non-medical facility. The facility provides 24- Planning Commission Meeting Way 5,2014 Page 6 of 16 hour care and supervision for the patients. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. An applicant must obtain a Zone Variance in order to operate with less than the required number of parking stalls. Section 17.108.020 sets criteria required for granting such a variance. If one of these criteria cannot be met, then the variance may not be granted. These criteria require that the granting of a variance will not: • Constitute a grant of special privilege inconsistent with the limitations upon other properties in the vicinity; The adult care facility differs from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. This facility provides 24-hour supervision for ambulatory adults in a non-medical capacity. As a result the facility operates with a limited staff level as direct medical care is not provided onsite to the patients. The facility patients do not have California Drivers Licenses and they do not drive personal vehicles. The adult care facility operates with a small staff, which reduces the actual demand for parking spaces. A parking study was conducted to determine the existing parking demand for the facility and the parking demand for the expanded facility. The parking study utilized the existing peak parking demand rate to determine the parking demand for the expanded facility. The anticipated parking demand for the expanded facility is three (3) spaces. The parking study concluded that the existing seven (7) parking spaces can be expected to adequately serve the proposed project. The parking variance would not grant a special privileged inconsistent with the limitations upon the other properties in the vicinity and zone as the actual parking demand for this facility is lower than a standard nursing home or assisted care facility. • Be materially detrimental to the public health or welfare or be injurious to the property or improvements in such zone or vicinity; The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of the addition of eight (8) patient beds. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. The granting of such variance will not be materially detrimental to the public health or welfare or injurious to the property or improvements in such zone or vicinity in which the subject property is located. • Adversely affect the comprehensive General Plan; and The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Planning Commission Heating May 5,2014 Page 7 of 16 Commission in 1996. The facility has operated in the same capacity since 1996. The property is designated as Residential in the General Plan. The adult care facility will continue to operate in the same manner with the exception of the addition of eight (8) patient beds. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. Therefore, the granting of the parking variance will not adversely impact the General Plan. • That because of special circumstances, the strict enforcement of the code would deprive the subject property of privileges enjoyed by other properties in the vicinity under identical zone classifications. Strict application of the zoning ordinance would require twenty-eight (28) onsite parking spaces for the facility. The adult care facility differs from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. The adult care facility operates with a small staff, which reduces the actual demand for parking spaces. A parking study determined that the facility could accommodate the expansion adequately. Therefore, approval of a Zone Variance allowing the adult care facility to expand is reasonable. PUBLIC NOTICE PROCESS This item has been noticed through the regular agenda notification process, which includes a 300' radius public hearing notice to forty-three (43) property owners, publication in the Rosemead Reader, and postings of the notice at the five (5) public locations and on the subject site. Prepared by: Submitted by: LIVItittIA a L6)11."- - Gina Casillas Michelle Ramirez Planning Technician Community Development Director EXHIBITS: A. Resolution 14-07 B. Conditions of Approval C. Site Plan and Floor Plan D. Assessor Parcel Map (APN:8594-008-036) E. Parking Study dated October 1, 2013 F. Planning Commission Resoluticn No 96-43 G. City Council Resolution No. 96-42 1 V Planning Commission Meeting May 5,2014 Page 6of16 EXHIBIT "A" PC RESOLUTION 14-07 A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF ROSEMEAD, COUNTY OF LOS ANGELES, STATE OF CALIFORNIA APPROVING MODIFICATION 14-01 FOR THE EXPANSION OF AN EXISTING ADULT CARE FACILITY AND ZONE VARIANCE 14-01 REQUESTING TO DEVIATE FROM THE REQUIRED NUMBER OF PARKING STALLS LOCATED AT 9025 GUESS STREET, IN THE R-1 (SINGLE FAMILY RESIDENTIAL) ZONE. (APN: 8594-008-036) WHEREAS, on February 27, 2014, Zosimo and Nelia Pascasio submitted a Modification application requesting to modify existing Conditional Use Permit 96-677 in order to expand the adult care facility and a Zone Variance application requesting to deviate from the required number of parking stalls located at 9025 Guess Street: and WHEREAS, 9025 Guess Street is located in the R-1 (Single Family Residential) zone; and WHEREAS, Section 17.112.020(6) of the Rosemead Municipal Code permits the operation of education institutions in any zone upon the granting of a Conditional Use Permit; and WHEREAS, Sections 65800 & 65900 of the California Government Code and Sections 17.112. 010 and 17.108.020 of the Rosemead Municipal Code authorize the Planning Commission to approve, conditionally approve, or deny Conditional Use Permit and Zone Variance applications; and WHEREAS, Section 17.112.010 of the Rosemead Municipal Code specifies the criteria by which a Conditional Use Permit may be granted; and WHEREAS, An applicant must obtain a Zone Variance in order to create a development that does not meet the minimum standards. Section 17.108.020 sets criteria required for granting such a variance. If one of these criteria cannot be met then the variance may not be granted: and WHEREAS. on April 24, 2014, forty-three (43) notices were sent to property owners within a 300-foot radius from the subject property, in addition to notices posted in five (5) public locations and on-site, specifying the availability of the application, plus the date, time, and location of the public hearing for Modification 14-01 and Zone Variance 14-01: and on April 24, 2014 notice was published in the Rosemead Reader; and Planning Commission Meeting May 5,2014 Page 9 of 16 WHEREAS, on May 5, 2014, the Planning Commission held a duly noticed and advertised public hearing to receive oral and written testimony relative to Modification 14-01 and Zone Variance 14-01; and WHEREAS. the Rosemead Planning Commission has sufficiently considered all testimony presented to them in order to make the following determination. NOW, THEREFORE, BE IT RESOLVED by the Planning Commission of the City of Rosemead as follows: SECTION 1. The Planning Commission HEREBY DETERMINES that Modification 14-01 and Zone Variance 14-01 is classified as a Class 9 Categorical Exemption pursuant to Section 15309 of California Environmental Quality Act (CEQA) guidelines. Section 15309 of the CEQA guidelines exempts projects that consist of inspections to check for the performance of an operation, or for quality, health, or safety of a project. SECTION 2. The Planning Commission HEREBY FINDS AND DETERMINES that facts do exist to justify approving Modification 14-01 according the criteria of Chapter 17.112.010 of the Rosemead Municipal Code as follows: A. The project is essential and desirable to the public convenience or welfare. FINDINGS: The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of adding eight (8) additional patient beds. The facility will continue to serve a need that is considered essential to the disabled community. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. B. The project is in harmony with the elements and objectives of the General Plan and Zoning Codes. FINDINGS: The use of the site is permitted upon the granting of conditional use permit. The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and a Conditional Use Permit was granted by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of adding eight (8) additional patient beds. The property is located in the R-1 (Single Family Residential) zone and is designated as Residential in the City's General Plan. C. The project will not be detrimental to the surroundings properties. Planning Commission Meeting May 5,2014 Page 10 of 16 FINDINGS: The facility is licensed and monitored by the State of California for ambulatory and non-ambulatory adults as a non-medical facility. The facility provides 24-hour care and supervision for the patients. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. SECTION 3. The Planning Commission HEREBY APPROVES Zone Variance 13-03 granting a deviation from the required number of parking stalls. D. Constitute a grant of special privilege inconsistent with the limitations upon other properties in the vicinity; FINDINGS: The adult care facility differs from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. This facility provides 24-hour supervision for ambulatory adults in a non- medical capacity. As a result the facility operates with a limited staff level as direct medical care is not provided onsite to the patients. The facility patients do not have California Drivers Licenses and they do not drive personal vehicles. The adult care facility operates with a small staff. which reduces the actual demand for parking spaces. A parking study was conducted to determine the existing parking demand for the facility and the parking demand for the expanded facility. The parking study utilized the existing peak parking demand rate to determine the parking demand for the expanded facility. The anticipated parking demand for the expanded facility is three (3) spaces. The parking study concluded that the existing seven (7) parking spaces can be expected to adequately serve the proposed project. The parking variance would not grant a special privileged inconsistent with the limitations upon the other properties in the vicinity and zone as the actual parking demand for this facility is lower than a standard nursing home or assisted care facility. E. Be materially detrimental to the public health or welfare or injurious to the property or improvements in such zone or vicinity; FINDINGS: The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The adult care facility will continue to operate in the same manner with the exception of the addition of eight (8) patient beds. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. The granting of such variance will not be materially detrimental to the public health or welfare or injurious to the property or improvements in such zone or vicinity in which the subject property is located. F. Adversely affect the comprehensive General Plan: and Planning Commission tvleeting May 5,2014 Page 11 of 16 FINDINGS: The subject site was approved for the operation of an adult care facility by the County Board of Supervisors in 1956 and by the Rosemead Planning Commission in 1996. The facility has operated in the same capacity since 1996. The property is designated as Residential in the General Plan. The adult care facility will continue to operate in the same manner with the exception of the addition of eight (8) patient beds. Specific conditions have been incorporated to mitigate potential negative impacts to the neighborhood. Therefore, the granting of the parking variance will not adversely impact the General Plan. G. That because of special circumstances. the strict enforcement of the code would deprive the subject property of privileges enjoyed by other properties in the vicinity under identical zone classifications. FINDINGS: Strict application of the zoning ordinance would require twenty-eight (28) onsite parking spaces for the facility. The adult care facility differs from standard nursing homes or assisted living facilities in that medical staffing is not required for the care of the patients. The residential facility operates with a small staff. which reduces the actual demand for parking spaces. A parking study determined that the facility could accommodate the expansion adequately. Therefore. approval of a Zone Variance allowing the residential care facility to expand is reasonable. SECTION 4. The Planning Commission HEREBY APPROVES Modification 14- 01 permitting the expansion of an existing adult care facility and Zone Variance 14-01 granting a deviation from the required number of parking stalls. SECTION 5. This action shall become final and effective ten (10) days after this decision by the Planning Commission, unless within such time a written appeal is filed with the City Clerk for consideration by the Rosemead City Council as provided in Article IX — Planning and Zoning of the Rosemead Municipal Code. SECTION 6. This resolution is the result of an action taken by the Planning Commission on May 5, 2014, by the following vote: YES: NO: ABSENT: ABSTAIN: SECTION 7. The Secretary shall certify to the adoption of this resolution and shall transmit copies of same to the applicant and the Rosemead City Clerk. PASSED, APPROVED and ADOPTED this 5th day of May, 2014. Diane Herrera, Chair Planning Commission Meeting May 5,2014 Page 12 of 16 CERTIFICATION I - - hereby certify that the foregoing is a true copy of a resolution adopted by the Planning Commission of the City of Rosemead at its regular meeting, held on the 5rd day of May. 2014 by the following vote: YES: NO: ABSENT: • ABSTAIN: Michelle Ramirez, Secretary APPROVED AS TO FORM: Gregory M. Murphy, Planning Commission Attorney Burke, Williams & Sorensen. LLP Planning Commission Meeting May 5.2014 Page 13 of 16 EXHIBIT "B" MODIFICATION 14-01 AND ZONE VARIANCE 14-01 (APN: 8594-008-036) CONDITIONS OF APPROVAL May 5, 2014 1. Modification 14-01 is approved for the expansion of an adult care facility and Zone Variance 14-01 is approved for the deviation from the required number of parking stalls in accordance with the plans marked Exhibit "C", dated April 7, 2014. Any revisions to the approved plans must be resubmitted for the review and approval of the Planning Division. 2. Approval of Modification 14-01 and Zone Variance 14-01 shall not take effect for any purpose until the applicant has filed with the City of Rosemead a notarized affidavit stating that he/she is aware of and accepts all of the conditions of approval as set forth in the letter of approval and this list of conditions within ten (10) days from the Planning Commission approval date. 3. Approval of Modification 14-01 and Zone Variance 14-01 is approved for a period of six (6) months from the date of adoption of Planning Commission Resolution 14-07. The applicant shall commence the proposed use or request an extension within 30-calendar days prior to expiration. The six (6) months initial approval period shall be effective from the Planning Commission approval date. For the purpose of this petition, project commencement shall be defined as beginning the permitting process with the Planning Division and Building and Safety Division so long as the project is not abandoned. if Modification 14-01 and Zone Variance 14-01 has been unused, abandoned, or discontinued for a period of six (6) months, it shall become null and void. 4. Modification 14-01 and Zone Variance 14-01 is granted or approved with the City and its Planning Commission and City Council retaining and reserving the right and jurisdiction to review and to modify Modification 14-01 and Zone Variance 14-01, including the conditions of approval, based on changed circumstances. Changed circumstances include, but are not limited to, the modification of the use, a change in scope, emphasis, size, or nature of the use. or the expansion, alteration, reconfiguration, or change of use. This reservation of right to review is in addition to, and not in lieu of, the right of the City, its Planning Commission, and City Council to review and revoke or modify any permit granted or approved under the Rosemead Municipal Code for any violations of the cond tions imposed on Modification 14-01 and Zone Variance 14-01. 5. The applicant shall defend, indemnify, and hold harmless the City of Rosemead or its agents, officers, and employees from any claim, action, or proceeding Planning Commission Meeting May 5,2014 Page 14 of 16 against the City of Rosemead or its agents, officers, or employees to attack, set side, void, or annul, an approval of the Planning Commission and/or City Council concerning the project, which action is brought within the time period provided by law. 6. The onsite public hearing notice posting shall be removed by the end of the 10- day appeal period of Modification 14-01 and Zone Variance 14-01. 7. The Planning Commission hereby authorizes the Planning Division to make or approve minor modifications to the approved Plans where necessary. 8. The following conditions must be complied with to the satisfaction of the Planning Division prior to final approval of the associated plans, building permits, occupancy permits, or any other appropriate request. 9. Prior to occupancy, the applicant shall obtain a City of Rosemead Business License. 10. The applicant shall comply with all Federal, State, and local laws relative to the approved use including the requirements of the Planning. Building, Fire, Sheriff, and County Health Departments. Prior to submittal to the Planning, Building, Fire, Sheriff, and Health Departments for any approvals related to this application, the applicant shall submit a revised and correct site plan to the Planning Division, which shall be subject to Division review and approval. 11. No portion of the lot, outside of the building, shall be used for storage of any type, unless designated and approved by the Planning Division. 12. The numbers of the address sign shall be at least 6" tall with a minimum character width of 3/4", contrasting in color and easily visible at driver's level from the street. Materials, colors, location, and size of such address numbers shall be approved by the City Planner, or his or her designee, prior to installation. 13. Occupancy will not be granted until all improvements required by this approval have been completed. inspected, and approved by the appropriate department(s). 14. The site shall be maintained in a graffiti-free state. Any new graffiti shall be removed within twenty-four (24) hours. A 24-hour Graffiti Hotline can be called at (626) 569-2345 for assistance. 15. The site shall be maintained in a clean, weed and litter free state in accordance with Sections 8.32.010-8.32.040 of the Rosemead Municipal Code, which pertains to the storage, accumulation, collection, and disposal of garbage, rubbish, trash, and debris. All trash containers shall be stored in the appropriate Planning Commission Meeting May 5,2014 Page 15 of 16 trash enclosure at all times. All trash, rubbish, and garbage receptacles shall be regularly cleaned, inspected, and maintained in a clean, safe, and sanitary condition. The trash enclosure doors shall be closed at all times. 16. The parking area, including handicapped spaces, shall be paved. and re-striped periodically to City standards to the satisfaction of the Planning Division. In accordance with Rosemead Municipal Code, all designated parking stalls shall be double striped and have wheel stops. Such striping shall be maintained in a clear, visible, and orderly manner. 17. All landscape planters onsite shall be rehabilitated and maintained at all times. 18. Adequate lighting shall be provided in the parking area where deemed appropriate by the Planning Division. All exterior lighting shall be directed away from adjacent properties. 19. The facility shall not exceed a maximum of twenty-eight (28) patient beds at any given time. 20. The facility shall provide adequate level of supervision for the patients at all times. 21. All roof top appurtenances and equipment shall be adequately screened from view of the public right of way. 22. All driveway entrances and exits shall remain open and unobstructed at all times. 23. Violations of the conditions of approval may result in citation and/or initiation of revocation proceedings. ..mil Planning Commission Meeting May 5,2014 Page 16 of 16 EXHIBIT "D" ... 8594J8 -- E 17'4= F".. - T I I 1--- rasa- 2001. k • ..i. .-- .....,.I.,..„..._.1 ! ------- IL I .. i gThir„LE r'.3r TRACT I ! • . . .: • it Fia. 1 ' I i. 4-iim I I ..- . i j it 1 I 1. .....1 i r•—••••■ 1 1 I 1 1 ■ ; i •Nei 1 i I I •• I : 17 I kir° r, 1 ei . IVO.®,o.eTolaio 9iel(g)Td +. ,,...----.. 1 I 1 ! 1 1 , 1 • - , Wk • tc.i., ...—;,_._,__ _..1 ., . ... , , I . I 1 1 1 i • I I BK I • I 1 1 1 I . I 5303 V !" .„'-` r .i 1,-• • I I ' , ' ----' Ne le4e e,iw eire i .Lei ,i, ,._ __.___. 2 6 It a k",..)■j " 41 T 92e7 i 0. g 4_5 ; ,... ! 7.4 . , i ,_ 1. ..-- j 6 Guess ST • ----- ;r I '1 I 1 ' ! T-- • • • i ; I --/ ; 1 i i I ID ! 1 1 1 ! I 161 i ' li I 1 1 i 1 SITE • • A & A ABRATIQUE&ASSOCIATES, INC. . 1'0—1--13 October 1,2013 Mr.Zosimo Pascasio Pascasio Enterprises,Inc. Rosemead Villa 9025 Guess St. • Rosemead,CA 91770 Re: Rosemead Villa Project Parking Assessment Rosemead,CA Dear Mr.Pascasio: As requested, we have completed a parking assessment of the proposed Rosemead Villa project, located in the City of Rosemead,California.The results of our assessment are provided below. Existing Conditions Rosemead Villa is located at 9025 Guess Street in the City of Rosemead, California. Rosemead Villa is an Adult Residential Care Facility with 22 beds. There are currently six (6) regular parking spaces and one (1)handicap-accessible parking space on the project site. A vicinity map is provided in the attached Figure 1. Title 22 Regulation states that Adult Residential Care Facilities are facilities of any capacity that provide 24-hour non-medical care for adults ages 18 through 59, who are unable to provide for their own daily needs. These adults are physically handicapped,developmentally disabled and/or mentally disabled. The clients at Rosemead Villa are ambulatory adults who are mentally disabled. They are capable of doing activities of daily living,self help skills and personal care hygiene. The staff at Rosemead Villa provides help in meeting the clients' medical needs. Although the facility does not have doctors and nurses on-site, the clients are capable of walking to a doctor's office and hospital with the help of the Administrator or direct care staff whenever they have a medical problem. Because they take psychotropic medications, they are not encouraged to drive. The clients at Rosemead Villa do not have California Driver's Licenses and,therefore,do not drive. 3424 Wilshire Boulevard,Suite 1108,Los Angeles,CA 90010 Phone:(213)251-5960 Fox:(213)251-5966 Mr.Zosimo Pascasio October 1,2013 Page 2 of 4 Proposed Project The proposed project includes the addition of one building with eight (8) additional beds for a total of 30 beds.The project site plan is provided in the attached Figure 2. Code Parking Requirements Based on the City of Rosemead Municipal Code, Section 17.84.050, one parking space shall be provided for each patient bed for hospitals, sanitariums, convalescent homes and homes for the aged. eased on the City Code parking requirements, a total of 22 off-street parking spaces, one (1)of which is handicap-accessible,are required for the existing facility. For the proposed facility, a total of 30 off-street parking spaces, two (2) of which are handicap- accessible, are required. With seven (7) available parking spaces, the existing facility has a deficiency of 15 parking spaces and the proposed facility is expected to have a deficiency of 23 parking spaces. Parking Generation The City Code parking requirements may not directly apply to the existing or proposed Rosemead Villa project. As a comparison, parking generation rates for similar land uses were compiled from Parking Generation, 4th Edition, prepared by the Institute of Transportation Engineers (lTE),2010. There are no land uses that exactly correlate with the residential care facility land use. However, there are similar land uses,such as Land Use Code(LUC)254—Assisted Living and LUC 620— Nursing Home. For LUC 254, the 85th percentile weekday peak period parking demand is 0.54 vehicles per dwelling unit (equivalent to bed). For LUC 620, the 85th percentile weekday peak period parking demand is 0.48 vehicles per bed. For the existing facility, these rates would yield a weekday peak period parking demand of 12 and I1 parking spaces, respectively. For the proposed facility, these rates would yield a weekday peak period parking demand of 16 and 14 parking spaces, respectively. With 7 available parking spaces, there would still be a parking space deficiency for both the existing and proposed facilities. Land Use Code 254—Assisted Living Assisted-living facilities offer care for people who need help with activities of daily living (called ADLs).Unlike nursing homes that care for weak people who can do little for themselves, assisted-living facilities usually customize a care plan for their residents.This care plan will probably change over time for each resident. Residents of assisted-living facilities typically need help with one or more of the following: bathing,laundry,eating and dressing. There is usually a nurse on duty to help residents who need Mr.Zosimo Pascasio October 1,2013 Page 3 of 4 help with taking medicines and a custodial staff to make sure residents' rooms is clean and tidy. Appropriate social activities and exercise are organized for residents by experts in those fields. Land Use Code 620—Nursing Home People with serious chronic medical conditions often live in special facilities. These residences are called "nursing homes." By definition, a nursing home provides skilled 24-hour medical care to individuals who are unable to manage daily living activities due to debilitating health conditions or old age. Nursing homes can be called different things.They may be referred to as skilled nursing care facilities or long-term care facilities. Nursing homes help people who are unable to care for themselves.These groups include senior citizens with debilitating chronic health problems and younger people who have limited capabilities due to disease or injury. Nursing homes provide intensive 24-hour care by a staff including nurses,physical therapists, occupational therapists and social workers.Residents receive help with their basic living needs, including bathing,eating and taking medication. Nursing homes also manage complex medical needs that require equipment,such as ventilators and IV lines. Adult Residential Care Facility is a facility licensed by the State of California for ambulatory and non-ambulatory adults. These are non-medical facilities. They do not have nurses and doctors on-site. The clients are mentally disabled; some may be dually diagnosed with developmental disability and mental illness that would require 24-hour care and supervision. The clients are capable of walking in a doctor's office to be seen. They arc also capable of doing their activities of daily living,personal care hygiene and self help skills. The level of care will not change with the proposed project. Existing Parking Demand Parking counts were conducted on a recent weekday and Saturday to help determine the parking demand for the existing facility.The parking count data is provided in Appendix A. As shown in Appendix A, the peak weekday parking demand occurred during both the morning and afternoon when there were two (2) occupied parking spaces. Also as shown in Appendix A, the peak Saturday parking demand was two (2)occupied parking spaces in the afternoon. During both of the parking counts, 20 of the 22 existing beds were occupied. Therefore, the peak weekday and Saturday parking demand is calculated to be 0.1 vehicles per bed [2 occupied parking spaces/20 occupied beds]. Future Parking Demand With the level of care remaining the same at the proposed facility, parking demand is expected to remain the same. Mr.Zosimo Pascasio • October 1, 2013 Page 4 of 4 The average future parking demand, using the Parking Generation rate and the parking demand rate,is for 9 spaces. Utilizing the peak parking demand, the anticipated parking demand for the proposed facility is calculated to be 3 spaces [30 beds * 0.1 vehicles per bed]. As such, there is expected to be a surplus of 4 parking spaces after the proposed project is completed. Therefore,7 existing parking spaces can be expected to adequately serve the proposed project. Conclusions Rosemead Villa is an existing residential care facility located at 9025 Guess Street in the City of Rosemead, California. The existing facility contains 22 beds and seven (7) parking spaces. The proposed facility will add eight(8)beds for a total of 30 beds. Utilizing the existing peak parking demand rate of 0.1 vehicles per bed yields a parking demand of three (3)spaces for the proposed project. Therefore,the seven(7) existing parking spaces can be expected to adequately serve the proposed project. We appreciate the opportunity to provide you with this parking assessment of the existing and proposed Rosemead Villa project, located in the City of Rosemead, California. If you have any • questions,please do not hesitate to contact us at (213) 251-5960. • Respectfully submitted, Abratique &Associates, Inc. • Hernando . tangco, P.E. Attachments • Rosemead Villa Parking Assessment(09-26-13).docx i I ra . s.- i ...,. : f ... • .1.11A ••,-- , .: I •... !rye ' :.;u5~ ' — ` rl Cr) _ •• -• 7, t « .. ...•i. �'.. .I ;.0 .. .! 1.1_. E y IS r 1=•i •+ • �% ' • !_.!•-• ••I i t- -7. ' ..1 ` 'K f 1 1 1. _.•1. •` p rla't n•: ...tr• i, t A. -• = ! tr. J ..a r_ . •-'RD r. •.% it _ ,Y •' ! tai •..e;, _ t •;;••••,:..:, X,_ �'1 __ . . tf " { _ • .-...f . kw!Y' lam. • i ; .v ;.:1,„:.4.. .. Acv .."•_ �. ._., '- ..,. /`I •� * i art' ..I. 7 .; _ `'': ,+ i a• • y ray 1 40'Z., i •.. k i.— L§°cn •• ___ V__ ÷-10,— _ r 1 Q _ .•i I t .. y. : i• i 1 L _ � r..t. J 117 LL ;t rom' ,' • I- . lik , ,.. 11--;:. . 1 . � . Zi+ .4 - to< �� Et *. i' r - ' ,, . „. ..,-.• • • ••w+• :Y, • u K M r• • — 1 • i ilr-•. Y r•-~-TI ;i-"`' �_..rrw�m�I , =, i... F -•--• •I 1 • D• J., ' I It.,- : '.... U I f! r "••.g' i e Y� `,�` '. • ' Z 8 e l .—.w rL .:.11 ilia I _. 11 - ' 'iiii•,_ r.40, ' to to fl .c I Z M 5. ...CI i 1r'riff 10 «.i N s i ;,.,.. , ii, s:2 , :� 1••V. _ Lk) cii ii .... APPENDIX A PARKING COUNTS rHtc"ervu 'JJUNI LJU Date: /U Number of Occupied Panting Spaces Facility Name Time L 8:00 AM 9:00 AM / • 10:00 AM / 11:00 AM / • 12:00 PM / 1:00 PM 2:00 PM 3:00 PM , 4:0.0 PM 5:00 PM 6:00 PM • � I ld PARKING COUNT LOG Date: /O. Number of Oavpied Parking Spaces Facility Name _Rosy Time 8:00 AM f 9:0C AM / 10:00 AM 11:00 AM / 12:00 PMT / 1:00 PM / 2:00 PM / 3:00 PM Z 4:00 PM 5:00 PM / 6:00 PM • I'd .. - PC RESOLUTION 96-43 . A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF ROSEMEAD, COUNTY OF LOS ANGELES, STATE OF CALIFORNIA APPROVING CONDITIONAL USE PERMIT 96-677, ALLOWING 1'HE • OPERATION OF A REST HOME FACILITY LOCATED AT 9025 GUESS•' . STREET (APN: 8594-008-036). • WHEREAS,Zosimo and Nelia Pascasio,3635 Carthwright Street,Pasadena, California, . 91107,filed an application requesting a Conditional Use Permit allowing the operation of a rest home facility at 9011 E. Garvey Aver.ue on May 16, 1996;and WHEREAS, 9025 Guess Street is located in the R-1; Single Family Residential zoning • district; and • WHEREAS, Section 9181.9 of the Rosemead Municipal Code (RMC) permits "Rest . • Homes"in any zone upon the granting of a Conditional Use Permit;and WfiEREAS,Section 65853 of the California Government Code and Section 9182 of the .. Rosemead Municipal Code authorize the Planning Commission to approve,conditionally approve or deny conditional use permits;and WHEREAS, Sections 9180 of the Rosemead Municipal Code specifies the criteria by . . . which a conditional use permit may be granted;and WHEREAS,on July 25, 1996, notices were posted in 10 public locations and 47 notices were sent to property owners within a 300-foot radius from the subject property specifying the • availability of the environmental analysis,plus the date, time and location of the public hearing • for Conditional Use Permit 96-677; and • - • WHEREAS, on August 5, 1996, the Planning Commission held a duly noticed and advertised public bearings to receive oral and written testimony relative to Conditional Use Permit - 96-677; and WHEREAS,the Rosemead Planning Commission has sufficiently considered all testimony presented to them in order to make the following determination. NOW, THEREFORE,BE IT RESOLVED by the Planning Commission of the City of Rosemead as follows: • SECTION 1, The Planning Commission HEREBY DETERMINES that Conditional Use • • - Permit 96-677 is Categorically Exempt from environmental review as a Class 9 Exemption•• . pursuant to Section 15309 of the California Environmental Quality Act(CEQA). The site had been used for a rest home under previous ownership when it was under County jurisdiction. This • • request is legalize an unpermitted area and make building improvements necessary for operating • • -- . . a rest home facility. Section 15309 exempts projects that constitute the inspection of an existing facility. SECTION?. The Planning Commission HEREBY FINDS AND DETERMINES that . • • facts do exist to justify approving Conditional Use Permit 96-677 according to the Criteria of Section 9180 of the Rosemead Municipal Code as follows: . A. The project is essential and desirable to the public convenience or welfare. . - FINDING: This site was approved for a rest home facility by the County Board of Supervisors in 1956. Various owners have operated this business, and there have been numerous occasions when the facility was notified of code violations. A conditional use permit will help to regulate the operation to assure the community of a clean rest home to serve it residents. v. .... ... . PC Resolution ion 96-43... w Conditional Use Permit 96-677 . Page2of5 • B. The project is in harmony with the elements and objectives of the General Plan and • •• Zoning Codes. FINDING: Rest homes are allowed in any zone upon granting a conditional use permit. • This site is in the R-1;Single Family Residential zone and is surrounded by office and commercial • uses on two sides. The location is in close proximity to Rosemead Boulevard which is a major . • arterial street. There is adequate access to the site without significant intrusion into a residential • neighborhood. Parking for the site is nonconforming in that there are only seven spaces for a use • that is required to provide 22 spaces. . • : C. The project will not be detrimental to the surrounding properties. • • FINDING: There are unpermitted structures on the site that are to be removed or ' remodeled to meet current Building Codes. The Fire Department has noted a number of code deficiencies that are being corrected. Alive in mangers office is to be located in the front of the • • facility to provide security and monitor any problems on the site. The parking lot has been • redesigned to eliminate a situation where cars were able to back up over the right-of-way. By • placing this project under a conditional use permit, the City can monitor the use to assure that it does not impact the surrounding properties. • SECTION.1. The Planning Commission HEREBY APPROVES Conditional Use Permit 96-677, allowing operation of a rest home facility located at 9025 Guess Street, subject to the ' conditions listed in Exhibit"A" attached hereto and incorporated herein by reference. SECTION 4. This aeon shall become final and effective ten(10)days after this decision • by the Planning Commission,unless within such time a written appeal is filed with the City Clerk . for consideration by the Rosemead City Council as provided in Article IX-Planning and Zoning of the Rosemead Municipal Code. • • SECTION 5. This resolution is the result of an action taken by the Planning Commission • on August 5, 1996, by the following vote: • . . • YES: ALARCON, LOI, ORT1Z,BREEN, RUIZ ' • NO: NONE ABSENT: NONE ABSTAIN: NONE • SRCT.TON ti. The secretary shall certify to the adoption of this resolution and shall . .• . transmit copies of same to the applicant and the Rosemead City Clerk . PASSED, APPROVED and ADOPTED this 19th day of August, 1996. ;064-r-a-"dr-''‘'34.--—-I Bill Ortiz,Chairman • • • • • PC Resolytion 96-43 -. • Conditional Use Permit 96-677 . - Page 3 of 5 - • CERTIFICATION • I, Jeffrey L Stewart,hereby certify that the foregoing is a true copy of a resolution adopted by the Planning Commission of the City of Rosemead at its regular meeting, held on the 19th day • of August, 1996, by the following vote: YES: Loi, Ortiz, Breen, Ruiz NO: • ABSENT: Alarcon ABSTAIN: • r L tewart, Secretary • • • • • • • • • • • k PC Resolution 96 43 _ - • Conditional Use Permit 96-677 - • Page 4 of 5 • • EXIIBIT"A" . CONDITIONAL USE PER IIT 96-677 • . • 9025 Guess Street,Rosemead Villa CONDITIONS OF APPROVAL • Autguct 54 1996 • 1 Conditional Use Permit 96-677 is approved for the operation of a 22-bed Rest Home to • be maintained in accordance with the plan marked Exhibit "B". Any revisions to the approved plans must be resubmitted for review and approval by the Planning Department_ 2 Approval of Conditional Use Permit 96-677 shall not take effect for any purpose until the . applicant has filed with the City of Rosemead an affidavit stating that they are aware of and accepts all of the conditions set forth in the letter of approval and this list of conditions. • • 3 The applicant shall comply with all Federal, State and local laws relative to the approved use including the requirements of.the Planning, Building, Fire, Sheriff and Health Departments. • 4 Prior to occupancy,Building "C" shall be removed, and Bedroom 7 may be remodeled into an office only to the satisfaction of the Planning Director. If permits for the canopy cannot be found, the applicant shall submit plans for Planning and Building Department - approvals. The conditions in this Exhibit "B" shall be copied onto any such plans. . 5 Prior to oxupancy,the applicant shall install screening for the fire sprinkler pipe located • on the southwest corner of Building"A"subject to the review and approval of the Fire and • • Planning Departments. •• 6 Prior to occupancy, the applicant shall install a buffer area(eg landscape planter)between . • parking spaces 4-6 and the handicap space to the satisfaction of the Planning Director. 7 No portion of any required front and/or side yards shall be used for storage of any type. 8 All roof top appurter.anecs and equipment shall adequately be screened from view to the satisfaction of the Planning Department. •: • . ' 9 Driveways and parking areas shall be surfaced and improved with Portland concrete • cement or asphaltic concrete, and thereafter maintained in good serviceable condition. 10 The property shall be graded to drain to the street, but in no case shall such drainage be • allowed to sheet flow across public sidewalk A grading and/or drainage plan shall be • prepared, submitted to and approved by the Building Official, and such grading and drainage shall take place in accordance with such approved plan. • . • 11 The.numbers of the address signs shall be at least 6"tall with a minimum character width • • of 1/4", contrasting in color and easily visible at driver's level from the street. The • location, color and size of such sign shall be subject to the approval of the Planning • Director. . • 12 Applicant shall obtain a public works permit for all work in or adjacent to the public - • ' _. _ . . .. _. . ri ght-of-way. •- • •- . _ . PC Resolution 96-43 Conditib;ial Use Permit 96-677 Page 5 of 5 13 Applicant shall install and compete all necessary public improvements,including but not • limited to street, curbs,gutters. sidewalks, handicap ramps, and storm drains, along the entire street frontage of the development site as required by the Director of Planning. 14 All ground level mechanical/utility equipment(including meters,back flow preservation devices, fire valves and other equipment) shall be screened by screening walls and/or landscaping to the satisfaction of the PIanning Department. 15 NO OCCUPANCY will be granted until ALL IMPROVEMENTS required by this • approval have been completed,inspected,and approved by the appropriate department(s). 16 All requirements of the Fire, Building and Safety and Planning Departments shall be complied with prior to the final approval of the proposed construction. 17 Violation of the conditions of approval may result in citation and/or initiation of revocation proceedings. • • • • BF_SOLI!TIf?N 96-42 A RESOLUTION- OF THE CITY COUNCIL OF THE CITY OF ROSEMEAD, APPROVING CONDITIONAL USE PERMIT 96-677, ALLOWING THE OPERATION OF A REST HOME FACILITY LOCATED AT 9025 GUESS STREET (APN:8594-008-036). WHEREAS,Zosimo and Nelia Pascasio, 3635 Carthwright Street,Pasadena,California, 91107,filed an application requesting a Conditional Use Permit allowing the operation of a rest home facility at 9025 Guess Street on May 16, 1996; and WHEREAS,9025 Guess Street is located in the R-1; Single Family Residential zoning district; and WHEREAS, Section 9181.9 of the Rosemead Municipal Code(RMC) permits 'Rest Homes" in any zone upon the granting of a Conditional Use Permit;and WHEREAS,Section 65853 of the California Government Code and Section 9182 of the Rosemead Municipal Code authorize the Planning Commission to approve, conditionally approve or deny conditional use permits;and WHEREAS, Sections 9180 of the Rosemead Municipal Code specifies the criteria by which a conditional use permit may be granted; and WHEREAS,on July 25, 1996,notices were posted in 10 public locations and 47 notices were sent to property owners within a 300-foot radius from the subject property specifying the availability of the environmental analysis,plus the date, time and location of the public hearing for Conditional Use Permit 96-677 pursuant to California Government Code Section 65091(a)(3); and WHEREAS, on August 5, 1996, the Planning Commission held a public hearing and adopted PC Resolution 96-43, approving Conditional Use Permit 96-677, subject to conditions of approval; and WHEREAS,on August 13, 1996,the applicant filed a written appeal requesting the City Council to amend the conditions of approval;and WHEREAS, on August 29, 1996, notices were posted in 10 public locations and 47 notices were sent to property owners within a 300-foot radius from the subject property specifying • the availability o`the environmental analysis,plus the date,time and Iocation of the public hearing for the appeal of Conditional Use Permit 96-677;and WHEREAS, on September 10, 1996, the Rosemead City Council held a duly noticed public hearing and sufficiently considered all testimony presented to them in order to make the following determination. NOW,THEREFORE, BE IT RESOLVED by the City Council of the City of Rosemead as follows: SECTION 1. The City Council HEREBY DETERMINES that Conditional Use Permit 96-677 is Categorically Exempt from environmental review as a Class 9 Exemption pursuant to Section 15309 of the California Environmental Quality Act(CEQA). The site had been used for a rest home under previous ownership when it was under County jurisdiction. This request is to legalize an unpermitted area and make building improvements necessary to operate a rest home facility. Section 15309 exempts projects that constitute the inspection of an existing facility. SFf'TION 2. The City Council HEREBY FINDS AND DETERMINES that facts do exist to justify approving Conditional Use Permit 96-677 according to the Criteria of Section 9180 of the Rosemead Municipal Code as follows: • • Resolution 96-42 Conditional Use Permit 96-677,appeal Page 2 of 5 • A. The project is essential and desirable to the public convenience or welfare. FINDING: This site was approved for a rest:'tome facility by the County Board of Supervisors in 1956. Various owners have operated this business,and there have been numerous occasions when the facility was notified of code violations. A conditional use permit will help to regulate the operation to assure the community of a clean rest home to serve it residents. B. The project is in harmony with the elements and objectives of the General Plan and Zoning Codes. FINDING: Rest homes are allowed in any zone upon granticg a conditional use permit. This site is in the R-I;Single Family Residential zone and is surrounded by office and commercial uses on two sides. The location is in close proximity to Rosemead Boulevard which is a major arterial street. There is adequate access to the site without significant intrusion into a residential neighborhood. Parking for the site is nonconforming in that there arc only seven spaces for a use that is required to provide 22 spaces. C. The project will not be detrimental to the surrounding properties. FINDING: There are unpermitted structures on the site that arc to be removed or remodeled to meet current Building Codes. The Fire Department has noted a number of code deficiencies that are being corrected. A live-in manger's office is to be located in the front of the facility to provide security and monitor any problems on the site The parking lot has been redesigned to eliminate a situation where cars were able to back up over the right-of-way. By placing this project under a conditional use permit,the City can monitor the use to assure that it does not impact the surrounding properties. In addition, the City Council finds that the fire hydrant improvements in the area are adequate in conjunction with the fire sprinkiers provided at this facility. SECTION 1. The City Council HEREBY APPROVES Conditional Use.Permit 96-677, allowing operation of a rest home facility located at 902f Guess Street,subject to the conditions of approval as adopted by the Planning Commission on August 5, 1996,incorporated herein by reference,except for Condition No. 4 which shall be amended to read as follows: "4. Prior to occupancy, the applicant may obtain permits to remodel Building'C" for storage use only and Bedroom 7 for an office use to the satisfaction of the Planning Director. If the applicant decides not to obtain permits for these structures, they must demolished and removed. The conditions in this Exhibit"B"shall be copied onto any such • plans." SFCTION 4. The City Clerk shall certify to the adoption of this Resolution and shall cause same to be published as required by law. PASSED AND APPROVED this 24th day of September, 1996. MAR AR K u or ATTEST: t NAN Y VALDERRAMA,City Clerk /\ • • • Resolution 96-42 Conditional Use Permit 96-677, appeal Page 4 of 5 EXHIBIT"A" CONDITIONAL USE PERMIT 96-677 9025 Guess Street, Rosemead Villa CONDITIONS OF APPROVAL August 5, I996(Axpended1 1 Conditional Use Permit 96-677 is approved for the operation of a 22-bed Rest Home to be maintained in accordance with the plan marked Exhibit "B". Any revisions to the approved plans must be resubmitted for review and approval by the Planning Department, 2 Approval of Conditional Use Permit 96-677 shall not take effect for any purpose until the applicant has filed with the City of Rosemead an affidavit stating that they are aware of and accepts all of the conditions set forth in the letter of approval and this list of conditions. Said affidavit shall be completed within ten(10)days of the date of approval. 3 The applicant shall comply with all Federal, State and local laws relative to the approved use including the requirements of the Planning, Building, Fire, Sheriff and Health Departments. 4 Prior to occupancy,_Building=C" shall be removed, and Bcrtronm 7_may be remode1cd intoan ofrtee only_tothe catisfartinn.oLthe Planning Director if p rme its for the canopy cannot be. ound,_the.applicant shall cithmit plansflr Planning-andBniiriing Department approvals The ennditinnc in tic FxhihiLi' shalt be copied onto any.cnrh plans. (Amended per Section 3 of City Council Resolution 96-42) 5 Prior to occupancy, the applicant shall install screening for the fire sprinkler pipe located on the southwest corner of Building"A"subject to the review and approval of the Planning Department. 6 Prior to occupancy, the applicant shall install a buffer area (eg landscape planter)between parking spaces 4-6 and the handicap space to the satisfaction of the Planning Director. No portion of any required front and/or side yards shall be used for storage of any type. 8 All roof top appurtenances and equipment shall adequately be screened from view to the satisfaction of the Planning Department. 9 Driveways and parking areas shall be surfaced and improved with Portland concrete cement or asphaltic concrete, and thereafter maintained in good serviceable condition. JO The property shall be graded to drain to the street.but in no case shall such drainage be allowed to sheet flow across public sidewalk. A grading and/or drainage plan shall be prepared, submitted to and approved by the Building Official, and such grading and drainage shall take place in accordance with such approved plan. I1 The numbers of the address signs shall be at least 6" tail with a minimum character width of 1/4", contrasting in color and easily visible at driver's level from the street. The location, color and size of such sign shall be subject to the approval of the Planning Director. 12 Applicant shall obtain a public works permit for all work in or adjacent to the public right-of-way. . . • • Resolution 96-42 Conditional Use Permit 96-677, appeal Page 5 of 5 13 Applicant shall install and complete all necessary public improvements, including but not limited to street, curbs, gutters,sidewalks,handicap ramps, and storm drains, along the entire street frontage of the development site as required by the City Engineer. 14 All ground level mechanical/utility equipment (including meters, back flow preservation devices, fire valves and other equipment) shall be screened by screening walls and/or landscaping to the satisfaction of the Planning Department. 15 NO OCCUPANCY will be granted until ALL IMPROVEMENTS required by this approval have been completed, inspected,and approved by the appropriate department(s). 16 Violation of the conditions of approval may result in citation ardor initiation of revocation proceedings. • • • • o' Minutes of the PLANNING COMMISSION MEETING May 5, 2014 The regular meeting of the Planning Commission was called to order at 7:00 p.m.by Chair Herrera in he Council Chambers,8838 E.Valley Boulevard. PLEDGE OF ALLEGIANCE-Chair Herrera INVOCATION-Commissioner Looez ROLL CALL -Commissioners Dinh, Lopez,Tang,Vice-Chair Eng, and Chair Herrera ROLL CALL OF OFFICERS PRESENT: City Attorney Murphy, Community Development Director Ramirez, Planning Technician Casillas,and Commission Secretary Lockwood. 1. EXPLANATION OF HEARING PROCEDURES AND APPEAL RIGHTS Greg Murohy, City Attorney, presented he procedure and appeal rights of the meeting. 2. PUBLIC COMMENTS FROM THE AUDIENCE) None 3. PUBLIC HEARINGS A. MODIFICATION 14-01 AND ZONE VARIANCE 14.01 - Zosimo and Neila Pascasia submitted a Modification application requesting to expand their existing adult care facility and a Zone Variance application requesting to deviate from the required number of parking stalls. The subject property is located at 9025 Guess Street, in the R-1 (Single Family Residence)zone. PC RESOLUTION 1407 - A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF ROSEMEAD, COUNTY OF LOS ANGELES, STATE OF CALIFORNIA APPROVING MODIFICATION 14.01 FOR THE EXPANSION OF AN EXISTING RESIDENTIAL CARE FACILITY AND ZONE VARIANCE 14.01 REQUESTING TO DEVIATE FROM THE REQUIRED NUMBER OF PARKING STALLS LOCATED AT 9025 GUESS STREET, IN THE R-1 (SINGLE FAMILY RESIDENTIAL)ZONE. STAFF RECOMMENDATION - Based on the analysis and findings contained in this report, it is recommended that the Planning Commission ADOPT Resolution No. 14-07 with findings and APPROVE Modification 14-01 and Zone Variance 14-01, subject to twenty-two (22)conditions. Planning Technician Casillas presented the staff report. Cnair Herrera asked the Planning Commission if there were any questions or comments for staff. Vice-Chair Eng stated she had the opportunity to visit the site and to 'earn about the facility with Mr. Zcsimo.owner of the fac!lity. She referred to Building "C"and the Conditions of Approval from "1996" that had been taken to the City Council under appeal. She explained she did not have the correct wording but the Condition of Approval stated that Building "C" can only be used for office. She asked staff since Building "C" was recently demolished is that Condition of Approval still relevant. 1 EXHIBIT "D" Planning Technician Casillas replied as a correction for the appeal to the City Council the Planning Commission approved the project for twenty-two (22) beds subject to specific conditions and one of the conditions was to demolish Building "C" due to being deficient in numerous fire and building codes. The applicant submitted an appeal to the City Council because they were requesting to keep Building"C"but City Council up-held the Planning Commission's vote and also agreed that Building "C" needed to be removed. She stated that Building "C" has been demolished. Vice-Chair Eng asked when that structure was demolished. Planning Technician Casillas replied she did not have that information available. Vice-Chair Eng asked wnich state agency regulates this type of facility. Planning Technician Casillas replied it is the Department cf Social Services. Vice-Chair Eng asked if this agency requires periodic audits of the operation of this facility. Planning Technician Casillas replied that inspections are made once a year. Vice-Chair Eng asked if the City has been able to review any of the audits. Planning Technician Casillas replied no. Community Development Director Ramirez clarified that Planning Technician Casillas did contact the agency and was told that information is not allowed to be given out. She added That inspections are not only conducted once a year but also when a complaint is received. Vice-Chair Eng asked if licenses are renewed annually or what is the process. Planning Technician Casillas replied the applicant is available to answer that question. Vice-Chair Eng asked if there is a regulation regarding the ratio of number of staff available to the residents of this facility. Planning Technician Casillas replied there is no set number for supervision and it is based on needs of the facility. Vice-Chair Eng clarified that the residents that are residing at this facility are not patients, they are individuals, and they are not receiving any medical care. Planning Techniciar Casillas stated that is correct. Vice-Chair Eng asked if staff knows the nature, types,or time,of the significant number of calls requested for service from law enforcement to this facility. Planning Technician Casilias replied the Chief of Police did not give her ary specific information due to privacy rights. She added he explained most of the calls were due to medical responses, disturbances, and the majority of the calls were missing persons. Vice-Chair Eng asked if this facility has had any other citizen complaints prior to the past two years since is has been in operation since 1996. 2 Planning Technician Casillas replied she only has documentation for the last two years but the applicant is present to answer that question. Vice-Chair Erg asked if there had been any recommendations by the Chief of Police or Public Safety to mitigate or provide solutions to address their concerns. Planning Technician Casillas replied nothing was specified. Vice-Chair Eng commented had there been recommendations in regards to their concerns it may have provided guidance for the Planning Commission to ensure mitigation measures. She asked who is the City's Traffic Consultant. Panning Technician Casillas replied it is through the Consultant Company Willdan, Vice-Chair Eng asked if there is a specific staff that the City uses. Planning Technician Casillas replied Joanne Itagaki. Vice-Chair Eng referred to the City's Municipal Code and asked if there are currently parking standards for these type of adult care facilities. Planning Technician Casilias replied ro. Vice-Chair Eng asked if there has been any research on neighboring cities in regards to their parking standards for this type of facility. Planning Technician Casillas replied she did not do a survey. Vice-Chair Eng recommended that it would be helpful to research what the surrounding cities parking requirements are for these types of facilities. She stated that the Staff Repor, Conditions of Approval,and the Resolution, refer to the individuals in this facility as patients and clarified that this is not a medical facility. She requested that since they do not receive medical care they should be referred to as residents and not patients. She stated she has a question in regards to Condition of Approval rumbe-twenty(20)but will defer it to the applicant. Commissioner Dinh stated currently there are twenty-two (22)beds in this facility and asked for clarification on how many beds will be in each bedroom and how many rooms are being added. Planning Technician Casillas explained that there are two(2) bedrooms that are being added to the new building and there will be two(2)beds per room. She added in the existing building the office is being converted into a bedroom. Community Development Director Ramirez explained that in the current building an existing office is being converted into a bedroom and two(2) beds will be going into this room which will add up to a total of six(6) beds. Commissioner Dinh asked in how many rooms. Community Development Director Ramirez replied in one room and explained they are converting an office into a bedroom. Commissioner Dinh referred to the site pan and stated she only sees the two new rooms. 3 The Planning Commission referred to the proposed site plan and discussed the locations of the bedrooms and was then clarified that the office in in the existing main building"B"(bedroom number seven(7)on site plan is currently an office)will be converted into a bedroom. The construction of the new building will have two new bedrooms. —here will be a total of three bedrooms,with six(6) beds, (two(2)beds will be in each room). Commissioner Dinh stated she is a nurse practitioner and familiar with this type of facility. She recommended if anyone would like to look around for comparisons on these types of facilities there are many of in the City of Pasadena and named"Villa Esperanza" as one of them. She also asked if the residents of this facility go to outside workshops from the hours of 8:00 am to 3:00 pm. Community Development Director Ramirez stated that question will need to be deferred to the applicant. Commissioner Dinh stated she is concerned with the use of the dining room and that's assuming if all twenty six (26) residents dine at the same time. She asked if it is an adequate size to seat all of the residents. Planning Technician Casillas stated that question can be deferred to the applicant. Commissioner Tang asked if there is an existing code that requires a certain amount of restrooms for each bed or each room. Planning Technician Casillas replied under the City Zoning Code there is no code. She added this is governed under State Regulations. Commissioner Tang asked if there is a State Regulation that would determine that. Planning Technician Casillas replied she does not have that information available at this time but she ca- research that question. Commissioner Tang stated he is concerned because in Building "A" there is one (1) restroom for potentially five (5) rooms and up to ten (10) beds whereas in the other buildings they have one(1) restroom for(4)four beds. He is also concerned that there is only one kitchen for one building and there is not a kitchen in the other build ng. Community Development Director Ramirez rep ied that question can be deferred to the applicant since this facility needs to be inspected by the State and meet the State's regulations to be approved. Commissioner Tang asked if there is a size requirement to allow a certain amount of beds in a room. Planning Technician Casillas replied this is not in the City's Zoning Code, so this would be referred bacK to State Regulations. Commissioner Tang referred to the number of service calls made and asked if the calls were made from the site or where they outside cars from neighbors. Planning Technician Casillas rep ied the calls for service would be from the facility and the Code Enforcement calls were from outside complaints. Commissioner Tang asked what the nature of the outside complaint calls were. Planning Technician Casillas replied the two complaints from Code Enforcement within the two year period were; 1) noise disturbance(coughing)and 2) lack of supervision on the site. 4 Commissioner Tang asked if the size of the parking stalls meet the Municipal Code and expressed concern that they looked small in terms of width. Planning Technician Casillas replied that the site plan states the parking stalls are 18' X 9' wide and there is a handicap stall. Commissioner Tang asked if a car is parked in the handicap stall does it block the driveway. Planning Technician Casillas replied it is 18 feet wide so it can pull entirely on site. Commissioner Tang stated that the location of the stall is in front of a gate that looks like it leads to a long driveway. Planning Technician Casillas clarified that is a walkway and not a driveway. Commissioner Tang recommended that the handicap stall needs to be marked more clearly because it is confusing. Commissioner Lopez referred to the deficiency in parking and asked if the residents of the facility drive or have cars. Planning Technician Casillas replied that according to the owner and parking study none of the residents staying at the facility have a driver's license. Commissioner Lopez asked if the parking stalls are for staff only. Planning Technician Casillas replied they are for staff and guest. Commissioner Lopez commented there are six (6) stalls for twenty-eight(28) residents and expressed concern that the public street may have an overflow of parking. Community Development Director Ramirez addressed Commissioner Tang's comment in regards to the handicap parking stall and stated Condition of Approval number sixteen (16)addresses that all spaces including the handicap has to be paved and re-striped as required. Commissioner Tang thanked Community Development Director Ramirez. Commissioner Lopez asked how many staff work at night and if the service calls were made by staff or the residents. Planning Technician Casillas replied she does not have information or reports on who made the service calls. She explained the facility is supervised 24/7 and during the day they have three(3) employees and in the evening they have one(1)employee. Community Development Director Ramirez explained that when staff spoke with the Chief of Police it was made very clear that information regarding calls for services cannot be given out due to the Privacy and HIPAA Act. Chair Herrera opened the Public Hearing and asked the applicant to the podium. Owner, Neila Pascasia stated she and her husband are here to represent "Rosemead Villas and to address any questions the Planning Commission may have. Vice-Chair Eng thanked the applicant and asked why they want to expand their business. Owner Neila Pascasia replied because this is a basic need for disabled persons and the community. 5 Vice-Chair Eng asked if the residents at this`acility are both male and females. Owner Neila Pascasia replied yes,there are twenty-two(22)clients of which eighteen(18)are males and four(4)are females. She explained the females are housed separately. The males are housed in Building "A and V. Vice-Chair Eng asked if there are twelve(12)currently residing at the facility. Owner Neila Pascasia replied the facility is currently full and the census is twenty-two(22)clients. Vice-Chair Eng asked what the age range is of the residents. Owner Neila Pascasia replied their license states they can care for ages 18 through 59 yeas of age. She added currently the youngest client residing at the facility is 29 years old and the oldest is 55 or 57 years old. She explained after they turn 59 they leave to reside at an elderly facility and there is a new ruling that 1 the ci'ent has been there for a long time and does not wart to leave,then they cannot be turned away. Vice Chair Eng asked if most of the residents have been long term residents. Owner Neila Pascasia replied their clients have been there a long time. She stated she has one client that has been there since 1994. Vice-Chair Eng asked i;they operate more than one adult care facility. Owner Nei'a Pascasia replied yes. Vice-Chair Eng asked if they are about the same size. Owner Neila Pascasia replied the previous facility had about fifteen(15) clients. She explained that facility has been closed and it was re-licensed to an adult developmentally disabled facility. She stated they have both facilities and they deal with people developmentally delayed,challenged,and people that are mentally challenged. Vice-Chair Eng asked how long she has been operating this type of facility. Owner Neila Pascasia replied 18 going on 19 years. Vice-Cha'r Eng asked what type of tasks the staff provides for the clients. Owner Neila Pascasia clarified that they are asking about the-Rosemead Vila". Vice-Chair Eng replied yes. Owner Neila Pascasia explained that staff provides: 1) coffee first thing in the morning, and then they are served breakfast; 2) they are given their medications and confirm that they are being taken as prescribed (if not a psychiatrist is called); 3) day programs are provided off-site and staff preps the clients to participate;4) activities are provided at the facility if the clients do not want to participate in the off-site day programs: 5) clients must complete task such as cleaning their rooms and laandry: 6) dinner is prepared around 3:00 pm and medications are given at 3:45 pm; 7) at 4:30 pm dinner is served; and 8) a recreation area is provided where they can watch television. She explained they can leave the facility provided they say where they are going and when they expect to be back. She added if They do not come back by a certain time then a missing person report may be filed. S'.,e explained that most 6 of the service calls to the Sheriff Department is to file a missing person report and very few calls are`or causing a disturbance. Vice-Chair Eng asked when the residents participate in the day programs located off s to now are they transported and If the off-site programs are located in Rosemead. Owrer Neiia Pascasia replied yes they are in Rosemead and they are picked up in the morning around 9:00 am and brought back to the facility around 3:00 pm. Vice-Chair Eng asked if the State requires that their staff have any special training or certifcatior. Owner Neila Pascasia replied when staff is first hired they are given "Title 22" training beginning with food preparation and giving medications. She stated Consultants also train staff on site in what is called "Positive Rein`orcement". She explained there are various trainings needed for their careers, including training by pharmacists,and LA County provides a DSP1 Training (Regional Occupational Program). Vice-Chair Eng asked if the main focus of task for staff is to help support the daily living of the residents. Owner Neila Pascasia reeled yes, but first staff encourages the clients to do everything themselves. She added if they can't er doesn't,then staff will have to do it. Vice-Chair Eng asked when meals are served does everyone dine together at the same time. Owner Neila Pascasia replied no everyone eats at different times. She explained that some go out to eat if they have money, but food is kept in case they come home and want to eat. Vice-Chair Eng asked if a client does not return on time is a call made to the Sheriffs Department. Owner Neila Pascasia replied that licensing regulation states a missing person po ice report may be filed within 24 to 48 hours,but she does not wait that long. Vice-Chair Eng asked if law enforcement is responsive if it is filed earlier than the time frame allowed. Owner Neila Pascasia replied yes. She added they will take the basic information over the phone and send a deputy to the facility. She explained once they arrive they take the'till report and a picture of the client is always available. Vice-Chair Eng asked if there is a mental health emergency situation,what is the procedure they follow. Owner Neila Pascasia replied staff needs to understand their client's illnesses and make sure medications are being taken properly. She explained if there are circumstances of violence or a sign that medication 's not being taken correctly, and then the psychiatrist is contacted. She continued that there is a"Mental Health Crisis Team' that is also available and is contacted if the need arises. Vice-Chair Eng asked if the facility is in contact with the resident's doctor. Owner Neila Pascasia replied yes. She explained the psychiatrist conducts a once a month visit and is called for emergencies or if she has a problem with her clients. Vice-Chair Eng asked how many employees are there currently. 7 Owner Neila Pascasia replied she currently has four(4)employees, her husband is the fifth(5th) as the Administrator of the facility, and one(1) maintenance employee that maintains and repairs all of their facilities. Vice-Chair Eng commented she was impressed with the maintenance of the grounds. Owner Neila Pascasia stated that they also own a boarding care located on Ralph Street that is a"Developmentally Disable Facility"and on y has four(4)clients. Vice-Chair Eng referred to the residents that do not want to participate in the off-site day programs and asked what type of activities they do. Owner Neila Pascasia replied that some may want to walk to Target, Starbucks, or go to Carl's Jr. She explained for the troublesome ones that cannot go alone,her husband will drive and assist them. Vice-Chair Eng asked if the residents are allowed to nave visitors. • Owner Neila Pascasia replied yes and the visiting hours are from 9:00 am to 8:00 pm. Commissioner Dinh referred to the dining room dimensions and asked if this will be an adequate area for everyone in the facility to dine if needed. Owner Neila Pascasia replied it is adequate and re-iterated that the residents do not dine at the same time in the dining room. She added the facility has been approved by the Department of Social Services. Commissioner Dinh asked if the facility provides a vanpool in case they have to transport the residents. Owner Neila Pascasia replied yes and explained it is a 15 passenger van and it is parked in the Pasadena facility. She added none of the employee's drive except`or one(1). Commissioner Dinh referred that majority of residents belong to the Category 1 and 2 on the DSM diagnosis and asked if they had any Category 3 cr�. Owner Neila Pascasia stated that Commissioner Dinh had referred to"Villa Esperanza"and explained it is a different type of facility. She explained that it is a facility for the developmentally disabled individuals and there are levels 1.2, 3, &4. She added 'Rosemead Villa's'clients are levels 1 & 2. She also explained there is not a client to staff ratio and they follow "Title 22'and the Department of Social Services regulations. Commissioner Dinh asked how often do family members visit and if street parking is a concern during the weekends or holidays such as Christmas. Owner Neila Pascasia replied that 70%of the facilities clients do not have any family support. She expla ned some have families that visit but they do not visit often. Commissioner Tang asked other than administrating medications and transporting clients to their day programs,what other services do they provide on-site. Owner Neila Pascasia replied services provided to the clients are taking them to their doctor appointments and holiday celebrations (such as a barbecue for Memorial Day or Thanksgiving buffet dinners this is the only time the parking lot is crowded). She added that recreational activities(such as basketball, playing cards, and bingo)are also provided. 8 Commissioner Tang asked if the State requires a certain size for a bedroom to accommodate two(2)beds. Owner Neila Pascasia replied yes but she does not recall the size requirement. She explained that before a license is issued they have to meet all of the State's"Title 22"regulations. Commissioner Tang asked if the clients with mental disabilities are allowed the freedom to leave the facility unsupervised. Owner Neila Pascasia replied yes and that licensing states the clients have their rights and they cannot be restricted. She explained they have to watch clients that may be getting sick and provide supervision especially in the evening. She commented that if anyone were to drive pass`Rosemead Villa' at night you would never know this was a facility because the clients are not loitering in the parking lot, they are inside, and they have a smoking area. She requested that she have the opportunity to respond to neighbors complaints in regards to the clients coughing and expressed concern that she has no control over clients coughing in the facility. Chair Herrera asked if the clients are ailowed to smoke in their rooms. Owner Neila Pascasia replied no, smoking is not allowed in the rooms and there is an open area available outdoors in the back yard. She stated they will smoke in the parking lot occasionally. Chair Herrera asked Brian Lewin to the podium. Resident Brian Lewin stated that an adult residential care facility is not strictly for mentally disabled non- drivers. He requested that the Planning Commission consider that if the expansion of this facility is approved with insufficient parking it may be a potential parking situation for that neighborhood. He expressed concern that the Chief of Police did not support the expansion of this facility and that they were concerned over the significant number of calls for service. He expressed concern with missing persons and stated there was an incident with a resident from a facility near his home trying to get into his mother's property. He also expressed concern with mental patients disturbances. -le asked the Planning Commission to please consider that if the expansion of this facility is allowed, is it a good idea, will it be essential to the public being and welfare.wi l it be in harmony of the elements of the General Plan and City's Zoning Codes, and if allowing this facility with these current issues will be detrimental to the surrounding properties. Resident Wilson Chien stated he is the neighbor next to this facility. He stated he has spoken with the owner directly and has not complained to the City. He stated his concerns are with the residents from this facility sitting and smoking on the sidewalk in front of his home, throwing their cigarette butts on his property, the'r black cat urinating and leaving feces on his front yard bothering his dog in the back yard, and shopping carts being left by them in front of his home. He expressed he has approached the owner with these concerns and the owner does not seem to care and will not do anything to take care of it. He stated when he is outdoors washing his car,the residents will approach him and ask for cigarettes. He expressed all of these problems happen everyday and no one takes the responsibility to take care of them. He expressed that his wife is bothered by the residents coughing very loud at night, which he has contacted the City to complain. Resident Judy Chien stated she lives next door and is the wife of Wilson Chien. She stated she agrees with the previous comments and expressed the owners need to take care of the current problems before this expansion is approved. She stated she has had to call the Sheriffs Department numerous times due to the residents screaming, coughing loudly at night, and playing music loudly. She added that she has called the night manager to complain while this is going on and is told there is nothing they can do. She stated she has tried to contact the owner numerous times and cannot get a hold of them. She stated she has to call the Sheriffs Department all the time and has tried to get the managers name but he will not tell her. She expressed concern with the cigarette butts and trash being left all over her property. She stated that they almost hit a resident backing out of their driveway and fee's that 9 9 this facility is very disturbing, should not be allowed to expand, and she has had to cal the City and Sheriffs Department numerous times She expressed the owner is rude and nothing gets taken care of. Owner Zosimo Pascasia stated he would like to respond to his neighbors'complaints and added he has been trying hard to address the problems. He stated that he admits there are some disturbances such as coughing. He added that he tells his residents that the neighbor works during the evening and sleeps during the day so he asks them to be quiet during the day. He stated they are trying their best to address the noise concerns. He referred to the insufficient parking and vehicles coming to the facility and explained they have been there for eighteen ("8) years and there has never been a problem with parking. Chair Herrera asked if there was anyone else wishing to speak on this item. None Chair Herrera closed the Pubic Hearing and asked the Planning Comm ssion if there any other questions or comments. Commiss orer Lopez stated this should be investigated because these complaints are something that should not be ignored (insufficient parking, and cigarette butts thrown in the neighbor's yard), and public safety needs to be called to confirm if there is loiterng taking place. He would like to see what the sideway height is to see if a sound wall barrier should be installed. He stated the community needs to be looked out for as well as the neighbor rights. He stated he does not recommend this be approved tonight. Commissioner Tang stated he concurs with Commissioner Lopez comments. He stated in addition to those concerns and the Chief of Police concerns, he also has concerns because this is a R-1 zone and the tenant use in an R-1 zone was not to accommodate twenty-eight(28) residents in a small facility of this size. He expressed that the neighbors' concerns are valid given you have twenty-eight (28) people in that small vicinity. He added those negativities are enough to impact the lives of their local neighbors. Vice-Chair Eng stated she is not ready to approve the project this evening. She requested that staff bok into: 1)staff to resident ratio;and,2) bedroom size regulation to make sure there is a level of comfort. She stated her sister had a mental illness and expressed they are members of the community and have the right tc be here. She explained just because they have a mental illness does not mean they are violent and the most important thing to remember is that they are in treatment. She stated there is a majcr need for this type of housing and she appreciates that everyone should be comfortable and be good neighbors. She stated it is important and we all have to live together peacefully. She expressed "these people"are individuals and the concems discussed tonight are valid and should be addressed. She requested that staffing regulations get clarified and asked Greg Murphy, City Attorney, if these types cf facilities are regu'ated by state law. City Attorney Murphy replied there seems to be a consensus to delay this item and recommended that the Planning Commission motion to Continue this item to a date uncertain. He stated when this item is brought back the staff report will include a more thorough discussion of the state regulations for assisted living facilities in residential zones and how the state oversees them, so the public and commission may have a better detail of how the various roles intertwine. Vice-Chair Eng requested that staff check with :he Chief of Police and Public Safety to determine the type of mitigations and what measures would be helpful to address some of their concerns. Community Development Director Ramirez stated staff will request that the Chief of Police or someone from Public Safety Department attend the Planning Commission meeting for this item when it is brought back. She stated the 10 reason staff is requesting an unspecified date is because they do not know how long it will take to get some of these answers and staff will also have to contact state agencies to get the requested information. Vice-Chair Eng stated since the City does not have a current parking standard for an Adult Residential facility she recommended that staff check with neighboring cities to see what standards that they have in place and see if those standards would be helpful for our City. City Attorney Murphy stated that is good idea and staff will conduct the survey and provide that information in the staff report 'or a future meeting. He stated that one of the things the Planning Commission was looking at was a Variance and no matter what our standard might be, the issue before the Commission was on the facts of this particular location,giving the nature of the residents of whom they serve,the interaction between those residents and their families, and what the traffic study showed or what happened on a daily basis. He stated the applicant is seeking a Variance and no matter what kind of standards that staff finds, it would be something we would want to put in the City Code for future use, but it would not be directly applicable for this instance because they are requesting no matter what the standards might be, they vary from it,due to facts of their case. Vice-Chair Eng referred to the Traffic Study and asked if it would be possible to update the study and have it reflect what other jurisdictions base their pricing standard on for that type of use i' t is applicable. City Attorney Murphy stated staff can recuest the applicant to do that. He explained that this Traffic Study showed what the actual demand for parking would be. He stated in terms of whether this parking study supported a Variance legally for this evening for approval he looked at the existing parking demand portion. He expressed it is important that staff look into other jurisdictions parking standards to see how they treat Assisted Living Facilities in R-1 zones and what they do, so we can see if our requirements need to be adjusted,or rather or not this Traffic Study would be applicable. Vice-Chair Eng stated the opportunity for individuals with a mental health condition or with a learning disability and to be able 10 be part of a community and society is a very empowering tool as part of their recovery. She explained that recovery does not mean they will be cured but the fact that they are able to function as par' of the community has been found by research that it is very important for their recovery to be part of society. Sne stated that the owners of "Rosemead Villa" have stated their ctierts are al Level 1 &2, which is a level of higher function. She expressed that education is important because there is a lot of stigma in regards to mental illness. She announced that this month considered Mental Health Month and hoped everyone would take the opportunity to educate themselves. Commissioner Dinh stated she is in agreement with the Planning Commissioners and is rot comfortable with approving this project after listening to comments from the residents that live next door. She stated she is not in favor of institutional facilities for highly functional individuals. She expressed that the quality of life is important and feels it's important on both ends for the residents and for the clients living at'Rosemead Villa". She recommended that Mr. Pascasia stay at his facility for a couple of nights to confirm what the residents next door may be experiencing. She expressed concern with the tight quarters of the facility and stated it appears to be a little small for what they are capable of doing. She expressed this is not about a having a business or expanding a business but it's about the quality of life. Chair Herrera asked if clients functioning at Levels 1 and 2 are able to drive. Owner Neila Pascasia replied they cannot drive due to the medication they are taking. She added if they are able to drve it must be with the psychiatrist approval. Commissioner Lopez asked how many of the clients residing at the facility have a California Driver's _icense. Owner Neila Pascasia replied none. 11 Chair Herrera thanked the applicant and asked the Planning Commission for a motion. Commissioner Lopez made a motion,seconded by Commissioner Dinh to CONTINUE MODIFICATION 14-01 AND ZONE VARIANCE 14.01 TO A DATE UNCERTAIN. Vote results: Yes: Dinh, Eng, Herrera, Lopez,and Tang No: None Abstain: None Absent: None 4. CONSENT CALENDAR A. Minutes-April 21, 2014 Commissioner Tang made a motion, seconded by Vice•Chair Eng,to approve the Minutes of April 21,2014 as presented. Vote resulted in: Yes: Dinh, Eng, Herrera,and Tang No: None Abstain: Lopez Absent: None 5. MATTERS FROM STAFF None 6. MATTERS FROM THE CHAIR&COMMISSIONERS A. STATUS OF MASSAGE ESTABLISHMENTS - At the Planning Commission Meeting of April 21, 2014, Commission Member Nancy Eng requested that the status of massage establishments within Rosemead be brought before the Planning Commission for discussion. STAFF RECOMMENDATION - It is recommended that the Planning Commission receive and file this report. Commissioner Lopez thanked everyone for their condolences on his brothers passing. Community Development Director Ramirez stated there is one item on Agenda from Matters of Chair & Commissioners which relates to Massage Establishments. She added this item was requested at the last Planning Commission meeting by Commissioner Nancy Eng. This report has been provided as requested. She stated if any member of the Planning Commission has questions she would be happy to answer them. Vice-Chair Eng thanked staff for taking the time to prepare this informative and eye-opening report. She stated hopefully Sacramento will provide cities a better tool to help monitor this concern. 12 Community Development Director Ramirez gave a brief exp anation of the proposed 'Massage T herapy Act of 2014", which is in line with what the City supports and includes giving back the local control to the cities over the zoning of these establishments making owners responsible and accountable for the actions done in their establishments, and doing away with the CMATC Committee, and organizing a professional board. The League of California Cities is holding a meeting on May 20,2014 regarding this issue and she will be attending. Commissioner Lopez asked if there is a current standard on how many Massage Establishments may be on a block. Community Development Director Ramirez replied no. Commissioner Lopez asked if they want to have multiple establishments' right next door to each ether up and down the block they can. Community Development Director Ramirez replied yes, and explaned this business must be treated like any other professional office in the City. She stated if the City allows any other professional office to do this, tnen we nave to allow them to do it too. Vice-Chair Eng referred to the window coverings of Massage Establishments and asked if curtains are a practice of these types of businesses. Community Development Director Rarnirez replied yes, they are allowed window coverings such as drapes, blinds. and so forth. She added if you are talking about window coverage and what they can put on the windows themselves then they are only allowed fifteen (15%) percent of the window to be covered with signage and so forth. She stated window drapes can be used; are used,and they are allowed to be closed. Vice-Chair Eng asked if there is anything being proposed in the "Massage Therapy Act 2014'to address window coverings. Community Development Director Ramirez replied no but that is a question, she can ask when she attends the League of California Cities workshop. She will also find out if these types of businesses will have to be treated like any professional office and if this is something that will be allowed to be incorporated into our AUP process. She explained when that time comes, staff will have to consult with our City Attorney to see what can or can't be done legally, based on what has been passed. Vice-Chair Eng requested that she find out what the definition of a professional office is and stated a doctor's office is considered a professional office. Community Development Director stated as far as land use goes it is considered a professional office. Commissioner Lopez asked who and how often massage establishment are inspected and what the procedures are when they are inspected. Community Development Director Ramirez replied the Public Safety Department conducts quarterly inspections. She explained they can do it sooner and more often, if they receive a complaint or the City has an ongoing 'issue. She stated if it is found they are not in compliance with the City Ordinance, then they could go out there everyday. Commissioner Dinh expressed concern with the rise of electronic cigarette {Nape) businesses that are being established in the San Gabriel Valley She asked if there have been any problems or applications for those types of businesses in Rosemead. 13 Community Development Director Ramirez replied there are two (2) facilities it Rosemead, there is not a rise of this type of business yet and has not posed an issue at this time. City Attorney Murphy stated this is something that the Planning Commission may see in the future. He explained that many of the cities his firm works with are dealing with this and that some cities have put moratoriums on this while they figure out what to do. He stated other cities have classified e-cigarettes as a tobacco product and are regulating them as other tobacco products. He explained there are a lot of ways to deal with this and how City Staff chooses to deal with it depends largely on how orevalent those store fronts are becoming in the city. The Community Development Director stated the City is not experiencing too many yet, so the City has some time to prepare.and the Planning Commission may not see them soon as of yet. Community Development Director Ramirez assured the Planning Commission that is something staff is aware of and is watching. Chair Herrera stated there is a speakers request for this item and invited Brian Lewin to the pod um. Resident Brian Lewn stated one of his concerns is the signage coverage verses window coverings. He recommended that the existing City Ordinance in regards to window coverage be modified and added to state, no *Mow be covered by curtains, blinds, or any other window coverage during operating hours". He explained that this would be universally applied and asked if something like this can be done. 7. ADJOURNMENT The next regular Planning Commission meeting will be held on Monday, May 19,2014, at 7:00 p.m. if/if\CY Dian errera Chair AT S : cte-Aeve3PagA-26Wk.,___ Rachel Lockwood Commission Secretary 14 Lily Trinh From: Theophile, Leah @DSS <Leah.Theophile @DSS.ca.gov> Sent: Monday, November 03, 2014 3:35 PM To: Lily Trinh Subject: 2011 Annual/Random - Rosemead Villa Inspection Report Attachments: SKM BT_50014110322310.pdf Dear Ms. Trinh, Per our conversation, attached is a copy of the most current annual inspection report for "Rosemead Villa" facility, dated August 9. 2011. Based on the departments computer generated list "Rosemead Villa" facility is not required to be visited annually at this time. A "5 year" inspection visit is required and will be conducted by August of 2016. Sincerely, Leah Theophile Licensing Program Analyst (323) 981-3980 From: 3111ko @dss.ca.gov [mailto:3111ko @dss.ca.gov] Sent: Monday, November 03, 2014 2:32 PM To: Theophile, Leah @DSS Subject: Message from KMBT_500 • 1 • 5 E M F MAYOR: City Ro CQ° /�� WILLLIM ALA&CON i i. t, ° .® lVV 1 i IVeb3risY • MAYOR PRO TEM: � . CMG 7R16F • MARGARET CLARK �',� 8838 E.VALLEY BOULEVARD P.O BOX 399 COUNCIL MEMBERS: ROSEMEAD,CALIFORNIA 91770 SANDRA A.WvtENi'A °"'°"•• TELEPHONE(626)569-2100 JEAN HALL FAX(626)307-9218 POLLY Low May 21, 2014 Rosemead Villa Mr. and Mrs. Zosimo Pascasio 9025 Guess Street Rosemead, CA 91770 Subject: Modification 14-01 and Zone Variance 14-01 Proposed expansion of Rosemead Villa 9025 Guess Street Dear Mr. and Mrs. Pascasio: As you are aware the City of Rosemead Planning Commission continued your public hearing for the proposed expansion of Rosemead Villa, located at 9025-Guess Street, to a date uncertain. •_ Please find enclosed the approved meeting-:minutes: from the May. 5,' 2014 Planning • ' • Commission •hearing, which provides an overview as to why the Planning Commission continued your request. In summary, your application did not provide a sufficient amount of information as to how the Department of Social Services (DSS) . regulates the Rosemead Villa business operation. Specifically,_there was a need for more information regarding Adult Residential Facility (ARF) business operations and building facility requirements, : The,meeting minutes also reflect that neighboring residents expressed concern about safety (residents loitering in the street), noise (especially during nighttime hours), and public nuisance disturbances (such as littering of - cigarette butts, shopping carts being left in the public-right-of-way, etc.). • In order to deem your application complete for a future Planning Commission meeting agenda, staff will require the following information to be submitted. The information will be inekideCiFin the report to the Planning Commission. 1. A copy of all DSS state requirements and responsibilities that govern the facility requirements and operation requirements of an ARF. Specific code regulations should be highlighted to provide answers to the Planning Commission's concerns regarding staffing ratios, parking standards, bedroom size requirements, ratio of residents to number of restrooms, minimum standards for dining area, and any quality of life measures. 2. Copies of your DSS annual review reports for the last three years. If DSS has not completed annual review within the past three years, request.an inspection and submit a copy of the inspection report. This report will be included as supporting documentation for the proposed expansion. 3. A summary of your application requirements from DSS for your proposed expansion of Rosemead Villa. EXHIBIT "E" 4. Submit a copy of the facilities "plan of action' that will address how neighborhood complaints/concerns are resolved. (Please refer to the "The Good Neighbor Guide —A Guidebook for Adult Residential Care Facilities — Establishing and Maintaining Positive Relationships in the Community' for reference.) 5. Submit a narrative describing how the facility operates. Provide a `typical daily activity schedule" for the residents, include the type of activities the facility offers to the residents, and provide details on how the facility responds to the individual resident needs. • In addition to the above required documents, staff recommends the following to be included in your architectural plans to provide more support for the expansion of the facility: 1. Construct a solid six (6) foot tall block wall along the west and east property boundary - • lines to provide screening from the residential properties. 2. Install a five (5) foot wide planter adjacent to the new block wall in order to further screen the residential properties. Plant hedge or shrub plant materials to provide the additional screening between the facility and the adjacent residential properties. •. 3. Retrofit all windows on the property with dual-pane glass windows to help minimize the . noise_impacts of the facility. - • ._. . - . - 4. Revise the floor plan to illustrate how-the existing facility will:be"modified to create one additional bedroom. A note should be added specifying "convert existing office to bedroom". • 5. Add a note to the floor plan to indicate the square footages of all bedrooms onsite. The • floor plan shall demonstrate that each bedroom will meet the required (allowable) minimum square footage for a bedroom. 6. Designate outdoor recreation areas on the site plan in order to demonstrate that the • • •••• facility provides `quality of life"for the residents. a. Identify locations where residents may dine outside. b. Provide outdoor furniture (i.e., dining tables and chairs) beneath the covered patio for outdoor dining. c. Provide outdoor recreation areas for the resident's usage. d. Designate a smoking area on the property that is a distance away from the residential properties in an attempt to minimize the impacts to the neighboring properties. Furthermore, the Planning Commission also indicated that mitigation measures be implemented to address the impacts the facility has on the neighborhood. A few of these measures that staff will be recommending to the Planning Commission include the following: 1. Resident Screening: The operator/applicant shall not admit as allowed by law, any client that: a. Has a conviction for a misdemeanor or felony involving a crime of violence or any sexual offense; b. Is on parole or probation as a result of conviction of a misdemeanor or felony involving a crime of violence or any sexual offense; Page 2 of 4 • .. c. Is required by Court Order to attend a drug and alcohol treatment and/or recovery facility and will be paid for by Federal, State or County funding; d. Has within the previous year, been known to the operator/applicant to have had two or more instances of aggressive and violent behavior or within the past six months has been known to the operator/applicant to have had at least one instance of aggressive and violent behavior; e. Has a history of violence, physical assault or abusive behavior at a previous adult residential care facility. f. If any of these criteria are found to apply to a client after being accepted into the facility the client shall be expelled from the facility, as allowed by law and regulation. 2. Property Nuisances: The operator/applicant shall at all times ensure the subject property is not unsafe, unsightly or poorly maintained. If operator/applicant receives a violation notice from the City with regards to any of the issues, operator/applicant shall correct the violation as required by the City or contact the Planning Division directly to reach .. agreement on an acceptable action plan to correct any violations. • 3. At no time shall facility residents hold a driver's license issued by the State of California. - In the event that the residents of the facility do hold a California Driver's license, a new parking study shall be submitted for review and a modification of the Conditional Use Permit and Zone Variance be approved by the Planning Commission. .:.. Reviews: The facility will be reviewed annually to ensure compliance with all conditions of approval: On an annual basis the applicant shall submit the following -- - documentation items•to be included in to a report to the Planning Commission: - a Annual review reports from DSS. - b. Annual Public Safety reports from the Los Angeles Sherriff Department and the •• • . .• = Rosemead Public Safety Center. •: . .. .. •c. Photographs of the facility documenting all outdoor recreation areas, dining room and common living areas of the facility. • • -• Once your application is deemed complete, staff will re-notice the project for the new public hearing date. It is your responsibility to pay the $500 Publication fee, as well as the costs associated with the required onsite public hearing sign. Planning staff will coordinate with the • • sign manufacturing company to schedule the posting of this sign. The sign company, Signs Express is located at 1438 Santa Anita Avenue, South El Monte, CA 91733. You can contact them at (626) 443-3333 to arrange payment once the application has been deemed complete. If you have any questions regarding this letter, please feel free to contact me at (626) 569-2141. Rosemead City Hall is open from 7:00 a.m. to 6:00 p.m., Monday through Thursday. City Hall is closed on Fridays Si cerely, kitio - • Gina Casillas Planning Division Page 3 of 4 CC Rosemead Villa Zosimo A. & Nelia V. Pascasio • • -• . . 615 East Wistaria Avenue • S Arcadia, CA 91006 Enclosure • • • • • • • • • • • • Page 4 of 4 _ I 3 I • Applicant • Letter EXHIBIT "F" Pascasio Enterprises Inc Rosemead Vitta 9025 Guess St. Rosemead CA 91770 (626)280-4375 August 27, 2014 Planning Commission City of Rosemead 8838 E. Valley Blvd Rosemead. CA 91770 Re: Modification 14-01 and Zone Variance 14-01 Proposed expansion of Rosemead Villa, 9025 Guess Street Dear Sir: Enclosed is the response to your letter dated May 21, 2014. Please feel free to call me at (626) 639-4374 if you need additional information. Respectfully, osimo Pascasio President/CEO ( AYOR: a f f1;4_i of l�semead vVILL1AM ALARCON MAYOR PRO TEM: MARGARET CLARK T uG _� 8838 E.VALLEY_BOULEVARD P.O BOX 399 COUNCIL MEMBERS: ROSEMEAD,CALIFORNIA 91770 IUHAT b TELEPHONE(626)569-2100 SANDRA ARMENIA JEAN HALL FAX(626)307-9218 POLLY Low May 21, 2014 Rosemead Villa Mr. and Mrs. Zosimo Pascasio 9025 Guess Street Rosemead, CA 91770 Subject: Modification 14-01 and Zone Variance 14-01 Proposed expansion of Rosemead Villa 9025 Guess Street Dear Mr. and Mrs. Pascasio: As you are aware the City of Rosemead Planning Commission continued your public hearing for the proposed expansion of Rosemead Villa, located at 9025 Guess Street, to a date uncertain. Please find enclosed the approved meeting minutes from the May 5, 2014 Planning Commission hearing, which provides an overview as to why the Planning Commission continued your request. In summary, your application did not provide a sufficient amount of information as to how the Department of Social Services (DSS) regulates the Rosemead Villa business operation. Specifically, there was a need for more information regarding Adult Residential Facility (ARF) business operations and building facility requirements. The meeting minutes also reflect that neighboring residents expressed concern about safety (residents loitering in the street), noise (especially during nighttime hours), and public nuisance disturbances (such as littering of - cigarette butts, shopping carts being left in the public-right-of-way, etc.). In order to deem your application complete for a future Planning Commission meeting agenda, staff will require the following information to be submitted. The information will be included in the report to the Planning Commission. 4 1. A copy of all DSS state requirements and responsibilities that govern the facility requirements and operation requirements of an ARE Specific code regulations should be highlighted to provide answers to the Planning Commission's concerns regarding staffing ratios, parking standards, bedroom size requirements, ratio of residents to number of restrooms. minimum standards for dining area, and any quality of life measures. 2. Copies of your DSS annual review reports for the last three years. If DSS has not completed annual review within the past three years, request an inspection and submit a copy of the inspection report. This report will be included •as supporting documentation for the proposed expansion. 3. A summary of your application requirements from DSS for your proposed expansion of Rosemead Villa. Page 1 of 4 4. Submit a copy of the facilities "plan of action" that will address how neighborhood complaints/concerns are resolved. (Please refer to the "The Good Neighbor Guide — A Guidebook for Adult Residential Care Facilities — Establishing and Maintaining Positive Relationships in the Community' for reference.) 5. Submit a narrative describing how the facility operates. Provide a ''typical daily activity schedule" for the residents, include the type of activities the facility offers to the residents, and provide details on how the facility responds to the individual resident needs. 6 In addition to the above required documents, staff recommends the following to be included in your architectural plans to provide more support for the expansion of the facility: 1. Construct a solid six (6) foot tall block wall along the west and east property boundary lines to provide screening from the residential properties. 2. Install a five (5) foot wide planter adjacent to the new block wall in order to further screen the residential properties. Plant hedge or shrub plant materials to provide the additional screening between the facility and the adjacent residential properties. 3. Retrofit all windows on the property with dual-pane glass windows to help minimize the noise impacts of the facility. 4. Revise the floor plan to illustrate how the-existing facility will be modified to create one additional bedroom. A note should be added specifying 'convert existing office to bedroom". 5. Add a note to the floor plan to indicate the square footages of all bedrooms onsite. The floor plan shall demonstrate that each bedroom will meet the required (allowable) minimum square footage for a bedroom. 6. Designate outdoor recreation areas on the site plan in order to demonstrate that the facility provides "quality of life" for the residents. a. Identify locations where residents may dine outside. b. Provide outdoor furniture (i.e., dining tables and chairs) beneath the covered patio for outdoor dining. c. Provide outdoor recreation areas for the resident's usage. d. Designate a smoking area on the property that is a distance away from the residential properties in an attempt to minimize the impacts to the neighboring properties. Furthermore, the Planning Commission also indicated that mitigation measures be implemented C to address the impacts the facility has on the neighborhood. A few of these measures that staff will be recommending to the Planning Commission include the following: 1. Resident Screening: The operator/applicant shall not admit as allowed by law. any client that: a. Has a conviction for a misdemeanor or felony involving a crime of violence or any sexual offense; b. Is on parole or probation as a result of conviction of a misdemeanor or felony involving a crime of violence or any sexual offense; Page 2 of 4 c. Is required by Court Order to attend a drug and alcohol treatment and/or recovery facility and will be paid for by Federal, State or County funding; d. Has within the previous year, been known to the operator/applicant to have had two or more instances of aggressive and violent behavior or within the past six months has been known to the operator/applicant to have had at least one instance of aggressive and violent behavior; e. Has a history of violence, physical assault or abusive behavior at a previous adult residential care facility. f. If any of these criteria are found to apply to a client after being accepted into the facility the client shall be expelled from the facility, as allowed by law and regulation. . 2. Property Nuisances: The operator/applicant shall at all times ensure the subject property is not unsafe. unsightly or poorly maintained. If operator/applicant receives a violation notice from the City with regards to any of the issues. operator/applicant shall correct the violation as required by the City or contact the Planning Division directly to reach agreement on an acceptable action plan to correct any violations. 3. At no time shall facility residents hold a driver's license issued by the State of California. In the event that the residents of the facility do hold a California Driver's license, a new parking study shall be submitted for review and a modification of the Conditional Use Permit and Zone Variance be approved by the Planning Commission. i • - ..4. :Annual Reviews: The facility will be reviewed annually to ensure compliance with all conditions:of approval. On._an: annual. basis the applicant shall submit the.:.following documentation items to.be included.in to a report to the Planning_Commission: - a: Annual review reports from DSS. • . b. Annual Public Safety reports from the Los Angeles Sherriff Department and the • -• •-- - Rosemead Public Safety Center. • - , c. Photographs of the facility documenting all outdoor recreation areas, dining room and common living areas of the facility. -- - Once your application is deemed complete, staff will re-notice the project for the new public hearing date. It is your responsibility to pay the $500 Publication fee, as well as the costs • associated with the required onsite public hearing sign. Planning staff will coordinate with the sign manufacturing company to schedule the posting of this sign. The sign company, Signs Express is located at 1438 Santa Anita Avenue, South El Monte, CA 91733. You can contact them at (626) 443-3333 to arrange payment once the application has been deemed complete. If you have any questions regarding this letter, please feel free to contact me at (626) 569-2141. Rosemead City Hall is open from 7:00 a.m. to 6:00 p.m., Monday through Thursday. City Hall is closed on Fridays . (,)Si cerely, Aki.uf-11 Gina Casillas Planning Division I Page 3 of 4 CC Rosemead Villa Zosimo A. & Nelia V. Pascasio 615 East Wistaria Avenue Arcadia, CA 91006 Enclosure • • • • • • • Page 4 of 4 Response to Planning Commission's Inquiry For Additional Information Regarding Operation of Rosemead Villa Facility 1. A copy of all DSS State Title 22 does not provide answers to the requirements and responsibilities Planning Commissions concerns regarding that govern the facility • Staffing ratios requirements and operational • Parking standards requirements of an ARF • Bedroom size requirements (See Cl Planning Notes) (For minimum room • size requirement is 120 per sq ft per CBC 310.6.2) • Ratio of residents to number of restrooms • Minimum standards for dining area Title 22 specific codes and regulations on how an Adult Residential Facility is managed is enclosed. Consulted with our Licensing • Program Analyst from Dept of Social Services, Leah Theophyle. Specific requirements are not outlined in the regulation. ( 2. Copies of DSS annual review A letter requesting for annual review addressed reports for the last 3 years to LPA Leah Theophyle, analyst for Rosemead Villa is enclosed. Awaiting LPA's presence. 3. A summary of the application A copy of the application is enclosed. requirements from DSS for the proposed expansion of Rosemead Villa 4. Submit a copy of the facility's Neighborhood complaint procedures are Plan of Action that will address enclosed. the Neighborhood Complaints and concerns. 5. Submit a narrative describing Enclosed are excerpts from the Rosemead Villa how the facility operates. Program Design submitted and approved by Provide a daily activity schedule Community Care Licensing. It describes how for the residents. Include the the facility operates, services offered, client type of activities the facility activities, and how the facility responds to offers to the residents and individual needs. . It includes the following provide details on how the topics: facility response to the • Staffing individual resident needs. • Admission policies, including client selection, screening and assessment. . I( • Facility program addressing quality of life for clients. OTHER REQUIRED DOCUMENTS I. Construct a solid six(6)foot A 6 foot fully covered wooden fence is along block wall along the west and the east and west property boundary lines. This east roperty boundary lines to provides proper screening from the residential provide screening from the properties. A locked gate was installed to residential properties prevent any resident from going into that area. 2. Install a 5 foot wide planter To be done when construction is finished. adjacent to the new block wall. 3. Retrofit all windows on the To be done after construction. property with dual pane glass windows to help minimize noise 4 Revise the floor plan to illustrate Revised and done. how the existing facility will be modified to create one additional bedroom 5 Add a note to the floor plan to Square footage is already noted in the plan. indicate the square footage of all bedrooms on site. 6 Designate outdoor recreational Two(2) gazebos will be installed for outdoor areas on the site plan in order to use by the residents." i.. demonstrate that the facility provides "quality of life"for the A dining table and chairs are already provided residents. on the covered area between the kitchen and laundry room for outdoor dining.' A basketball court will also be set up when the addition is completed. Smoking area will be relocated to the back of the building when completed. This will minimize noise to the neighbors. Outdoor chairs and tables will be provided. V 1. Resident screenings (a)to (f) Admission Polices enclosed. See Pre-Placement Appraisal. In addition to the existing procedures on how clients are being selected and screened for acceptance to Rosemead Villa, we will also accept the recommendation of the Commission to screen residents for any convictions for a misdemeanor or felony, parole or probation or any crime or violence or any sexual offense, and any history of violence or physical assault. Current admissions agreement specifies that one of the reasons for eviction is assault and combative behavior during residency at Rosemead Villa. 2. Property Nuisances Administrator will make sure that the facility is safe and well maintained at all times. 3. Parking review Recommendation accepted. Copy of the DSS annual review will be 4. Annual Reviews provided to the Planning Commission. Photographs of the facility documenting all outdoor recreation areas, dining room and common living areas of the facility will be maintained. DSS Requirements Regulations GENERAL LICENSING REQUIREMENTS ■ TABLE OF CONTENTS TITLE 22,DIVISION 6 CHAPTER 1 GENERAL LICENSING REQUIREMENTS Article 1. General Definitions Section 80000 General 80001 Definitions Article 2. License License Required 80005 Operation Without a License 80006 Exemption From Licensure 80007 Licensing of Integral Facilities 80008 Limitations on Capacity and Ambulatory Status 80010 Advertisements and License Number 80011 False Claims 80012 Article 3. Application Procedures I Nondiscrimination of Applicants 80017 Application for License 80018 Criminal Record Clearance 80019 Criminal Record Exemption 80019.1 Child Abuse Central Index 80019.2 Fire Clearance 80020 Water Supply Clearance 80021 80022 Plan of Operation 80022 Disaster and Mass Casualty Plan 80024 Waivers and Exceptions Bonding 80025 80025 Safeguards for Cash Resources,Personal Property,and Valuables 80027 Initial Application Review 80028 Capacity Determination 80028 Withdrawal of Application 80030 Provisional License 80031 Issuance of License 80032 Repealed by CDSS Manual Letter No.CCL-01-07,effective 6/29/01 80033 Repealed by CDSS Manual Letter No. CCL-01-07,effective 6/29/01 80034 Submission of New Application 80035 Conditions for Forfeiture of a Community Care Facility License 80036 Licensing Fees CALIFORNIA-DSS-MANUAL-CCL Effective 8/8/08 MANUAL LETTER NO.CCL-08-02 Page 1 Regulations GENERAL LICENSING REQUIREMENTS TABLE OF CONTENTS(Continued) Article 6. Continuing Requirements Section Reporting Requirements 80061 Finances 80062 Accountability 80063 Administrator-Qualifications and Duties 80064 Personnel Requirements 80065 Personnel Records 80066 Admission Agreements 80068 Needs and Services Plan 80068.2 Modifications to Needs and Services Plan 80068.3 Eviction Procedures 80068.5 Client Medical Assessments 80069 Renumbered and amended to Section 80092.2 by Manual Letter No.CCL-98-05, effective 10/1/98 80069.1 Functional Capabilities Assessment 80069.2 Renumbered to Section 85069.3 by Manual Letter No.CCL-98-09,effective 10/1/98 80069.3 Client Records 80070 Register of Clients 80071 Personal Rights 80072 Telephones 80073 Transportation 80074 Health-Related Services 80075 Automated External Defibrillators(AEDs) 80075.1 Food Service 80076 Personal Services(Reserved) 80077 Care for Clients Who Rely Upon Others to Perform All Activities of Daily Living 80077.2 Care for Clients Who Lack Hazard Awareness or Impulse Control 80077.3 Care for Clients with Incontinence 80077.4 Care for Clients with Contractures 80077.5 Responsibility for Providing Care and Supervision 80078 Activities(Reserved) 80079 Article 7. Physical Environment Alterations to Existing Buildings or New Facilities 80086 Buildings and Grounds 80087 Fixtures,Furniture,Equipment and Supplies 80088 CALIFORNIA-DSS-MANUAL-CCL MANUAL LETTER NO.CCL-02-11 Effective 9/8/02 Page 3 80079 ACTIVITIES (RESERVED) 80079 (b) All clients shall be protected against hazards within the facility through provision of the following: Article 7. PHYSICAL ENVIRONMENT (1) Protective devices including but not limited to nonslip material on rugs. 80086 ALTERATIONS TO EXISTING 80086 BUILDINGS OR NEW FACILITIES (c) All outdoor and indoor passageways, stairways, inclines, ramps, open porches and other areas of (a) Prior to construction or alterations, all licensees potential hazard shall be kept free of obstruction. shall notify the licensing agency of the proposed change. (d) The licensee shall provide an isolation room or area for use by ill clients. (b) The licensing agency shall have the authority to require that the licensee have a building inspection by (e) General permanent or portable storage space a local building inspector if the agency suspects that a shall be available for the storage of facility equipment hazard to the clients' health and safety exists. and supplies. HANDBOOK BEGINS HERE (1) Facility equipment and supplies shall be stored in this space and shall not be stored in (c) Prior to construction or alterations, state or space used to meet other requirements specified local law requires that all facilities secure a building in this chapter and Chapters 2 through 7. permit. (f) All licensees serving children or serving clients HANDBOOK ENDS HERE who have physical handicaps, mental disorders, or developmental disabilities shall ensure the NOTE: Authority cited: Section 1530, Health and inaccessibility of pools, including swimming pools (in- Safety Code. Reference: Sections 1501 and 1531, ground and above-ground), fixed-in-place wading pools, Health and Safety Code. hot tubs, spas, fish ponds or similar bodies of water through a pool cover or by surrounding the pool with a fence. 80087 BUILDINGS AND GROUNDS 80087 (1) Fences shall be at least five feet high (a) The facility shall be clean, safe, sanitary and in and shall be constructed so that the fence does good repair at all times for the safety and well-being of not obscure the pool from view. The bottom clients, employees and visitors. and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 (1) The licensee shall take measures to Uniform Building Code. In addition to meeting keep the facility free of flies and other insects. all of the aforementioned requirements for fences, gates shall swing away from the pool, (2) The licensee shall provide for the safe self-close and have a self-latching device disposal of water and other chemicals used for located no more than six inches from the top of cleaning purposes. the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use. 89 80087 BUILDINGS AND GROUNDS 80087 (j) The items specified in Section 80087(h) above (Continued) shall not be stored in food storage areas or in storage areas used by or for clients. (A) If licensed prior to June 1, 1995, facilities with existing pool NOTE: Authority cited: Section 1530, Health and fencing shall be exempt from the fence Safety Code. Reference: Sections 1501 and 1531, requirements specified in Section Health and Safety Code. 80087(0(1) until such fence is replaced or structurally altered. If the licensee replaces or alters the fence, it shall 80088 FIXTURES, FURNITURE, 80088 meet the fence requirements specified EQUIPMENT AND SUPPLIES in Section 80087(0(1). (a) A comfortable temperature for clients shall be (2) Where an above-ground pool structure maintained at all times. is used as the fence or where the fence is mounted on top of the pool structure, the pool (1) The licensee shall maintain the shall be made inaccessible when not in use by temperature in rooms that clients occupy removing or making the ladder inaccessible or between a minimum of 68 degrees F erecting a barricade to prevent access to (20 degrees C)and a maximum of 85 degrees F decking. If a barricade is used, the barricade (30 degrees C). shall meet the requirements of Section 80087(0(1). (A) In areas of extreme heat the maximum shall be 30 degrees F (g) All in-ground pools, and above-ground pools (16.6 degrees C) less than the outside which cannot be emptied after each use shall have an temperature. operative pump and filtering system. (2) Nothing in this section shall prohibit (h) Disinfectants, cleaning solutions, poisons, clients from adjusting individual thermostatic firearms and other items which could pose a danger if controls. readily available to clients shall be stored where inaccessible to clients. (b) All window screens shall be in good repair and be free of insects, dirt and other debris. (1) Storage areas for poisons, and firearms and other dangerous weapons shall be locked. (c) Fireplaces and open-faced heaters shall be made inaccessible to clients to ensure protection of the clients' (2) In lieu of locked storage of firearms, safety. the licensee may use trigger locks or remove the firing pin. HANDBOOK BEGINS HERE (A) Firing pins shall be stored and (1) The use of a fireplace screen or similar locked separately from firearms. barrier will meet this requirement. (3) Ammunition shall be stored and locked HANDBOOK ENDS HERE separately from firearms. (d) The licensee shall provide lamps or lights as (i) Medicines shall be stored as specified in Section necessary in all rooms and other areas to ensure the 80075(h) and (i) and separately from other items comfort and safety of all persons in the facility. specified in Section 80087(h) above. 90 i 80088 FIXTURES, FURNITURE, 80088 (g) The licensee shall provide linens of various f EQUIPMENT AND SUPPLIES kinds necessary to meet the program of services being (Continued) offered by the facility and the requirements specified in Chapters 2 through 7. (e) Faucets used by clients for personal care such as shaving and grooming shall deliver hot water. NOTE: Authority cited: Section 1530, Health and Safety Code. Reference: Sections 1501 and 1531, (1) Hot water temperature controls shall be Health and Safety Code. maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by clients to attain a hot water Article 8. HEALTH RELATED SERVICES temperature of not less than 105 degrees F (40.5 degrees C) and not more than 80090 HEALTH AND SAFETY 80090 120 degrees F (48.8 degrees C). SERVICES (2) Taps delivering water at 125 degrees F (a) The provisions of this article are applicable to (51.6 degrees C) or above shall be prominently adult CCFs and shall be used in conjunction with identified by warning signs. Articles 1 through 7 of this chapter. (3) All toilets, handwashing and bathing (b) In adult residential and social rehabilitation facilities shall be maintained in safe and facilities, when the licensee chooses to accept or retain sanitary operating condition. Additional a client with a restricted health condition as specified in equipment, aids, and/or conveniences shall be Section 80092, the following shall apply: provided in facilities accommodating physically handicapped clients who need such items. (1) The licensee shall develop an individual health condition care plan as specified in (f) Solid waste shall be stored, located and Section 80069.1. disposed of in a manner that will not transmit communicable diseases or odors, create a nuisance, or (2) Care shall be provided as specified in provide a breeding place or food source for insects or this article. rodents. (3) Waivers or exceptions will not be (1) All containers, including movable bins, granted to accept or retain clients who have used for storage of solid wastes shall have health conditions prohibited by Section 80091. tight-fitting covers kept on the containers; shall be in good repair, shall be leakproof and (4) The licensee shall maintain a list of • rodent-proof. clients with restricted health conditions with their medical conditions identified. (2) Solid waste containers, including movable bins, receiving putrescible waste shall (5) The licensee shall notify the be emptied at least once per week or more Department when he/she begins providing care often if necessary to comply with (f) above. to the client, as specified in Section 80061(d). (3) Each movable bin shall provide for (6) Waivers or exceptions will not be suitable access and a drainage device to allow granted to meet the needs of clients by means complete cleaning at the storage area. other than those specified in Section 80092.2 through 80092.12. i • 91 80065 PERSONNEL REQUIREMENTS 80065 (c) The licensee shall be permitted to utilize 1 volunteers provided that such volunteers are supervised, ( (a) Facility personnel shall be competent to provide and are not included in the facility staff plan. the services necessary to meet individual client needs and shall, at all times, be employed in numbers (d) The following facility personnel staff shall be at necessary to meet such needs. least 18 years of age: HANDBOOK BEGINS HERE (1) Persons who supervise employees and/or volunteers. (1) Section 1522(b)(2) of the Health and Safety Code provides: (2) Persons, including volunteers, who provide any element of care and supervision to Any person, other than a client, clients. residing in the facility. (e) The licensee shall provide for direct supervision (2) Section 1522(c)(3) of the Health and of clients during participation in or presence at Safety Code provides in part: potentially dangerous activities or areas in the facility. Except for persons specified in (1) An adult other than a client shall be paragraph (2) of subdivision (b), the present at all times while clients are using a licensee shall endeavor to ascertain the pool or other body of water from which rescue previous employment history of requires the rescuer's ability to swim. persons required to be fingerprinted under this subdivision. (2) Adults who supervise while clients are using a pool or other body of water from which HANDBOOK ENDS HERE rescue requires the rescuer's ability to swim, shall have a valid water safety certificate. (b) The licensing agency shall have the authority to require any licensee to provide additional staff (f) All personnel shall be given on-the-job training whenever the licensing agency determines and or shall have related experience which provides documents that additional staff are required for the knowledge of and skill in the following areas, as provision of services necessary to meet client needs. appropriate to the job assigned and as evidenced by safe The licensee shall be informed in writing of the reasons and effective job performance. for the licensing agency's determination. The following factors shall be taken into consideration in determining (1) Principles of nutrition, food preparation the need for additional staff. and storage and menu planning. (1) Needs of the particular clients. (2) Housekeeping and sanitation principles. (2) Extent of the services provided by the (3) Provision of client care and facility. supervision, including communication. (3) Physical arrangements of the particular (4) Assistance with prescribed medications facility. which are self-administered. (4) Existence of a state of emergency or (5) Recognition of early signs of illness disaster. and the need for professional assistance. 61 80065 PERSONNEL REQUIREMENTS 80065 (i) Pending receipt of a criminal record transcript (Continued) as specified in Section 80019, and prior to employment i or at initial presence in the facility all employees and (6) Availability of community services and volunteers determined by the licensing agency to resources. require criminal record clearance shall sign a statement under penalty of perjury, on a form provided by the (g) All personnel, including the licensee, Department, which contains either of the following: administrator and volunteers, shall be in good health, 1 and shall be physically, mentally, and occupationally (1) A declaration that he/she has not been capable of performing assigned tasks. convicted of a crime, other than a minor traffic violation as specified in Section 80019(1). (1) Except as specified in (3) below, good physical health shall be verified by a health (2) Information regarding any prior screening, including a test for tuberculosis, convictions of a crime, with the exception of performed by or under the supervision of a any minor traffic violations as specified in physician not more than one year prior to or Section 80019(1). seven days after employment or licensure. (A) If a person has been convicted (2) A health screening report signed by the of a crime other than a minor traffic person performing such screening shall be violation as specified in Section 80019 , he/she shall also made on each person specified above, and shall - (� indicate the following: acknowledge that his/her continued employment is conditioned on approval (A) The person's physical of the licensing agency. qualifications to perform the duties to be assigned. (j) Clients shall not be used as substitutes for required staff but shall be permitted, as a voluntary part (B) The presence of any health of their program of activities, to participate in condition that would create a hazard to household duties and other tasks suited to the client's the person, clients or other staff needs and abilities. members. (1) Such duties and tasks shall be specified (3) The good physical health of each in the client's needs and services plan as volunteer who works in the facility shall be specified in Chapters 2, 4, 5 and 6. verified by: (k) When regular staff members are absent, there (A) A statement signed by each shall be coverage by personnel capable of performing volunteer affirming that he/she is in assigned tasks as evidenced by on-the-job performance. good health. (1) Personnel shall provide for the care and safety (B) A test for tuberculosis of persons without physical or verbal abuse, performed not more than one year exploitation or prejudice. prior to or seven days after initial presence in the facility. (m) All personnel shall be instructed to report observations or evidence of violations of any of the (h) Personnel with evidence of physical illness that personal rights specified in Section 80072 and/or any of poses a threat to the health and safety of clients shall be the personal rights provisions of Chapters 2 through 7. relieved of their duties. 62 80065 PERSONNEL REQUIREMENTS 80065 (ij Pending receipt of a criminal record transcript (Continued) as specified in Section 80019, and prior to employment or at initial presence in the facility all employees and (6) Availability of community services and volunteers determined by the licensing agency to resources. require criminal record clearance shall sign a statement under penalty of perjury, on a form provided by the (g) All personnel, including the licensee, Department, which contains either of the following: administrator and volunteers, shall be in good health, and shall be physically, mentally, and occupationally (1) A declaration that he/she has not been capable of performing assigned tasks. convicted of a crime, other than a minor traffic violation as specified in Section 80019(t). (1) Except as specified in (3) below, good physical health shall be verified by a health (2) Information regarding any prior screening, including a test for tuberculosis, convictions of a crime, with the exception of performed by or under the supervision of a any minor traffic violations as specified in physician not more than one year prior to or Section 80019(f). seven days after employment or licensure. (A) If a person has been convicted (2) A health screening report signed by the of a crime other than a minor traffic person performing such screening shall be violation as specified in made on each person specified above, and shall Section 80019(1), he/she shall also indicate the following: acknowledge that his/her continued employment is conditioned on approval (A) The person's physical of the licensing agency. qualifications to perform the duties to be assigned. (j) Clients shall not be used as substitutes for required staff but shall be permitted, as a voluntary part (B) The presence of any health of their program of activities, to participate in condition that would create a hazard to household duties and other tasks suited to the client's the person, clients or other staff needs and abilities. members. (1) Such duties and tasks shall be specified (3) The good physical health of each in the client's needs and services plan as volunteer who works in the facility shall be specified in Chapters 2, 4, 5 and 6. verified by: (k) When regular staff members are absent, there (A) A statement signed by each shall be coverage by personnel capable of performing volunteer affirming that he/she is in assigned tasks as evidenced by on-the-job performance. good health. (1) Personnel shall provide for the care and safety (B) A test for tuberculosis of persons without physical or verbal abuse, performed not more than one year exploitation or prejudice. prior to or seven days after initial presence in the facility. (m) All personnel shall be instructed to report observations or evidence of violations of any of the (h) Personnel with evidence of physical illness that personal rights specified in Section 80072 and/or any of poses a threat to the health and safety of clients shall be the personal rights provisions of Chapters 2 through 7. relieved of their duties. 62 . 80065 PERSONNEL REQUIREMENTS 80065 (c) The licensee shall be permitted to utilize - volunteers provided that such volunteers are supervised, i (a) Facility personnel shall be competent to provide and are not included in the facility staff plan. the services necessary to meet individual client needs The following facility personnel staff shall be at and shall, at all times, be employed in numbers (d) g ty necessary to meet such needs. least 18 years of age: HANDBOOK BEGINS HERE (1) Persons who supervise employees and/or volunteers. (1) Section 1522(b)(2) of the Health and Safety Code provides: (2) Persons, including volunteers, who provide any element of care and supervision to Any person, other than a client, clients. residing in the facility. (e) The licensee shall provide for direct supervision (2) Section 1522(c)(3) of the Health and of clients during participation in or presence at Safety Code provides in part: potentially dangerous activities or areas in the facility. Except for persons specified in (1) An adult other than a client shall be paragraph (2) of subdivision (b), the present at all times while clients are using a licensee shall endeavor to ascertain the pool or other body of water from which rescue previous employment history of requires the rescuer's ability to swim. persons required to be fingerprinted under this subdivision. (2) Adults who supervise while clients are using a pool or other body of water from which HANDBOOK ENDS HERE rescue requires the rescuer's ability to swim, shall have a valid water safety certificate. (b) The licensing agency shall have the authority to All personnel shall be given on-the-job training require any licensee to provide additional staff (f) Pe whenever the licensing agency determines and or shall have related experience which provides documents that additional staff are required for the knowledge of and skill in the following areas, as provision of services necessary to meet client needs. appropriate to the job assigned and as evidenced by safe The licensee shall be informed in writing of the reasons and effective job performance. for the licensing agency's determination. The following Principles of nutrition, food preparation factors shall be taken into consideration in determining (1) P the need for additional staff. and storage and menu planning. (1) Needs of the particular clients. (2) Housekeeping and sanitation principles. (2) Extent of the services provided by the (3) Provision of client care and facility. supervision, including communication. 4 Assistance with prescribed medications (3) Physical arrangements of the particular which are self-administered. facility. (4) (5) Recognition of early signs of illness disaster.Existence of a state of emergency or and the need for professional assistance. disaster. 61 80021 WATER SUPPLY CLEARANCE 80021 ( 1) Statement of purposes, and program methods and goals. (a) All community care facilities where water for human consumption is from a private source shall meet ( 2) Statement of admission policies and the following requirements: procedures regarding acceptance of clients. (1) As a condition of initial licensure, the ( 3) A copy of the admission agreement. applicant shall provide evidence of an on-site inspection of the source of the water and a ( 4) Administrative organization, if bacteriological analysis which establishes the applicable. safety of the water, conducted by the local health department, the State Department of ( 5) Staffing plan, qualifications and duties, Health Services or a licensed commercial if applicable. laboratory. ( 6) Plan for inservice education of staff if (2) Subsequent to initial licensure, the required by regulations governing the specific licensee shall provide evidence of a facility category. bacteriological analysis of the private water supply as frequently as is necessary to ensure ( 7) A sketch of the building(s) to be the safety of the clients, but no less frequently occupied, including a floor plan which than specified in the following table: describes the capacities of the buildings for the uses intended, room dimensions, and a PERIODIC designation of the rooms to be used for LICENSED ANALYSIS SUBSEQUENT nonambulato clients, if an CAPACITY REQUIRED ANALYSIS any. I � 6:or fewer Initial Licensing Not required unless evidence supports e ( 8) A sketch of the grounds showing th need for such buildings, driveways, fences, storage areas, analysis to protect pools, gardens, recreation areas and other clients. space used by the clients. 7 through 15 Initial Licensing Annually (A) The sketch shall include the 16 through 24 Initial Licensing Semiannually dimensions of all areas which will be 25 or more Initial Licensing Quarterly used by the clients. NOTE: Authority cited: Section 1530, Health and ( 9) Sample menus and a schedule for one Safety Code. Reference: Sections 1501, 1520, 1528 calendar week indicating the time of day that and 1531, Health and Safety Code. meals and snacks are to be served. (10) Transportation arrangements for clients 80022 PLAN OF OPERATION 80022 who do not have independent arrangements. (a) Each licensee shall have and maintain on file a (11) Rate setting policy including, but not current, written, definitive plan of operation. limited to, policy on refunds. (b) The plan and related materials shall contain the = 44-4-64v7 - ti,TA-.4G7 following: .d t t 1— I ,a!e/L t . 27 • 80022 PLAN OF OPERATION 80022 regulations adopted by the State Fire Marshal (Continued) pursuant to Section 13143 of the Health and Safety Code. (12) A statement whether or not the licensee will handle the clients' money, personal (h) The plan shall include, but shall not be property, and/or valuables. If money, personal limited to, all of the following: property, and/or valuables will be handled, the method for safeguarding shall ensure (1) A description of how the compliance with Sections 80025 and 80026. facility will provide training for staff regarding the use and operation of the (13) Consultant and community resources to egress control devices utilized by the be utilized by the facility as part of its program. facility. (14) A statement of the facility's policy (2) A description of how the concerning family visits and other facility will ensure the protection of the communications with the client pursuant to residents' personal rights consistent Health and Safety Code Section 1512. with Sections 4502, 4503, and 4504 of the Welfare and Institutions Code. HANDBOOK BEGINS HERE (3) A description of how the (A) Section 1512 of the Health and facility will manage the person's lack Safety Code provides that: of hazard awareness and impulse control behavior. This policy shall be designed to encourage regular family (4) A description of the facility's involvement with the client emergency evacuation procedures. and shall provide ample opportunities for family HANDBOOK ENDS HERE participation in activities at the facility. (d) If the licensee intends to admit or care for one or more clients who have a restricted health condition HANDBOOK ENDS HERE specified in Section 80092, or clients who rely on others to provide all activities of daily living as (c) If the licensee of an adult residential facility specified in Section 80077.2, the facility policies and a plans to use delayed egress devices, the plan must meet program description shall be included. At a minimum, the requirements of Health and Safety Code Sections the information related to those clients and their needs 1531.1(g) and (h). shall specify: HANDBOOK BEGINS HERE (1) The type of restricted health condition that the licensee plans to admit. Health and Safety Code Section 1531.1(g) and (2) The licensee's plans for serving that (h) read: client. (g) The facility shall develop a plan of operation approved by the State Department of (3) The services which will be provided, Social Services that includes a description of and how the facility is to be equipped with egress control devices that are consistent with 28 80022 PLAN OF OPERATION 80022 (1) Designation of administrative authority (Continued) and staff assignments. (4) Staffing adjustments in order to provide (2) Contingency plans for action during the proposed services. fires, floods, and earthquakes, including but not limited to the following: (A) This may include increased staffing, hiring staff with additional (A) Means of exiting. qualifications, or hiring licensed professionals. (B) Transportation arrangements. (5) Licensees of adult day care facilities (C) Relocation sites which are and adult day support centers shall also specify equipped to provide safe temporary whether a client's personal care attendant's accommodation for clients. services will be used and where the client will receive his/her medical care. (D) Arrangements for supervision of clients during evacuation or (e) If the licensee intends to admit and/or specialize relocation, and for contact after in care for one or more clients who has a propensity for relocation to ensure that relocation has behaviors that result in harm to self or others, the been completed as planned. facility plan of operation shall include a description of precautions which will be taken to protect that client and all other clients. (E) Means of contacting local agencies, including but not limited to (1) Any changes in the plan of operation which the fire department, law enforcement affect the services to clients shall be subject to licensing agencies, and civil defense and other agency approval and shall be reported as specified in disaster authorities. Section 80061. (c) The licensee shall instruct all clients, age and (g) The facility shall operate in accordance with the abilities permitting, all staff, and/or members of the terms specified in the plan of operation and may be household in their duties and responsibilities under the cited for not doing so. plan. NOTE: Authority cited: Section 1530, Health and (d) Disaster drills shall be conducted at least every Safety Code. Reference: Sections 1501, 1507, 1512, six months. 1520, 1528, 1531, and 1531.1, Health and Safety Code. (1) Completion of such drills shall not require travel away from the facility grounds or 80023 DISASTER AND MASS 80023 contact with local disaster agencies. CASUALTY PLAN (2) The drills shall be documented and the (a) Each licensee shall have and maintain on file a documentation maintained in the facility for at current, written disaster and mass casualty plan of least one year. action. NOTE: Authority cited: Section 1530, Health and (b) The plan shall be subject to review by the Safety Code. Reference: Sections 1501, 1520, 1528 licensing agency and shall include: and 1531, Health and Safety Code. 29 Request for Annual Review PASCASIO ENTERPRISES INC. Rosemead Villa 9025 Guess St. Rosemead, CA 91770 (626) 280-4375 August 25, 2014 Leah Theophyle, LPA Department of Social Services Community Care Licensing 1000 Corporate Center Dr, Suite 500 Monterey Park, CA 91754 Dear Ms. Theophyle During our phone conversation of August 19, 2014, I have mentioned about the need for the annual inspection reports for Rosemead Villa within the past 3 years as per request by the Rosemead Planning Commission. This documentation will be used to support our request for the proposed expansion of Rosemead Villa facility. . Please consider this letter as a formal request for an annual review.. Thank you for your prompt attention to this matter. Very respectfully, NELIA V. PASCASIO DSS Application for Expansion PASCASIO ENTERPRISES INC. Rosemead Villa 9025 Guess St. Rosemead, CA 91770 (626) 280-4375 August 25, 2014 Leah Theophyle, LPA Department of Social Services Community Care Licensing 1000 Corporate Center Dr, Suite 500 Monterey Park, CA 91754 Dear Ms. Theophyle I am writing this letter as a formal request to increase the licensed bed capacity of Rosemead Villa from 22 to 28. Enclosed are the following documents to support the request: • Corporate Resolution and Approval • LIC 200, Application request to Increase the Bed Capacity • LIC 9054, Request for a Fire Clearance • LIC 999, Facility Sketch (Floor Plan) • A check for $25.00 Since major construction is required, I have enclosed a Construction Safety Plan for Rosemead Villa. Please feel free to contact me at (626) 639-4270 if additional information is needed. Thank you for your kind and prompt consideration to this matter. Very respectfully, NELIA V. PASCASIO CONSENT TO HOLD A MEETING OF INCORPORATORS AND DIRECTORS OF PASCASIO ENTERPRISES, INC A California Corporation We,the undersigned,being all of the incorporators,first directors and/or the directors named in the Articles of Incorporation of the above-named California Corporation do hereby approve the following resolution during a meeting held on June 3,2014 Be it RESOLVED that the Board of Directors of the Pascasio Enterprises Inc.has agreed and approved the increase in bed capacity of the Rosemead Villa facility from 22 to 28. Six additional beds will be added with an office and storage space. Construction will start as soon as the Conditional Permit is approved by the City of Rosemead. WITNESS our signatures this 3rd day of June 2014. O IO ASCASI President ZONEL PASCASIO Vice President NELIA PASCASIO Secretary-Treasurer • 'T • • LORIE P;tCASIO Director • AE OF CALIFORNIA ALIFORNIA DEPARTMENT OF SOCIAL SERVICES—HEALTH AND HUMAN SERVICES AGENCY COMMUNITY CARE LICENSING \PPLICATION FOR A COMMUNITY CARE FACILITY OR RESIDENTIAL CARE FACILITY 'OR THE ELDERLY (See Instructions on Back) FOR DEPARTMENT USE ONLY REPLY TO: J sk )LINTY. FACILTY NUMBER: ATE: ACTION TYPE: VIEWED BY: FACILITY TYPE: APPLICANT(S)NAME(S)(PLEASE PRINT) 2. REQUESTED ACTION(CHECK ONE): ❑ D. CHANGE OF FACILITY TYPE PASCASIO ENTERPRISES INC. ❑A.INITIAL APPLICATION ❑ E. CHANGE OF AMB/NON-AMB STATUS ®B.CHANGE OF CAPACITY ❑ F. CHANGE WITHIN CORPORATION ❑C.CHANGE OF LOCATION ® G. OTHER(Specify) APPLICANT MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/TELEPHONE 615 E. WISTARIA AVE. ARCADIA CA 91006 626 639-4370 APPLICATION ❑ ❑ C.NON PROFIT CORP. ❑ G.LIMITED A.INDIVIDUAL ❑ B.PARTNERSHIP LIABILITY FILED BY: ® ❑ F OTHER PUBLIC AGENCY COMPANY D PROFIT CORP ❑ E.COUNTY FACILITY OR AGENCY NAME ROSEMEAD VILLA FACILITY STREET ADDRESS CITY COUNTY ZIP CODE AREA CODE/TE LEPHONE 9025 GUESS ST. ROSEMEAD LOS ANGELES 91770 626 280-4375 • FACILITY MAILING ADDRESS CITY STATE ZIP CODE 315 E.WISTARIA AVE. ARCADIA CA 91006 ADMINISTRATOR OR PERSON IN CHARGE OF FACILITY TITLE ZOSIMO A. PASCASIO ADMINISTRATOR . TYPE OF AGENCY OR FACILITY 10. TOTAL REQUESTED CAPACITY 11. FOR CHILDRENS FACILITIES 28 ONLY ADULT RESIDENTIAL ❑ SOCIAL REHABILITATION 7 RESIDENTIAL FACILITY-ELDERLY NUMBER OF ❑ FOSTER FAMILY AGENCY • 10A RESIDENTIAL FACILITY-CHRONICALLY ILL INFANTS ❑ ADOPTION AGENCY NUMBER OF NON-AMBULATORY (AGES 0 LILT DAY CARE (IF ANY) 0 THROUGH 2) J ADULT DAY SUPPORT CENTER ❑ TRANSITIONAL HOUSING CHILDREN P.ACEMENT PROGRAM NUMBER OF TRANSFER DEPENDENT (AGES 3 GROUP HOME ❑ CTHER(SPECIFY) AND/OR BEDRIDDEN(IF ANY) THROUGH 17) 3 SMALL FAMILY HOME 2. DAYS AND HOURS OF OPERATION 13. PROPERTY OWNERSHIP AONDAY TO SUNDAY 0000-2400 ❑ owN ® RENT ❑ OTHER(SPECIFY) 3A. NAME,ADDRESS,AND PHONE NUMBER OF PROPERTY OWNER,IF RENTING OR LEASING: ZOSIMO A. PASCASIO 615 E. WISTARIA AVE. ARCADIA, CA 91006 (626) 679-4354 4.WAS FACILITY PREVIOUSLY LICENSEE IF YES.FACILITY NAME AND NUMBER: LICENSING AGENCY NAME ROSEMEAD VILLA 197801709 DEPARTMENT OF SOCIAL SERVICES ® YES ❑ NO 5. IS MAJOR CONSTRUCTION REQUIRED? DATE CONSTRUCTION TO BEGIN: NOT STARTED 16.SOURCE OF WATER FOR HUMAN CONSUMPTION ® PUBLIC [3 PRIVATE ® YES ❑ NO DATE TO BE COMPLETED: 7. ENTER THE INFORMATION BELOW FOR ANY COMMUNITY CARE FACILITY OR HEALTH FACILITY PREVIOUSLY OR CURRENTLY OWNED OR OPERATED BY APPLICANTS.REFER TO INSTRUCTIONS. LICENSING AGENCY NAME FACILITY NAME AND NUMBER \. NELVILLE GUEST HOME-RALPH 198600166 NELVILLE GUEST HOME-ORANGE GROVE 191222631 3. NELVILLE GUEST HOME-WASHINGTON 198601057 NELVILLE GUEST HOME-TOPEKA 198600401 f 8.APPLICANTS/LICENSEE(S)RESPONSIBILITIES A. IN ADDITION TO COMPLYING WITH THE HEALTH AND SAFETY CODES AND REGULATIONS APPLICABLE TO LICENSING AND FIRE SAFETY,I/WE UNDERSTAND THET THERE MAY BE OTHER STATE,FEDERAL,AND/OR LOCAL LAWS,WHICH ARE NOT ENFORCED BY THIS AGENCY,THAT MAY NEED TO BE MET SUCH AS:ZONING,BUILDING,SANITATION AND LABOR REQUIREMENTS, B. I/WE HAVE READ AND UNDERSTAND THE STATUTES AND REGULATIONS WHICH PERTAIN TO MY/OUR LICENSING CATAGORY PRIOR TO THE ISSUANCE OR RENEWAL OF MY/OUR LICENSE. C. I/WE SHALL ENSURE THATAT THE TIME OF EMPLOYMENT OR FIRST DAY IN THE FACILITY ALL PERSONS SUBJECT TO FINGERPRINT REQUIREMENTS SHALL BE FINGERPRINTED AND COMPLETE AN AFFIDAVIT ON PRIOR CRIMINAL RECORD HISTORY.FINGERPRINTS SHALL BE SUBMITTED TO THE DEPARTMENT OF JUSTICE AS REQUIRED. D. IF WE OPERATE A FACILITY WHICH PROVIDES CARE AND SUPERVISION TO CHILDREN,WE SHALL ENSURE THAT A CHILD ABUSE INDEX CHECK FORM FOR EACH PERSON SUBJECT TO FINGEROPRINT REQUIREMENTS IS SUBMITTED TO THE DEPARTMENT OF JUSTICE AS REQUIRED. PERSON,E. I/WE SHALL NOTIFY THE LICENSING AGENCY IMMEDIATELY IF A FINGERPRINTING F. I/WE SHALL OBTAIN APPROVAL ROM T E LICENSING AGENCY PRIORTO MAKING ANY C HANGE(S)THAT AFFFECT THE TERMS OF THE CONVICTED SECR/f sE AFTER EMPLOYMENT /9. I/WE UNDERSTAND THAT I/WE HAVE THE RIGHT TO APPEAL ANY DECISION REGARDING THE DISPOSITION OF THIS APPLICATION. 20. I/WE DECLARE UNDER PENALTY OF PERJURY THAT THE STAEMENTS ON THIS APPLICATION AND ON THE ACCOMPANYING ATTACHMENTS ARE CORRECT TO THE BEST OF MY/OUR KNOWLEDGE. I/WE AM/ARE AUTHORIZED TO SIGN THIS APPLICATION ON BEHALF OF THE NAMED APPLICANT 5��.� �/� APPLICANT LOS ANGELES DATE 08/20/2014 SIGNED / iV!_ TITLE COUNTY Wr(ERE SIGNED COUNTY WHERE SIGNED DATE SIGNED �� LIC 200(3199) • FAVILI I T Qis I i,,n (moor rian) Applicants am required to provide a sketch of the floor plan of the home or facility and outside yard. The floor sketch must label rooms such as the kitchen,bath,living room,etc. Circle the names of the rooms that will be used by staff/residents/clients/children. Door and window exits from the rooms must be shown in case of an emergency (see Energency Disaster Plan). Show room sizes (e.g. 8.5 x 12). Keep dose to scale. Use the space below. 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I • I .■/11/11.11••11 .__/■__1111•• m •••• I ! i Q••■QmQ11••••mm••••m11/m ! 1I1I 11 i ! II I ! it 1 i 1 . IL LI ti ! 111 it i i I II STATE OF CALIFORNIA-HEALTH AND WELFARE AGENCY DEPARTMENT OF SOCIAL SERVICES LOCAL FIRE INSPECTION AUTHORITY INFORMATION DATE: SEPTEMBER 1, 2014 h_QUIRED BY THE DEPARTMENT OF APPLICANT NAME: PASCASIO ENTERPRISES INC. SOCIAL SERVICES, COMMUNITY CARE LICENSING FACILITY NAME: DIVISION ROSEMEAD VILLA FACILITY ADDRESS: 49025 GUESS ST. ROSEMEAD, CA 91770 As part of the application process, the licensing agency is responsible for obtaining a fire safety inspection from the local fire inspection authority having jurisdiction in the area where your facility is located. To help us expedite this process, we are requiring that you identify the local fire inspection authority that is responsible to inspect your facility and issue a fire clearance. LOCAL FIRE INSPECTION AUTHORITY: LOS ANGELES COUNTY FIRE PREVENTION ADDRESS: 7733 GREENLEAF AVE CITY AND ZIP CODE: WHITTIER, CA 90602 PLEASE RETURN THIS FORM WITH YOUR COMPLETED APPLICATION LIC 9054(8192) .TE OF CALIFORNIA-HEALTH AND WELFARE AGENCY DEPARTMENT OF SOCIAL SERVICES LOCAL FIRE INSPECTION AUTHORITY INFORMATION DATE: REQUIRED BY THE DEPARTMENT OF APPLICANT NAME: SOCIAL SERVICES, COMMUNITY CARE LICENSING FACILITY NAME DIVISION FACILITY ADDRESS: As part of the application process, the licensing agency is responsible for obtaining a fire safety inspection from the local fire inspection authority having jurisdiction in the area where your facility is located. To help us expedite this process, we are requiring that you identify the local fire inspection authority that is responsible to inspect your facility and issue a fire clearance. LOCAL.FIRE INSPECTION AUTHORITY: ADDRESS: CITY AND ZIP CODE: PLEASE RETURN THIS FORM WITH YOUR COMPLETED APPLICATION LIC 9054(8/92) 4 CONSTRUCTION SAEETY PLAN FOR ROSEMEAD VILLA Keeping the facility and the residents safe and protected from health hazards is very important during construction. In order to ensure the safety of all the residents of Rosemead Villa, the following measures will be followed: Post workplace safety signs and labels. They are a key part of an on- going effort to promote safe practices throughout the project. Some of these safety signs are: • CONSTRUCTION AREA - KEEP OUT • CAUTION AREA UNDER CONSTRUCTION • AUTHORIZED PERSONNEL ONLY • WARNING - DO NOT ENTER. STOP These signs will be posted around the construction site before project begins. The contractor will be asked to install an interlink fence around the area All construction materials will be kept inside the fenced area. The fence must be locked after working hours. The contractor will inspect the work area at the end of the day to make sure no tools are being left unattended and unkept. Hazardous materials and debris must be disposed of in dumpsters. . Administrator and staff of Rosemead Villa will make sure that residents will not go into the work area. • + PASCASIO ENTERPRISES INC. 90-7182/3222 930 DBA:ROSEMEAD VILLA/NELVILLE • bOir , GUEST HOMES 1100 W ORANGE GROVE AVE - ARCADIA,CA 91006-1925 20_L� • PAY (626)280-4375 TO THE / .• • - 1I1 ORDER OF ,_" . AS O o DOLLARS• 8 J Morgan Chase Bank,N.A. FOR lel/ I: 3 2 2 2 7 1.E, 2 71: 0984.713 4.1-E.E!.'0930 • • • • • • 12 COMPLAINT PROCEDURES As neighborhood complaints and reports are received, the following procedures will be undertaken by the Licensee or Administrator: 1. Log the problem. 2. Call the complainant to verify and understand the problem. 3. Investigate the problem. 4. Provide the Administrator and Licensing with a copy of the report. 5. Hold a staff meeting to address the complaint. 6. Correct the problem and institute corrective measures. 7. Document the resolution and provide Licensing with a copy. 8. Call back the complainant to provide with a status. 9. Hold a neighborhood meeting on a monthly basis to monitor and learn the complaints and concerns of the neighbors. 10. Provide neighbors with a telephone number to call for future complaints. The Neighborhood Complaint Procedure is attached. Facility Program 7 ii FACILITY PROGRAM CLIENTS SERVED Rosemead Villa is an Adult Residential Facility for ambulatory adults, male or female, regardless of race, creed. and religion who are mentally disabled. . Their ages range from 18-59 years old. . These clients may be diagnosed with schizophrenia, depression, anxiety and other mental disabilities. In all cases, the Administrator will evaluate the clients prior to admission and conditions reviewed on a case-by-case basis. FACILITY ENVIRONMENT: The facility is located at 9025 Guess St. Rosemead, CA 91770. a nice residential area in the City of Rosemead. It is bounded on the east by Hart St/ and Rosemead Blvd on the west. It has two buildings: Building A with 7 bedrooms and 2 bathrooms and an adjoining Reception Rcom currently being utilized as a Recreation and TV Room. Every effort will be made to make this facility as home-like for the clients as possible. B7. FACILITY PROGRAM Rosemead Villa is an Adult Residential Facility for ambulatory adults, male or female, who are mentally disabled whose ages range between 18-59 years old. It is established in order to provide the best practices in training techniques to allow future clients to achieve greater independence, normalization and community integration. In addition, it is established in order to: 1. Provide a 24-hour non-medical client care and supervision. 2. Deliver quality of care and assistance. • Ensure that the Clients are kept comfortable, clean and protected from accidents. • Provide good Client nutrition. • Provide assistance in taking medications. • Recognize early signs of illness and provide the need for professional assistance. 3. To provide direction and rehabilitation services to clients with I mental, social, emotional and functional capabilities. 5. To offer recreational and occupational therapy for the clients in order to • Improve concentration • Organize thoughts • Peactice making decisions • Improve problem solving capabilities • Experience success • Feel productive • Socialize • Be creative • Have fun 4. To serve as al alternative solution to hospitalization 5. To instill in the minds of the clients the spirit of self-reliance and improve their self-esteem to help them prepare to live independently and be released from welfare dependency and other means of public support , 2 SERVICES PROVIDED: Lodging Private and semi-private rooms with a total bed capacity of twenty-two (22). The basic rate of service is as follows: $1003 for a single SSI recipient and $1023 for a combined SSI and Social Security recipient. Physical Structure The facility must be clean and safe at all times. A maximum of two clients will be placed in a room. Each room must be well lighted and equipped with the following: 2 night stand 2 lamps 2 drawers 2 chairs closet comfortable beds The temperature must be no more than 80 degrees and no less than 68 degrees. Electric fans will be provided in each room. Staff will have his/her own bedroom. The bathrooms should have a wash basin, shower or tub, sink and toilet. The toilets must have toilet papers and paper towels at all times. The kitchen will be equipped with two refrigerators and three freezers. It will be opened at meal times and will be accessible to the clients at night. A cold water fountain will be available in the covered patio for easy reach. Cold soda machine will also be available. 3 Food Services Three full meals and two snacks will be served per day. BREAKFAST, LUNCH and DINNER. An afternoon and evening snack will be provided. Mealtimes will be extended from a regular one hour to two hours. Other client needs for food and drinks at night will be handled by the Night Person. Breakfast 7:00 to 8:00 a.m. 8:00 to 9:00 a.m. Lunch 11:30 a.m. to 12:30p.m. 12:30 to 1:30 p.m. Afternoon Snack 3:00 to 3:30 p.m. Dinner 5:00 to 6:00 p.m. 6:00 to 7:00 p.m. Evening Snack 8:00 p.m. Laundry Services Laundry services will be done once a week or often if needed by the client and will be scheduled as follows: Clients # 1,2,3, and 4 Monday Clients # 5,6, 7, and 8 Tuesday Clients # 9,10,11, and 12 Wednesday Clients # 13,14,15, and 16 Thursday Clients # 17,18,19 and 20 Friday Clients # 21, 22 Saturday Laundry will be supervised. Residents will be encouraged to wash, fold, and stack their own laundry, but if they cannot do it, the staff will assist. . 4 Cleaning Services Client's rooms will be cleaned three times a week. The Clients will be encouraged to clean their own rooms except if they have physical disabilities that will prevent them to do so. Other areas in the facility such as bathrooms, kitchen and dining areas will be cleaned daily or often if needed. Gardening will be done once a week. Linen Distribution Fresh linens will be distributed once a week or more often if required. The Clients will be encouraged to change their own linens except when they have physical disabilities that will prevent them to do so. Transportation The facility will plan, arrange and/or provide transportation to medical and dental appointments. Transportation will also be provided to take clients to picnics, outings, sporting events,movie theaters, and other amusements. Clients will be encouraged to take public transportation for their personal appointments. TYPE OF VEHICLE SEATING CAPACITY 1998 Dodge Caravan 15 1998 Toyota Sienna Van 7 2005 Honda Odyssey 7 The above vehicles are safety checked once every three months. wilmse 5 1 Notification to family and other appropriate person/agency of client/resident's needs. Close communication with the client's family and other appropriate/agency will be done to ensure that Client's needs are met. 6 Other Services Provided 1. The staff at Rosemead Villa will provide continuous observation, care and supervision. Bedside care as needed for minor temporary illness will also be provided. Client's medical and psychiatric conditions will be closely monitored. The facility will have its own medical physician to do routine medical examinations, required immunizations, and yearly physical and medical examinations, and a house psychiatrist to evaluate behaviors and psychiatric conditions. The primary care physician will do a bi-monthly follow up visits. The psychiatrist will do a monthly follow up or often as needed. The Clients will be given a yearly physical and medical examination. If during their stay at Rosemead Villa the clients develop complications that would require hospitalization, the Administrator will arrange for their immediate hospitalization. Client's representative will be notified. 2. Medical and dental appointments will be scheduled. A once every six month dental cleaning will be scheduled for each Client if their dental coverage will permit. 3. Laboratory work will be scheduled as ordered by the physician. Clients who are on medications that would require weekly or monthly blood work will be coordinated and handled at the facility. Results of the lab work will be sent to the ordering physician, primary care MD, and psychiatrist for evaluation. Changes in medications will be sent to the Pharmacy. Same day delivery of medications will be encouraged. 4. Consent for Treatment will be completed and signed by each client at Rosemead Villa. Should a client refuse any medical or psychiatric appointment, his/her rights shall not be violated,however, his/her family will be notified and the chart will indicate REFUSAL. 5. A record for each Client will be maintained. Every doctor's visits will be documented and so with any changes in the client's medical and psychiatric condition will be tracked. 7 Emergency Situation: Rosemead Villa will seek the assistance of the following agencies during a crisis: • Mental Health Crisis Team of LA County Mental Health • Temple City Police Department • Mobile Assessment Team of Silver lake Medical Center and Mission Community Hospital. During a medical emergency, the Administrator or the Caretaker will call the Paramedics (911), to handle life and death situations; otherwise, the Administrator or the Caretaker will bring the Client to the nearest hospital emergency room. 8 MEDICATION PROCEDURES Assistance in providing medications will be provided. Medication compliance is required at Rosemead Villa Medications will be administered as prescribed by the physician and will be logged in the Monthly Medication Record form . The following codes will be used in the medication record form: R = REFUSED D/C = DISCONTINUED H = HOME D/P = DAY PROGRAM 0 = ORDERED NP = NOT PRESENT All medications will be kept in a locked area. Those medications that require refrigeration will also be kept in a locked container and stored in the refrigerator. Medications will be properly labeled with the client's name. Over the counter medication will only be given upon the doctor's orders. A written approval stating that the client is capable of requesting over-the-counter medications will be requested from the physicians and the physicians will list in detail, the approved over-the-counter medications that the clients can take. These documents will be filed in client's file. All PRN medications will be logged in the PRN Medication Form (Exhibit 2) stating the client's name, medication name, dosage, reason for the medication and results. Before the staff gives the medication, he/she will do the following procedures: 1. Wash hands with soap and water. 2. Put on the gloves. 3. Use the 5 rights: Always check for the Right Person, Right Medication, Right Dose, Right Time and Right Route before giving the medications. 4. Initial the Medication Record Administration form (Exhibit 3) immediately after the medications are given. Y 9 Medication refills will be handled in a timely manner. A medication refill cycle of once every three weeks will be established. Newly delivered refills have to be checked against medication record form for errors. Medication errors will be reported to the physician as soon as possible. Any change in the medication dosage shall be reported to the Pharmacist to get a new prescription label. Any change and unused client's medication will be properly documented in LIC 622, Centrally Stored Medication and Destruction Record Form, (Exhibit 4). The Medication Administration Record will be used to log daily medications administered to the clients. All unused medication will be logged and destroyed within two days. Any errors in a client's medication shall be reported to the physician. Pharmacist will be called for any change in the medication dosage to request for a new label. When a client goes home on week-ends, give the bubble pack to the client representative, or whoever picks up the client. Also request the pharmacy early enough to create bubble packs good for the number of days the client will be gone. Direct Care Staff will marked the medication record administration form as "H=Home". When the client returns to the facility, it is the duty of the caretaker to check on the bubble packs to make sure that they are all taken. a . 10 ACTIVITY PROGRAM In an effort to provide a well balanced set of activities, Rosemead Villa will provide recreational and occupational activities to the residents. A planned activity program will be followed (a weekly activity schedule is attached). The Administrator being a certified Activity Director will plan the activities of the clients and will delegate the responsibility to the staff for implementation. Movement • Exercise (includes walking, exercise bike) • Play ping-pong, air hockey, pool, etc. Occupational • Constructive crafts, such as, woodworking for men • Arts and crafts for women, such as crocheting, knitting, and possibly sewing. Outside resources will be solicited. • Gardening Health Education Residents will be taught personal hygiene and grooming, and how to eat a well- balanced meal. Basic Skills Teach residents how to: • Budget money • Balance checkbook • Fix beds, change linens, clean their rooms and do their laundry Leisure • Indoor movies • Games, such as, table chess, cards,bingo and scrabble 11 OUTDOOR ACTIVITIES • Trip to the mall, park,beach, and other places of interest, such as, Santa Anita Mall, Rosemead Library, Descants Gardens • Once a year trip to Disneyland and Universal Studios. CLIENT REHABILITATION Clients will be encouraged to attend one of the following programs if needed: • Partial Day Hospitalization Program • Vocational Rehabilitation OTHER RESOURCES Rosemead Villa will utilize resources both state and local. There will be a house medical physician who will come once a month in the facility to check all clients or often as needed. A house psychiatrist will also come once a month or often to follow-up old clients and assess new ones. A clinical psychologist will conduct therapy sessions on individual clients who need the therapy. A podiatrist will come once every 2 months to service the clients. If needed,help from other resources, such as, home health nurse, physical therapist and occupational therapist will be solicited. HOURS OF OPERATION The hours of operation are Monday to Sunday from 0000-2400 hours. ( — — .J N C A: O O O 3 O sw O O --1 O 3 rn ID c 3 E 0 O O a O O T (n C O A; a lw Iv . n r- r9 z —1 � Q. _ O n low ,e ° w O. - - e eD —I a 0 _0 v mo = o cra fw 9 . < I ' O O - I -3 c c a r!1 co U0. U0. O 9 O n G� 0 O C o 0 r+ C eeD © e 9 .5' S AN et, a S n A; F" - 'Ft et o v c n co O -5 sw S' C, co -5 r a — -5 ee Vi S Re CD 5 f 7 c5 w . ( 0 7 & o % k k k x \ w 7 ƒ ¥ 7 o o - 'F |s R ) 2 ) § 9 / 3 z E E = = 2 a 2 2 : ¥ / S. � 2- 2 0. 0 = 1>v c <-< c< 7 cc nn « m 0 0' « 70 z- n c = z 1 rm = E % § ; § % $ 2 © c n a 2 % = C 9. A E _ e § r , © % - k 2 a ■ T p = 14 NURSE CALL COMMUNICATION SYSTEM A communication system will be installed at the facility to monitor incoming emergency calls. This system provides for audible and visual call indication without the use of intercom communication. There are 12 push-button emergency stations installed in each room and 4 nylon cord emergency stations installed in each bathroom. The system will allow residents to push a button or pull a string whenever there is an emergency. This will activate the control panel and will create audible signals and indicator lights that will signal the presence of emergency calls. There are a total of two duty stations. One duty station is installed in the Recreation Room and the other is located in the office. These stations provide an indication of incoming calls in work areas away from the Control Station. COMMUNITY RESOURCES The facility is very close to shopping centers such as the Rosemead Square (a shopping mall), Church, Rosemead Library, Grocery Stores, Restaurants, Donut Shops, Ice Cream Parlors and various eating places and fast food chains. The Community Resources List is attached. ADMISSION POLICIES PRE-PLACEMENT APPRAISAL Prior to admission, a pre-placement appraisal is done to a prospective client. The Administrator of Rosemead Villa will conduct the assessment and will make the determination of whether to accept or deny the admission. A Pre-placement Interview Form (Exhibit 5) will be used to record the Client's information. There are several ways by which this assessment is done: First, is to request a referral packet from the referring agency. Second, interview the social worker, referring agency or client representative. Third. have the assessment done by the medical or mental health provider. Last, interview the client. If the client is in the hospital, review the file with the attending physician or any mental health provider who knows the history of the client. The purpose of the interview is to determine the following: 1. General health of the client 2. Physical disabilities or any statement of the client's ambulatory or non- ambulatory status. 3. Mental condition 4. Health history, prior hospitalizations, major illnesses, history and exposure to tuberculosis and prescribed medications 5. Client's needs and services, such as, special dietary requirements and functional capabilities... 6. Other disabilities, such as, impaired vision, hearing loss, etc. Any known information pertaining to client's likes or dislikes, abilities, interests and activities Other information that can be gathered is: 1. Any known history of aggressive or dangerous behavior towards self or others. 2. Any history of alcohol and drug use. 3. Any known conviction of a misdemeanor or felony involving a crime of violation or any sexual offense 4. Demographic information of the client including telephone and address of his/her authorized representative 5. History of violence, physical assault or abusive behavior at a previous residential care facility. 6. Information related to the client's authorized representative, the level of support that he/she provides to the client. The Pre-placement Appraisal is also necessary to determine the appropriateness and the compatibility of the new client to the other residents. Compatibility is established when the client's age factor is similar and the mental and emotional needs are similar. The Administrator of Rosemead Villa will review this information and other documents forwarded by the referring agency in order to determine if the facility can meet the needs of the client. Once this is determined, the Administrator will arrange for a pre-admission visit. The purpose of the pre-admission visits is to determine the suitability of the facility as a living environment. The Administrator of Rosemead Villa will be available to discuss the facility and its services and will determine if the facility can meet the service needs of the consumer. An agreement regarding the date and time of admission will be established. ADMISSIONS Once the Client is accepted for admission, the Admissions Agreement Form, LIC 604 (Exhibit 6) is completed and discussed with the Client and his/her representative. The information such as, services to be provided, rent, refund policy, house rules, personal rights, how the personal and incidental monies of the clients will be disbursed and recorded, and other information pertaining to the admission are discussed. A date and time of admission is then established by the Administrator and client's representative. Within 30 days after admission, a medical assessment will be conducted on every client. A TB test will also be administered to make sure that the client does not have any communicable diseases PERSONAL RIGHTS The prospective client must be advised of his personal rights. Client needs to sign and date the Personal Rights Form, LIC 613 (Exhibit 7). CLIENT PERSONAL VALUABLES Client's personal belongings and valuables will be inventoried upon admission, transfer and discharge. It will also be inventoried after one year of residency at the facility. Upon admission, inventory of client's personal belongings will be logged on the Client Personal Valuables Form, LIC 621 (Exhibit 8) and signed by the Caretaker and the Client. The same form will be updated when doing the first year inventory. The same procedure will be followed when a Client is transferred or discharged. The facility will only be responsible for the loss of the inventoried items. THEFT AND LOSS PLAN The Client Representative will be oriented to the theft and loss policy and procedures of the facility. A detailed Theft and Loss Plan (Exhibit 9). A copy will be posted in the bulletin board. The Administrator of Rosemead Villa will be responsible for disseminating this policy to the staff. APPRAISAL OF CLIENT'S NEEDS AND SERVICES PLAN As part of the pre-placement interview is the Client's assessment. During this assessment, the needs of the prospective client are assessed. The purpose of this assessment is To determine the type of care and assistance that the prospective client would require To determine if the facility can meet these needs; and, To ensure that the staff can handle the needs of the client. An Appraisal and Services Plan (Exhibit 10) is completed if possible upon admission, or 14 days following the admission. The needs, appraisal and individual program plan of the prospective client are discussed. The facility will work out a plan to implement these needs. UNUSUAL INCIDENTS OR INJURIES Special incidents will be reported by the Administrator or Direct Care Staff to licensing at the time the incident happened by using Licensing Report Form 624 (Exhibit 11). The original copy of this form will be sent to Community Care Licensing within 7 days, one copy will be sent to the referring agency and another copy will be attached to the client's file. The incident or injury will be called in to Licensing by the next working day. If unsure whether an incident needs to be reported, Licensee/Administrator will call the Licensing Evaluator for verification. Client activities will be documented in the Log Book on a daily basis. RATE SETTING AND REFUND POLICY A written thirty (30) day notice is required by the management of Rosemead Villa for the following: discharge transfer to another Board & Care Facility A written withdrawal letter is required also if the Client decides to withdraw the 30-day notice. The notice and the withdrawal letters must be properly signed and dated. Money will be refunded to the Client if a 30-day notice is received. Example # 1. If a Client gave a 30-day notice on December 15, 2001, paid the full rent in January 2002, and left on January 14, 2002. The Client will get a refund from January 15 up to January 31, 2002 the same refund will be given if the client decides to leave before January 14, 2002. Example # 2 If a client gave a 30-day notice on January 1, 2002 and paid a full rent in January, left the facility on January 20, he is not entitled to a refund. If the Client goes to the hospital for medical emergency and the facility is holding the bed (assuming that the client will return to the facility), no refund will be given. If the Client is placed in another Board and Care facility without any thirty day notice, no refund will be given. However, if the Client is discharged and transferred to another board and care with prior approval from Licensee, a refund will be given. Refund will be calculated from the date placement was made in another facility. Rent will be prorated on a daily basis multiplied by the number of days the Client is at the facility. The Client will be charged only for the portion of the month he/she stayed at the facility. CLIENT CASH RESOURCES Client funds shall be recorded using LIC 405 - Client Cash Resources Form (Exhibit 12). This form will be used to log all the monies received and the expenditures and withdrawals the client makes. Client and the facility representative will sign the form. The facility will manage the cash resources of the clients. However, the client's representative may decide how the funds will be handled and spent. Clients who have accrued savings shall receive a full refund of their money upon termination of their residency. Purchases for a client must be documented with receipts properly identified with the client's name and placed in an envelope. This envelope will be filed in his personal folder. MONEY DISTRIBUTION POLICY: Rosemead Villa will follow the following money management procedures for the Clients. The facility will maintain a Ledger to show the flow of the Client's P & I monies. All monies spent for the clients will be documented with receipts. Receipts will be given as rent payments are made. The facility will not lend any money to the Clients. SIGN IN AND SIGN OUT POLICY Each Client or his representative will be required to sign in and out of the facility. A log will be available that will indicate the date and time of departure, name of the client, destination, and expected date and time of return. In addition, all visitors to the facility will also be required to sign in and out. ( EVICTION POLICY The Licensee or Administrator of Rosemead Villa may, upon giving a thirty (30) day notice to the client, evict the client for one of the following reasons: 1. non-payment of the rate for basic services 2. illegal possession of drugs or alcohol 3. If the Client has a behavior which threatens the safety of other Clients. 4. combative and assaultive behavior, property destruction, such as, breaking windows and doors and throwing objects 5. destructive to the next door neighbors. 6. Non-compliance to the House Rules, such as, smoking inside the house and use of street drugs or marijuana. 7. The facility cannot meet the client's needs. Depending upon the violation, a client may be given three subsequent warnings before evicting. However, if the client's behavior threatens the safety of other clients, the eviction will be immediate. Licensee will request approval from Licensing for a 3-day notice and will be coordinated to the referring agency. PHONE POLICY Local calls will be given free to the clients. Toll calls will be paid. VISITING POLICY Visiting hours are Monday to Sunday, from 9:00 a.m. to 8:00 p.m. Immediate family members (mother, father, sister, brother, husband or wife) can visit at anytime. The staff needs to be notified whenever a visitor enters a client's room. Residents will be encouraged to receive and entertain visitors in the Reception Room. � r Parking Policy Facility is located in a residential area with ample parking and no street parking restrictions. Facility currently has 7 parking spaces that can adequately serve visitors on a daily basis. In addition, facility has a driveway that can occupy additional 2 vehicles. There is also additional street parking in front of the facility for 3 more vehicles. Facility's neighbors utilize their driveways for personal vehicle parking. There is ample neighborhood street parking for visitors. Zosimo Pascasio Administrator Telephone (626) 639-4354 IDENTIFICATION AND REPORTING OF CLIENT ABUSE The staff at Rosemead Villa will be trained to identify abuse and neglect of clients. The staff must report physical abuse under the following circumstances: 1. When the staff has observed an incident that reasonably appears to be physical abuse. 2. When the staff has observed physical injury where the nature of the injury, its location on the body, or the repetition of the injury clearly indicates that physical abuse has occurred. Abuse must be reported immediately by phone and must be followed by a written report within two days to the following agencies: • Licensing • Regional Center • Ombudsman • Adult Protective Services and, if needed, • Law Enforcement Agency The report must include the following: 1. Name of the person making the report. 2. Name, age, and present location of the dependent adult. 3. Name and addresses of family members or other persons responsible of the dependent adult's care, if known. 4. The nature and extent of the person's condition. 5. Any information that led the informant to suspect that abuse has occurred. 6. Date of the incident. OVERVIEW Rosemead Villa as the service provider, will be responsible for the clients 24 hours a day, seven days a week. A staff person must always be present at the facility when clients are present. When the care provider is absent from the facility, a competent adult must be left in-charge. This person must be familiar with the clients and must be provided with all the necessary information and procedures in case of emergency. There must be, at all times, a staff person on duty who can communicate in English and to be able to handle with competency any situation that may arise. particularly those that would require interaction with agencies, such as, Regional Center, Police. Fire Department, and others. The Administrator of Rosemead Villa will be responsible for the selection and hiring of personnel to work in the facility. Rosemead Villa is an equal opportunity employer where employees could be hired regardless of race, color, and creed provided they possess the necessary qualifications to do the job. The factors to be considered in assessing staffing needs are: • Type of clients to be serviced. • Extent of the services provided by the facility. • Physical arrangements of the facility. • Existence of a state of emergency or disaster. The facility will be permitted to utilize volunteers provided that such volunteers meet the qualifications and they are supervised and not included in the facility staff plan. The staff at Rosemead Villa must be at least 18 years or older - Physically, mentally and occupationally capable of performing assigned tasks. Have a good command of English language. Possess knowledge of or shall have related experience in the following areas: • Principles of nutrition, food preparation and storage. • Housekeeping and sanitation principles • Provision of client care and supervision including communication. • Assistance with prescribed medications • Recognition of early signs of illness and the need for professional assistance. Have a knowledge of the available community services and resources. Must undergo a health screening and a TB test performed by or under the supervision of a physician prior to employment. If an employee has prior health screening report, it must not be more than one year prior to the current 7 employment. For a new employee, health screening must be performed within seven days after employment. The Health Screening Report must be signed by the person performing such screening and shall indicate the following: • Person's physical qualifications to perform the duties to be assigned. • Presence of any health condition that would create a hazard to the person. • Evidence of physical illness that poses a threat to the health and safety of clients. Each employee's fingerprint must be livescanned for any criminal record or offense. He/She could also be fingerprinted. Fingerprint cards must be submitted for clearance to: Department of Justice Bureau of Criminal Investigation Centralized Fingerprint Unit Box 903417 Sacramento, CA 94203 Information regarding any prior convictions of a crime with the exception of any minor traffic violations as specified in Section 80019(F), shall be acknowledged and that his/her continued employment is conditioned on approval of the licensing agency. Personnel with evidence of any criminal history or any minor offense shall be relieved of their duties. Pending receipt of a criminal record statement as specified in Section 80019, and prior to employment or at initial presence in the facility, all employees and volunteers are required to sign a statement under penalty of perjury on a form provided by the Department which contains the following: A declaration that he/she has not been convicted of a crime Other than a minor traffic violation as specified in Section 80019(F). Each employee must pass the Direct Care Support challenge test. 8 R. B2. ADMINISTRATOR'S QUALIFICATIONS ZOSIMO A. PASCASIO The above named administrator of Rosemead Villa is a Doctor of Veterinary Medicine graduate from the University of the Philippines He has been the Administrator of Rosemead Villa since 2001. Zosimo Pascasio has completed the following training: • Orientation for Adult Residential Facility (certificate of completion is attached. • First Aid & CPR Training • Residential Services Specialist Training Course from Frank Lanterman Regional Center.. • HIV and TB class. • Administrator Certificate Program for Adult Residential Facility (certificate is attached). • Direct Support Professional I and II JOB DESCRIPTION Rosemead Villa will have a full-time experienced Administrator who is in good physical and mental health, of good moral character and capable of making mature judgments. He/She must possess the experience necessary to operate and manage a residential services for persons with mental disabilities The Administrator will provide over-all supervision to the direct care staff and others. The Administrator shall maintain his membership in professional organizations and must provide for his continuing education by attending workshops related to the supervision and special services to persons with mental disabilities. The Administrator of Rosemead Villa will have the following duties and responsibilities: 1. Over-all management of the clients services as described in the program design. 2. Promotion of client's rights, health, safety and social and physical integration. 3. Writes policies and procedures that will include provisions for staff development; and client's health, privacy and property. 4. Maintains accurate client's records by documenting client's cash resources, health status, notification of client's attending physician and other responsible persons. 5. Possess knowledge of the requirements for providing the type of care and supervision needed by the Clients including the ability to communicate with the Clients. 6. Responsible for managing the financial resources of the organization. She is expected to operate the facility both efficiently and effectively. 7. Possess special leadership, interest and concern for people, a leadership capable of change and an organizing expertise. 8 Possess knowledge of and the ability to comply with applicable laws and regulations. 9 Provide transportation for Clients as needed. 10 Order medication from Pharmacy as required. 9 11 Inspect facility interior and exterior repairs and maintenance on a daily basis. 12 Conduct monthly staff meetings to include discussions of staff problems with clients. The Administrator will also become the Facility Safety Coordinator who will ensure that the provisions of the Disaster Preparedness Plan are strictly followed in the event of a Disaster. Qualifications: Minimum 2 years of college education and 1 year experience working in an adult residential facility for mentally disabled. Must complete and pass the 35-hours Adult Residential Facility Administrator Training and Certification. Must have a fingerprint clearance, TB test, health screening report and volunteer statement or a statement of prior criminal convictions prior to hire. 10 DIRECT CARE STAFF The Direct Care Staff will work under the supervision of the Administrator of Rosemead Villa. He/She will have the following duties and responsibilities: Provides client care and supervision including communication. Ensures that each client receives proper care, diets and medication. Delivers quality of care. Ensures that clients are kept comfortable, clean and protected from accidents, injury and infection. Provides help in transferring in and out of bed and dressing.if needed Help with bathing,hair care and personal hygiene if needed. Help with eating. Help with toileting if necessary. Help in participating in activity programs. Recognize early signs of Client's illness and the need for professional assistance. Responsible for the Client's nutrition. Ensure that foods are to be kept properly prepared,attractively served at proper temperatures. Must practice hygiene in food handling techniques. Administers First Aid and CPR if needed. Provide sufficient housekeeping to maintain a safe, clean, and orderly interior. Changes linens and maintains a facility free from insects and rodents through a pest control program. Provide an on-going program of meaningful activities appropriate to the needs and interests of clients in order to promote opportunities to engage normal pursuits. Suggest and supervise clients personal and incidental expenses. 11 ( Provide other duties as may be required by the Administrator. Qualifications: • Must be at least a high school graduate. • Must have worked at least six months in an Adult Residential Facility for elderly or developmentally disabled. • Must pass the Direct Support Professional (DSP) challenge test. • Must possess good oral and written communication skills. • Good organizational skills. • Sensitivity to the well being of clients. • Employment is contingent upon the successful completion of the following: Medical examination and health screening which may include drug and alcohol screening. • TB test • First Aid Training • Fingerprint clearance • Statement of prior criminal convictions. 12 (/ 1 1 NIGHT PERSON The Night Person will have the following duties and responsibilities: 1. Makes hourly head counts and log counts in a logbook. Determine missing clients. 2. Provides client care and supervision at night in the evening. Provide the necessary assistance to the clients when needed. 3. Monitors the clients by making rounds; check clients in their rooms to ensure that clients are asleep. 4. Guards and patrols the compound to ensure safety of clients. 5. Must be able to handle emergency situations which may arise particularly those that would require interaction with other agencies, such as, Police, Fire, { Crisis Team, etc. 6. Documents incident reports. 7. Handle correctly and document resident behavior pattern. 8. Provide housekeeping services, such as cleaning the kitchen, floors, walls and bathrooms routinely when required. 9. Notifies Licensee or Administrator in case of an emergency. The Night Person will be fully awake and alert at all times. He/She will work under the supervision of the Administrator. QUALIFICATIONS 1. Good oral and written communications skill. 2. Minimum high school diploma 3. Must have at least six months working experience in a mentally disabled facility. t. 44 f QUALIFICATIONS (Continued) 4. Must have a fingerprint clearance, statement of prior criminal convictions, TB clearance,First Aid clearance, physical examination and health screening report as a condition of the initial and continued employment at the facility. PERSONNEL POLICIES The staff of Rosemead Villa must be competent enough to provide the services necessary to meet individual client needs and shall, at all times, be employed in numbers necessary to meet such needs. Staff must possess these qualifications: - 18 years or older. - physically, mentally, and occupationally fit to perform the task - have a good command of English language. Licensee shall be permitted to utilize volunteers provided that such volunteers are supervised, and not included in the facility staff plan. Licensee shall provide for direct supervision of clients during participation in or presence at potentially dangerous activities or areas in the facility, such as, swimming pools. An adult other than a client shall be present at all times while clients are using a pool or other body of water in which rescue requires the ability of rescuer to swim. An adult who supervises while clients are using a pool of water from which rescue requires the rescuer's ability to swim, shall have a valid water safety certificate. All personnel shall be given on the job training or shall have related experience which provides knowledge of and skill in the following areas, as appropriate to the job assigned and as evidenced by safe and effective job performance. Training includes the following: • Principles of nutrition, food preparation and storage and menu planning. • Housekeeping and sanitation principles • Provision of client care and supervision, including communication • Assistance with administration of prescribed medications. • Recognition of early signs of illness and the need for professional assistance. • Availability of community services and resources. 16 ( All personnel, including the Licensee, Administrator and Volunteers shall be in good health, and shall be physically, mentally and occupationally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a TB test performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. A health screening report signed by the person performing such screening shall be made on each person specified above and shall indicate the following: • person's physical qualifications to perform the duties to be assigned • presence of any health condition that would create a hazard to the person, clients or other staff members. The good physical health of each volunteer who works in the facility shall be verified by: • statement signed by each volunteer affirming that he/she is in good health. • test for tuberculosis performed not more than one year prior to or seven days after initial presence at the facility. 9.. Personnel with evidence of physical illness that poses a threat to the health and safety of clients shall be relieved of their duties. 10. Pending receipt of a criminal record transcript as specified in Section 80019, and prior to employment or at initial presence in the facility, all employees and volunteers determined by the licensing agency to require criminal record clearance shall sign a statement under penalty of perjury, form provided by the Department, which contains either of the following A declaration that he/she has not been convicted of a crime, other than a minor traffic violation as specified in Section 80019(F). All personnel shall be required to have fingerprint clearance to be turned in to the - Department of Justice Bureau of Criminal Investigation Centralized Fingerprint Unit Box 903417 Sacramento, CA 94203 17 11. Information regarding any prior convictions of a crime, with the exception of any minor traffic violations as specified in Section 80019(F). If a person has been convicted of a crime other than a minor traffic violation as specified in Section 80019, he or she shall also acknowledge that his/her continued employment is conditioned on approval of the Licensing Agency. 12. Clients shall not be used as substitutes for required staff but shall be permitted as a voluntary part of their program of activities, to participate in household duties and other tasks suited to the client's needs and abilities. Such duties and tasks shall be specified in the clients needs and services plan as specified in Chapters 4, 5 and 6. 13. When regular staff members are absent, there shall be coverage by personnel capable of performing assigned tasks as evidenced by the on- the-job performance. 14. Personnel shall provide for the care and safety of persons without physical or verbal abuse, exploitation or prejudice. 15. All personnel shall be instructed to report observations or evidence of violations of any of the personal rights specified in Section 80072 and/or any of the personal rights provisions of Chapters 2 through 7. 16 All personnel shall be instructed to report any unusual incident or client abuse which threatens the physical or emotional health or safety of any client. Upon the occurrence of such abuse during the operation of the facility, a report shall be made to the licensing agency within the next working day during the agency's normal business hours. Within seven days, the staff shall submit to the licensing agency a written report containing the information pertinent to the client abuse. .17 Each employee will be informed about the Employee Rights and the right to be protected by Federal, State and Labor laws. 18 As a condition of the initial and continued employment at Rosemead Villa , all employees will be required to submit to random drug testing a maximum of two times per year, unless the Administrator of the facility determines the need for more frequent testing. All new applicants will be required to go through a pre-employment drug screening prior to start of work unless waived by the Administrator of the facility. The results of the tests will be kept confidential. 19 Personnel shall provide for the care and safety of persons without physical or verbal abuse, exploitation or prejudice. 18 20 Each employee will be instructed to report observations or evidence of violations of any of the personal rights specified in Section 80072 and/or any of the personal rights provisions of Chapters 2 through 7. 21 The Licensee shall be permitted to utilize volunteers provided that such volunteers are supervised and not included in the facility staff plan. If personnel shall be given on-the-job training on the areas related to their work assignment and any task appropriate to the operation of the facility 22 A complete personnel file must consist of the following: • Personnel Application • Completed Health Screening Report • Signed Employee Rights • Completed and signed Criminal Record Statement Form • Fingerprint Clearance • Signed Personnel Policy and Procedure 19 Week End Reliever The Week End Reliever will have the same duties and responsibilities as the Direct Care Staff. He/She will work under under the supervision of the Administrator of Rosemead Villa.. He/She will have the following duties and responsibilities: 1. Provides client care and supervision including communication 2. Ensures that each client receives proper care, diets and medication. 3. Delivers quality of care. 4. Ensures that clients are kept comfortable,clean and protected from accidents, injury and infection 5. Provides help in transferring in and out of bed and dressing if needed. 6. Help with bathing, hair care and personal hygiene if needed. 7. Help with eating. if needed 8. Help with toileting if necessary. 9. Help in participating in activity programs 10. Recognize early signs of Client's illness and the need for professional assistance 11. Responsible for the Client's nutrition. Ensure that foods are to be kept properly prepared, attractively served at proper temperatures. Must practice hygiene in food handling techniques. 12. Provide sufficient housekeeping to maintain a safe,clean, and orderly interior. Changes linens and maintains a facility free from insects and rodents through a pest control program. 13. Administers First Aid and CPR if needed. 13 14. Provide a program of meaningful activities appropriate to the needs and interests of patients. 15. Suggest and supervise clients personal and incidental expenses 16. Provide other duties as may be required by the Administrator. Qualifications: • Must be at least a high school graduate. • Must have worked at least six months in an Adult Residential Facility for developmentally disabled. • Must pass the DSP challenge test. • Must possess good oral and written communication skills. • Must have familiarity with the needs of developmentally disabled clients. • Awareness of human growth and development. • Good organizational skills. • Sensitivity to the well being of clients. • Employment is contingent upon the successful completion of the following: Medical examination and health screening which may include drug and alcohol screening. • TB test • First Aid Training • Fingerprint clearance • Statement of prior criminal convictions. 14 B6. INSERVICE TRAINING FOR STAFF 20 { INSERVICE TRAINING The Administrator of Rosemead Villa will assume the responsibility for providing a planned in-service training for the staff. In addition, a continuing in-service education program shall be provided once every three months to the staff. Training opportunities will be offered both in the facility and in the community. On-the-job training will include the following: • Principles of nutrition, food preparation and storage. • Housekeeping and sanitation principles. • How to provide good client care and supervision including communication. • Dispensing of client's prescribed medications and charting. • How to recognize early signs of illness and the need for professional assistance. Other subjects to be covered are: • Health and emergency procedures including fire safety • Identification and reporting of unusual incident or injury • Facility's program design. • Identification and reporting of client abuse, if there's any. • Documentation and record keeping. Direct Care Staff will take continuing education as they relate to planning and implementation of residential services for persons with developmental disabilities. In order to be able to handle clients with mental disabilities, the staff development program will be specific to mental disabilities. For example, for clients with any history of aggression and mental disabilities, training of staff personnel shall be specific to behavioral management techniques. Staff personnel will also attend the following training in : • First Aid • CPR • Disaster Recovery and Preparedness Training will be documented in a form (Exhibit 1) which includes the date and time of training, topic, and instructor and will be kept in the Personnel File. A proposed training plan will be prepared for the staff. 21 INSERVICE TRAINING The Administrator of Rosemead Villa will assume the responsibility for providing a planned in-service training for the staff. In addition, a continuing in-service education program shall be provided once every three months to the staff. Training opportunities will be offered both in the facility and in the community. On-the-job training will include the following: • Principles of nutrition, food preparation and storage. • Housekeeping and sanitation principles. • How to provide good client care and supervision including communication. • Dispensing of client's prescribed medications and charting. • How to recognize early signs of illness and the need for professional assistance. Other subjects to be covered are: • Health and emergency procedures including fire safety • Identification and reporting of unusual incident or injury • Facility's program design. • Identification and reporting of client abuse, if there's any. • Documentation and record keeping. Direct Care Staff will take continuing education as they relate to planning and implementation of residential services for persons with developmental disabilities. In order to be able to handle clients with mental disabilities, the staff development program will be specific to mental disabilities. For example, for clients with any history of aggression and mental disabilities, training of staff personnel shall be specific to behavioral management techniques. Staff personnel will also attend the following training in : • First Aid • CPR • Disaster Recovery and Preparedness Training will be documented in a form which includes the date and time of training, topic, and instructor and will be kept in the Personnel File. A proposed training plan will be prepared for the staff. 21 Resident Concerns • • .. . • ...if:1 Osi . . . . city of IlloS0m9ad golahnini Division , • Fending Plan Example STRET NAME • REQUIRED INFORMATION 4FOOTI4AXIMUM owNEg ZS/rlyo Pry S6.is.,o •-\-- x .�or�. .L_ „...e." c9. W c • ,Q PNDNFC Crn.7G JoLf'acr--.4.g7r_ O I f- FRQNT YARD TYPE OFFENCE/WNL•iL_ ‘.1.-'4144- N .•I; I DEBCRPTION OF EXISTING FENCE/WAIL • I . i /r/UVa�iV F6.t��C I • EXISTING TYPE OF LOT -I HOUSE TOTAL UNEAR FEET OF FENCE,WA1J172 O' / • I` t 1 REPORT OF FENCE 1WAW 2 �� .I < TOTAL SQUARE FOOTAGE• cOSEIX • I: CO • W amours eIONA �� • In 2 DATE:�I`4� 7/7 • S 70'—Oa I r c o . I I $ '� 1 :( , v V ' T W EXISTING N = FINISHED GRADE •17)' GARAGE . 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O O N 3 (T O D V O) CO O m in 0) A N 0 0 V) J Q - Neighborhood Complaint Procedures 13 NEIGHBORHOOD COMPLAINT PROCEDURES (PER H &S 1524.5 and 1569.175) ZOSIMO PASCASIO, the Administrator of Rosemead Villa is designated to receive neighborhood complaints and reports. He will be responsible to resolve the complaint as quickly as possible. Nelia Pascasio,the Licensee will take his place during his absence. Each Friday,he will be available to meet with the neighborhood residents to learn about the complaints and concerns about the home. Office hours are from 9:00 am to 5:00 pm. As soon as the complaint is received,the Administrator will log the complaint and will inform the Licensee immediately. Then he will investigate the complaint by asking the staff on duty when the incident occurred and other residents nts who d may have some knowledge about the complaint. He will keep the of the process at the weekly staff meeting held each month. Administrator will document the resolution We agree to work with the neighbor(s) to clarify and resolve the complaint issue. Follow-up will consist of a phone call back to the complainant on the outcome of the complaint or the incident reported to him/her. A written reply will be provided when the complainant asks for a written response. Applicant/Licensee Applicant Phone# Applicant/Licensee's Residence Address I . - dmissions ' AMBULATORY STATUS (this person is E ambulatory ❑ nonambulatory) Ambulatory means able to demonstrate the mental and physical ability to leave a building without the assistance of a person or the use of a mechanical device. 'n ambulatory person must be able to do the following: YES NO ❑ ❑ Able to walk without any physical assistance(e.g.,walker,crutches,other person),or able to walk with a cane. ❑ ❑ Mentally and physically able to follow signals and instructions for evacuation. ❑ ❑ Able to use evacuation routes including stairs if necessary. ❑ ❑ Able to evacuate reasonably quickly(e.g.,walk directly the route without hesitation). FUNCTIONAL CAPABILITIES (Check all items below) YES NO ❑ ❑ Active,requires no personal help of any kind-able to go up and down stairs easily ❑ ❑ Active,but has difficulty climbing or descending stairs ❑ ❑ Uses brace or crutch ❑ ❑ Feeble or slow ❑ ❑ Uses walker.If Yes,can get in and out unassisted? ❑ Yes ❑ No ❑ ❑ Uses wheelchair.If Yes,can get in and out unassisted? ❑ Yes ❑ No ❑ ❑ Requires grab bars in bathroom ❑ ❑ Other: (Describe) SERVICES NEEDED (Check items and explain) YES NO ❑ ❑ Help in transferring in and out of bed and dressing ❑ ❑ Help with bathing,hair care,personal hygiene ❑ ❑ Does client desire and is client capable of doing own personal laundry and other household tasks(specify) ❑ ❑ Help with moving about the facility ❑ ❑ Help with eating(need for adaptive devices or assistance from another person) ❑ ❑ Special diet/observation of food intake ❑ ❑ Toileting,including assistance equipment,or assistance of another person ❑ ❑ Continence,bowel or bladder control.Are assistive devices such as a catheter required? ❑ ❑ Help with medication ❑ ❑ Needs special observation/night supervision(due to confusion,forgetfulness,wandering), ❑ ❑ Help in managing own cash resources ❑ ❑ Help in participating in activity programs ❑ ❑ Special medical attention ❑ ❑ Assistance in incidental health and medical care ❑ ❑ Other"Services Needed"not identified above Is there any additional information which would assist the facility in determining applicant's suitability for admission? ❑ Yes ❑ No If Yes,please attach comments on separate sheet. To the best of my knowledge;I(the above person)do not need skilled nursing care. _ SIGNATURE DATE COMPLETED APPLICANT(CLIENT)OR AUTHORIZED REPRESENTATIVE SIGNATURE DATE COMPLETED LICENSEE OR DESIGNATED REPRESENTATIVE DATE COMPLETED MENTAL AND PHYSICAL HEALTH INTAKE ASSESSMENT CLIENT INFORMATION: Date of Assessment: Client's Name: . , Address: Date of Birth: Age: Sex: Social Security Number: Conservator(Yes/No): If yes, include name and address of conservator . , Insurance Coverage: Medi-Cal Medicare Group Insiiraiice Private Pay 'Primary Diagnosis: Presenting Behaviors: Substance Abuse History: Last Date Used: Type & Amount t Isril: Alcohol Abuse History: • Last Date Used: . . u r r MENTAL STATUS YES NO 1. Mental Disorder 2. Developmental Disability 3. Dual Diagnosis—Dnrg/Alcohol/`;uhslarrce Abuse/Mental Health or Regional Center If any of the above conditions exists, please describe: The Condition: Severity of the Disorder: Current/Previous Treatment: BEHAVIOR ASSESSMENT: Does the client have a history of any of the following: YES NO 1 . Physical Assaultivelicss 2. Verbal Assaultivenes 3. Sexual Assaultiveness 4. Molestation 5. Cruelty to Others 6. Attempts to Poison Others 7. Use of weapon(s) 8. Cruelty to Animals 9. Destruction of Property 10. Stealing/Then 11. Arson 12. Smoking 2 • • 13. Dangerous Behaviors HEAJLTII HISTORY Client's primary physician: • • Telephone number: YES NO _ Does the client use any prescription medications? If yes, please list all prescription medications: YES NO . • • Does the client use any non-presri iplion (over-the-counter) medications? If yes, please list all non-prescription medications: • Does the client have any of the following: YES NO 1 . Asthma 2. Epilepsy 3. Allergies 4. Diabetic 5. Eating Disorders ( . Visual Impairments 7. Physical Impairments S. Infectious Disease Special Diet Needs • 10. Pregnancy I 1. Chronic Medical Condition 12. Incontinence 13. Hearing Impairments 3 • If the answer to any of 13 questions is yes, please describe: The type of severity of the condition: The Treatment the Client is receiving for the Condition: Names and Dosages of Medications the Client is receiving: Any Limitations Due lo the Condition: Any Special Services Required Due to the Condition: 4 BEHAVIOR ASSESSMENT(continued) Does the Client have a hTistory of any of the following: YES NO 1. Depression or Withdrawal 2. Anxiety 3. Mood Swings 4. Suicidal Ideation 5. Suicide Attempts 6. Paranoia 7. Hallucinations R. Restlessness or Hyperactivity 9. Inappropriate Sexual Activity 10. Confusion with.Sexual Identity 1 I. Refusal to attend Therapy 12. Disruptiveness 13. Taiittums • 14. Wandering 15. AWOL 16. Substance Abuse/Alcohol Abuse • 17. Ingestion of Toxic Substances I R. Refusal of Medications 19. Refusal of Medical Treatment 20. Refusal to Bathe or Wear Clean Clothes. 21. Resistance to Authority 2.2. Careless Disposal of Smoking Materials If the answer to any of the above is yes,please describe: • Frequency and Duration of the Behavior(s): • • • • 5 FUNCTIONAL STATUS • Do any of the Following Conditions apply to the Client: • YES NO • 1. Non-Ambulatory 2. Bedridden/Bedfast 3. Paralysis 4. Contracture(s) 5. Inability to Transfer to and from Bed 6. Needs Assistance with Eating, Bathing, Dressing, Grooming or Grooming If the answer to any of the above are yes,please describe: The Type of Limitation and it's Severity: Any Assistive Devices Used by the Client: Any Treatment of Therapy Needed by the Client as a ltesinil bf the Condition: . . Ter Title 22 Regulations, Section 85069.3 this documentation must be completed by a licensed mental health professional or a student intern it the work is supervised by a properly licensed mental health professional. A licensed mental health professional per Title 22 Regulations definitions: means a licensed clinical psychologist; a psychiatrist; a licensed clinical social worker; or a licensed marriage, family and child counselor. Name of Licensed Mental I lealth Professional that completed this documentation: Date: Completed by Facility Administrator: .• Client's Admission Accepted: Admission Denied: 6 S I A It UI-CALIFORNIA-HEAL NI AND HUMAN SERVICES AGENCY DEPARTMENT OF SOCIAL SERVICE S COMMUNITY CARE LICENSING FUNCTIONAL CAPABILITY ASSESSMENT ' . Licensees of Adult Residential and Social Rehabilitation Facilities must obtain the following information prior to olacernent. The Licensee can obtain this assessment from the applicant or his/her authorized representative. Adult Day ( are Facilities and Adult Day Support Centers may use this from to identify the functional ability of the applicant as required. The Licensee must maintain this information in the client's file as a part of the Needs and Services Plan. Note: Residential Care Facilities for the Elderly may use this form to assess the person's functional capabilities as required in Section 87584 of the regulations. CLIENT'S NAME DATE OF BIRTH AGE SEX El MALE El FEMALE Check the box that most appropriately describes clients Check the box that most appropriately describes clients ability: ability: BATHING REPOSITIONING ❑ Does not bathe or shower self. ❑ Unable to reposition. ❑ Needs help with bathing and showering. ❑ Repositions from side to side. ❑ Bathes or showers without help. ❑. Repositions from front to back and back to front DRESSING: WHEELCHAIR: ❑ Does not dress self. ❑ Unable to sit without support. El Needs help with dressing. ❑ Sits without support. ❑ Dresses self completely. ❑ Uses wheelchair. ❑ Needs help moving wheelchair. • TOILETING: . . . • ❑ Moves wheelchair by self. ❑ Not toilet trained. '—] Needs help toileting. VISION: 1 j Uses toilet by self. ❑ Severe vision problem. ❑ Mild/moderate vision problem. •.TRANSFERRING: ❑ Wears glasses to correct vision problem. ❑ Unable to move in and out of a bed or chair. ❑ No vision problem. ❑ Needs help to transfer. El Is able to move in and out of a bed or chair. HEARING: ❑ Sever hearing loss. CONTINENCE: ❑ Mild/moderate hearing loss. ❑ No bowel and/or bladder control. ❑ Wears hearing aid(s). ❑ Some bowel and/or bladder control. ❑ No hearing loss. ❑ Use of assistive devices, such as a catheter. ❑ Complete bowel and/or bladder control. COMMUNICATION: ❑ Does not express verbally. EATING: ❑ Expresses by facial expressions or gestures. ❑ Does not feed self. ❑ Expresses by sounds or movements. ❑ Feeds self with help from another person. LI Expresses self verbally.• [111 Feeds self completely. WALKING: GROOMING: ❑ Does not walk. LI Does not tend to own personal hygiene. ❑ Walks with support. F] Needs help with personal hygiene tasks. ❑ Uses walker. _A Handles own personal hygiene. U Walks well alone. (over) LIC 9172(8101) • F § @ D § 0 ) ) . . \ li g G § Gƒ7 / . k § \ ) o \ w J , �m z ? m \ \\ f _ z 7 ° G / }�2f m Q \ rn}o % / / /j ;) Z o = -. 74•-.G,, _ $ m E \ \ : 0 - » B / Jpo G - k � j Le--=2 �] C _ Z a 777c D ° G ° % Z § B9 \ \2,}7 , a mn �! ® / ; E§m ( \ / r ® f ƒCD ; { m //] } %E[) 2 DJ w <# s ® E°= < /\ \ \%fi I0 \/ . ƒ\00 ° n - ƒ\ 3 }\/; � \\ y , a\± r- { G e iw , : D @ § „ 7= � Z \\ « 9e/ � ¥, _ 0EE0 �� a k=q3 , -0 0)\/ ) Q_ k $\ - ; ; ��J CI-Z" a = »E \ 5§ } ;E e o Eo _=0\� 340 . ®2 ƒ /}7 e § G % ` _0FAo I/ co3=° a\ \ -, -0 ® a ; 7m % \ / 0. 0-0Cn ; / k !] \\ � § a, , Cr < , R� © ƒ2 C. \$ \ 'Q a o� cr , ; =m cn )ƒ / c = .- mr , � ,J G 2 -t -D . 3 �7 / k U ±-. % b ] E•�=a) �\ �� � , \ ]& .. y f,y; m c\ \\� \ k o ® _, /3 ] }§ 2E m \\ //E \/ \ }a \ 0 K - _ * {/ g }}[, � 2o j - \� \ m , ; a � 2 \\ ° ID \ 7 ( \ ) ) w k \ ,; CD m §\ p§ § J ;= ` Z 2 K! ma \ iƒ 2 \q / }/ { \ I\ _ ( \ ( \ \ Z� GG k Cl) . 0 k § d e ( r z { \ 0 I z F 5 g M @ • @ C k co c & 0 — » §3 \ k 0 ) \ § / C - . B § 2 C E • \ 0 E \ q \ > m cn 3 X, • ® z M• m \/_ 2r m k _ . 0 r \ M \ 0 i§ I/ • 22 Cl) m § Bk co 0 \ . -I \ \ I E R 0 • r / m ' = m i1 0 ( / ® ttt / � E § E / � / k : : E vi 7 2 --- 0 ; J � % 1 7 ,/ 0 co ,P. } C\ e� , 3 co m \ § m « & 7 MS a - o 2 IL O JC 0 cr k 7 \ § c1 J 1 Cr , E g Ill \- - 7 E ' 9 cr, I o r 3:t ■ %k En > z kr m k k r f k q ; D \ \ k -n ' m \ 2 @ K � : r . § § -n 2 . t. § •� i •\ � \ \ / \ 7 0 , 0 . 6 4 ° \ • 5 \ 7 a ƒ \ co \ \ z . ~ - E \ . ) I § ® a @ z k ) § k ( - m . § \ z —.0" ) 3 f ` m ® o k § k ( §rs,se 5 / _* 0 a a j ® § d % / \ R i - k E m & m D m CD \ 0 z ° o ƒ 3 su a k i rn m 0 k \ .. .7. § c Cl) _ § ƒ ( 3 z co q « § k CD / § 0 A m o 3 } \ \ \ \ § § § r - \ \ \ \ ± k \ ` R co 7 ¢ - q i \ z \ \ \ Z k co CD ® H i e CD k $ z » 7 \ 0 m { 7 \ > , k \ ° 3 \ R £ « • o $ § § \ r § E @ . z , » ! 0 i / m /7-4: co / ! = k \ ...,a' ] E = m = 3 = 7 { k 33 3 E ƒ m E \ 7 7 /� E , G 2m \ CD � } § ¥ § z k � / 5' m / C \ o a § K K 0 a » ` \ / § ) } \ § q ; w § § n % & 3 f § 0 0 � , m ® 0 E ( ) § ( ) Lily Trinh • From: Theophile, Leah @DSS <Leah.Theophile @DSS.ca.gov> Sent: Monday, November 03, 2014 3:35 PM To: Lily Trinh Subject: 2011 Annual/Random - Rosemead Villa Inspection Report Attachments: SKMBT_50014110322310.pdf Dear Ms. Trinh, Per our conversation, attached is a copy of the most current annual inspection report for "Rosemead Villa" facility, dated August 9, 2011. Based on the departments computer generated list "Rosemead Villa" facility is not required to be visited annually at this time. A "5 year" inspection visit is required and will be conducted by August of 2016. Sincerely, Leah Theophile Licensing Program Analyst (323) 981-3980 From: 3111ko @dss.ca.gov [mailto:3111ko@dss.ca.dov] Sent: Monday, November 03, 2014 2:32 PM To: Theophile, Leah @DSS Subject: Message from KMBT_500 EXHIBIT "G" 1 STATE OF CALIFORNIA-HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FACILITY EVALUATION REPORT CCLD Regional Office,1000 CORPORATE CNTR DR.ST 500 MONTEREY PARK,CA 91754 FACILITY NAME: ROSEMEAD VILLA FACILITY NUMBER: 197801709 ADMINISTRATOR:PASCASIO,ZONEL FACILITY TYPE: 735 ADDRESS: 9025 GUESS ST TELEPHONE: (626)280-4375 CITY: ROSEMEAD STATE:CA ZIP CODE: 91770 CAPACITY: 22 CENSUS:21 DATE: 08/09/2011 TYPE OF VISIT: Annual/Random UNANNOUNCED TIME BEGAN: 08:30 AM MET WITH: Zosimo Pascasio TIME COMPLETED: 01:15 PM NARRATIVE .. 1 LPA, Efren Malagon,made an unannounced visit to Rosemead Villa.The purpose of today's visit was to 2 conduct a Random Inspection. On today's visit LPA met with the Administrator,Zosimo Pascasio. LPA 3 reviewed staff's 1st Aid Certificates,client Needs/Service plans,checked staff fingerprint clearances,client • 4 P&I balances, reviewed all medications and inspected the facility for hazards.The home currently has 21 5 clients.The home is licensed for 22 clients.All clients living in the home are ambulatory,between the ages of 6 18-59 and one client is a diabetic, pill form Insulin and client checks his own Glucose levels. 7 8 The property consists of three buildings.All client bedrooms were checked. Mattresses and box-springs are 9 in fair condition,adequate lighting, plenty of dresser and closet space observed.Walls and floors were in fair 10 condition. Bed-lines,comforters and bath-towels were adequately stocked at time of visit. Bathrooms were 11 found to be with-in Title 22 regulation.Toilets and water facets worked properly.Showers was free of 12 mold/mildew,sufficient toiletries accessible to consumers.Water temperature was with-in regulatory 13 guidelines.The Los Angeles County Fire Department inspected the property on April 22,2010. 14 15 Perishable and nonperishable food supply was checked and adequately stocked at time of visit. Fire 16 extinguishers were fully charged and operational,chemical compounds and knifes were locked and 17 inaccessible to clients. Medications were centrally stored and properly locked,first aid kit was checked and in 18 order. Outside grounds were toured and no hazards were observed. 19 20 Advisory: 1st Aid certificates for 5 caregivers will expire in 4 days. Please provide 1st aid training for staff. 21 22 23 24 25 SUPERVISOR'S NAME:Tina Garcia TELEPHONE: (323)981-3962 LICENSING EVALUATOR NAME: Efren Malagon TELEPHONE: (323)981-3350 -• LICENSING EVALUATOR SIGNATURE: DATE:08/09/2011 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE:08/09/2011 This report must be available at Child Care and Group Home facilities for public review for 3 years. Page;1 of2 LIC809(FAS)-(0504) • STATE OF CALIFORNIA-HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE UCENSING DIVISION FACILITY EVALUATION REPORT (Cont) CCLD Regional Office,1000 CORPORATE CNTR DR.ST 500 MONTEREY PARK,CA 91754 FACILITY NAME: ROSEMEAD VILLA FACILITY NUMBER: 197801709 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE:08/09/2011 Deficiency Type POC Due Date/ DEFICIENCIES PLAN OF CORRECTIONS(POCs) Section Number 1 Needs&Service: 1 Licensee ensured that the Needs and Service Type B 2 LPA observed that several clients did not have 2 Plans for each consumer would be updated within 09/09/2011 3 current Needs and Service Plans. 3 30 days.The needs and service plans must 4 4 incorporate the psychiatric evaluations or the Section Cited 5 5 psychiatric notes. 80068.2 6 6 7 7 1 Building and Grounds: 1 Licensee ensured that the walls would be repaired Type B 2 LPA observed room#5 had some electrical work 2 and repainted. 09/09/2011 3 done to it.The west wall had two holes with wires 3 Section Cited 4 coming out of it.The walls were also stained. 4 5 5 80087(a) 6 6 7 7 1 Building and Grounds: 1 Licensee ensured that the old dressers would be Type B 2 LPA observed several old dressers along the 2 removed and the walkway would be cleared. 09/09/2011 3 walkway. 3 4 Section Cited 5 5 • 80087(a) 6 6 7 7 1 1 2 2 3 3 4 4 5 5 6 6 7 7 Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. SUPERVISOR'S NAME:Tina Garcia TELEPHONE: (323)981-3962 LICENSING EVALUATOR NAME:Efren Malagon TELEPHONE: (323)981-3350 • LICENSING EVALUATOR SIGNATURE: kojvf DATE:08/09/2011 q I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE:08/09/2011 r Page:2 of 2 UC809(FAS)-(06;04) A & A ABRATIQUE&ASSOCIATES, INC. 1V—1;13 October 1, 2013 • Mr.Zosimo Pascasio Pascasio Enterprises,Inc. Rosemead Villa • 9025 Guess St. • Rosemead, CA 91770 Re: Rosemead Villa Project Parking Assessment Rosemead, CA Dear Mr.Pascasio: • •As requested, we have completed-a parking assessment of the proposed Rosemead Villa project, located in the City of-Rosemead, California.The results of our assessment are provided below. • Existing Conditions • - Rosemead Villa is located at.9025.Guess Street in the City of Rosemead, California. Rosemead - Villa is. an..Adult Residential Care Facility with 22 beds. There are currently six (6) regular • - parking spaces and one (1)handicap-accessible parking space on the project site. A vicinity map - is provided in the attached Figure 1. - . . Title 22 Regulation states that Adult Residential Care Facilities are facilities of any capacity that provide 24-hour non-medical care for adults ages 18 through 59, who are unable to provide for their own daily needs. These adults are physically handicapped, developmentally disabled and/or mentally disabled. The clients at Rosemead Villa are ambulatory adults who are mentally disabled. They are capable of doing activities of daily living, self help skills and personal care hygiene. The staff at Rosemead Villa provides help in meeting the clients' medical needs. Although the facility does not have doctors and nurses on-site, the clients are capable of walking to a doctor's office and hospital with the help of the Administrator or direct care staff whenever they have a medical problem. Because they take psychotropic medications, they are not encouraged to drive. The clients at Rosemead Villa do not have California Driver's Licenses and,therefore,do not drive. • 3424 Wilshire Boulevard,Suite 1108,Los Angeles,CA 90010 Phone:(213)251-5960 Fax:(213)251-5966 EXHIBIT "H" Mr.Zosimo Pascasio October 1,2013 Page 2 of 4 • Proposed Project The proposed project includes the addition of one building with eight (8) additional beds for a total of 30 beds. The project site plan is provided in the attached Figure 2. Code Parking Requirements Based on the City of Rosemead Municipal Code, Section 17.84.050, one parking space shall be provided for each patient bed for hospitals, sanitariums, convalescent homes and homes for the aged. Based on the City Code parking requirements, a total of 22 off-street parking spaces, one (1) of which is handicap-accessible,are required for the existing facility. For the proposed facility, a total of 30 off-street parking spaces, two (2) of which are handicap- accessible, are required. With seven (7) available parking spaces, the existing facility has a deficiency of 15 parking spaces and the proposed facility is expected to have a deficiency of 23 parking spaces. • Parking Generation The City Code parking requirements may not directly apply to the existing or proposed Rosemead Villa project. As a comparison, parking generation rates for similar land uses were compiled from Parking Generation, 4th Edition, prepared by the Institute of Transportation Engineers (ITE), 2010. • There are no land uses that exactly correlate with the residential care facility land use. However, there are similar land uses, such as Land Use Code(LUC) 254—Assisted Living and LUC 620— Nursing Home. For LUC 254, the 85th percentile weekday peak period parking demand is 0.54 vehicles per dwelling unit (equivalent to bed). For LUC 620, the 85th percentile weekday peak period parking demand is 0.48 vehicles per bed. For the existing facility, these rates would yield a weekday peak period parking demand of 12 and 11 parking spaces, respectively. For the proposed facility, these rates would yield a weekday peak period parking demand of 16 and 14 parking spaces, respectively. With 7 available parking spaces, there would still be a parking space deficiency for both the existing and proposed facilities. Land Use Code 254—Assisted Living Assisted-living facilities offer care for people who need help with activities of daily living (called ADLs).Unlike nursing homes that care for weak people who can do little for themselves, assisted-living facilities usually customize a care plan for their residents.This care plan will probably change over time for each resident. Residents of assisted-living facilities typically need help with one or more of the following: bathing,laundry, eating and dressing.There is usually a nurse on duty to help residents who need • Mr.Zosimo Pascasio October 1, 2013 Page 3 of 4 help with taking medicines and a custodial staff to make sure residents' rooms is clean and tidy. Appropriate social activities and exercise are organized for residents by experts in those fields. Land Use Code 620—Nursing Home People with serious chronic medical conditions often live in special facilities. These residences are called "nursing homes." By definition, a nursing home provides skilled 24-hour medical care • to individuals who are unable to manage daily living activities due to debilitating health • conditions or old age. Nursing homes can be called different things.They may be referred to as skilled nursing care • facilities or long-term care facilities. Nursing homes help people who are unable to care for themselves.These groups include senior citizens with debilitating chronic health problems and younger people who have limited capabilities due to disease or injury. Nursing homes provide intensive 24-hour care by a staff including nurses,physical therapists, occupational therapists and social workers.Residents receive help with their basic living needs, including bathing,eating and taking medication.Nursing homes also manage complex medical needs that require equipment, such as ventilators and IV lines. • Adult Residential Care Facility is a facility licensed by the State of California for ambulatory and . non-ambulatory adults. These are non-medical facilities. They do not have nurses and doctors on-site. The clients are mentally disabled; some may be dually diagnosed with.developmental _. . disability and mental illness that would require 24-hour care and supervision. The clients are - capable of walking in a doctor's office to be seen. They are also-capable of doing their activities . • of daily living,personal care hygiene and self help skills. _ . . The level of care will not change with the proposed project. • Existing Parking Demand Parking counts were conducted on a recent weekday and Saturday to help determine the parking demand for the existing facility. The parking count data is provided in Appendix A. As shown in Appendix A, the peak weekday parking demand occurred during both the morning and afternoon when there were two (2) occupied parking spaces. Also as shown in Appendix A, the peak Saturday parking demand was two (2) occupied parking spaces in the afternoon. During both of the parking counts, 20 of the 22 existing beds were occupied. Therefore, the peak weekday and Saturday parking demand is calculated to be 0.1 vehicles per bed [2 occupied parking spaces/20 occupied beds]. Future Parking Demand With the level of care remaining the same at the proposed facility,parking demand is expected to remain the same. Mr. Zosimo Pascasio October 1, 2013 Page 4 of 4 The average future parking demand, using the Parking Generation rate and the parking demand rate,is for 9 spaces. Utilizing the peak parking demand, the anticipated parking demand for the proposed facility is calculated to be 3 spaces [30 beds * 0.1 vehicles per bed]. As such, there is expected to be a surplus of 4 parking spaces after the proposed project is completed. Therefore,7 existing parking • spaces can be expected to adequately serve the proposed project. Conclusions Rosemead Villa is an existing residential care facility located at 9025 Guess Street in the City of Rosemead, California. The existing facility contains 22 beds and seven (7) parking spaces. The proposed facility will add eight(8)beds for a total of 30 beds. Utilizing the existing peak parking demand rate of 0.1 vehicles per bed yields a parking demand of three(3) spaces for the proposed project. Therefore,the seven (7) existing parking spaces can be expected to adequately serve the proposed project. We appreciate the opportunity to provide you with this parking assessment of the existing and proposed Rosemead Villa project, located in the City of Rosemead, California. If you have any questions,please do not hesitate to contact us at (213) 251-5960. . • Respectfully submitted, . Abratique &Associates, Inc. klFZ. Hernando . tangco,P.E. Attachments Rosemead Villa Parking Assessment(09-26-13).docx ' r n ‘ t j-: - e¢ & r_a i - -i r.'4-�g� p Sd _ [— Q cU c� 1 1 sap. ''ate .i - _ a) � x 4 a • t 1 --;•-i-,--3,1• 1 11 a 'oyt - }n t �1 . s`t•�°"1 ' V m :-._ $ P. • 1 - b.- :C>;�-:-- t; 4r_ '�. x.49 _ . 1 1 b irl `ra. dy' [ 1 c lq ?r rdC.7 k5- `r F•.; 1 . :'`444-. IV ..mss .r: .#-1 -,js, a It A j _2 a ._ _ , ♦ . I :I [ :IL I. 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Ili u �- i ` •- `o. �i V j -.:.� I ,N A - 1 f ry to 3 r ; Illikkh.sr I CD"cc,'; Ati\Ft- \ -r, r / i. t- I — ti ° Uut) • i V;i , i �• r 1 et) - W xx p� Z M � U1 J° a l7k s rr�_ O.0-,,_ ,. ... .,,..;, . .,. . ...„ _ • ., t, 2 Lo • ^_' ' ii� r- 1 t J --.,�!1♦tZ 4 �"� lit A • - it e l.. i[`Y[jly�� -t 'ci • !d ",4 -' ' I rsff' ms's ! //( ti • i I • • • APPENDIX A . . PARHING COUNTS • • • • • • rimsn!p ) %Ail) 1 LU Date: fU Number of Occupied Parking Spaces Facility Name igoscfYe-2 (A/ Time 8:00AM 9:00 AM / I - 10:00 AM l 11:00 AM / 12:00 PM / 1:00 PM J 2:00 PM�A, 3:00 PM ,„2., 4:00 PM o,Z. 5:00 PM / 6:00 PM • • • t.d • PARKING COUNT LOG • Date: /G.' 7---- Number of Occupied Parking Spaces Facility Name ROSE".0-e-7 Time 8:00 AM 9:00 AM • 10:00 AM / 11:00 AM / 12:00 PM / 1:00 PM / 2:00 PM / 3:00 PM 4:00 PM • 5:00 PM / • . • 8:00 PM, • . I 85941 8 'A"" iin -es MOM I 112.,7 1 _ . 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