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042-450-038
VNING COMMISSION SUMMARY�I;T APPLICANT G.B.S_ertiesz-;, �n ADDRESS 375 Cohassot Road, Chico, CA 95926' .Co. �2 Wijjirrmsburg Lane, Chico 95926 OWNERLowen PROJECT DESCRIPTION =Usermit to allowd 99 Bed Convalescent Hospital Nursing Facility) —(Skilled N PROPERTY ZONED R-4 & R-3 LOCATED on the north side of East Avenue 600 ft East of Cussick Avenue Chico. ASSESSOR'S PARCEL NU1 i3ER(Sj IDENTIFIED AS ,,AP' 42-45-38 , GEN. PLAN PROJECT CONSISTENT? CITY , ,. .... . DATE APPLICATION RECEIVED 5/20/85 DATE REZONING PETITION SIGNATURES CHECKED PERCENTAGE 0 DATE LEGAL DESCRIPTIONPREPARED OR CHECKED: DATE PUBLICATION NOTICE WRITTEN PURL SHED DATE DISPLAY AD PREPARED PUBLISHED PLACE NEWSPAPER NOTICE (S) PUBLISHED - 0, C. P. G, B DATE MAILING LIST PREPARED DATE 'MAIL --OUT 'NOTICES WRITTEN KkILED t NUMBER _ ENVIRONMENTAL CATEGORICAL EXEMPTION - DATE, VILED DETERMINATION AND DATE NEGATIVE DECLARATION • DATE ADOPTED..m.,......�,. , ENV. IMPACT REPORT - DATE CERTIFIED- OTHER HEARING DATES $�r°, COMMISSION .....�.,,_,........_..�.. �.. ....,. COMMISSION .ACTION 7 �t��� ,1� , " r� `� � ,�, ` ,.�.�• BOARD ACTION :' 50 ORDINANOB (S) ADOPTED COMMENTS ._..o....�. ..... x, i G..ronrtief and prtoper5ed �legatvii5pitl�tttorl 0ar,il.lr��d Use Permit to allovw a 99 bed c0nvalonec�nFt�, it eaium Domsi.ty nur'sinq f aci.l ity) on property Ms Resi dent i al ) and R-4 0,, aX i mum Density Fees dint i al. A $ t Restricted Service) located �oiok the Avenctey idents Cxct6 4% AP A 'nua l 60-0 feet: east of C4t�s (Grantiolted close fron 7f'S/8 ) submitted a "memo with addi tional conditions. Sta'f f `" ,, and the reason ^a1 prr�ralsx Chaii�m7nvx1: chairman Avis that d�ch was for stated thahe applicantnt, �r�c=t state,,and1~e_ r«1 quo5tioned the necessity +err the new erandit inn 1y � .for tt`jo applicant to tcnraw he n0edia 5t�+ff Stated that it was necessary bod i -y. a-f+c� {1qt ./4 of an acro more in order to an ththe permit the pplic staff 't»xtod that with this condition o h,x%'10 to Como back in hater if there Was a prciblem. r . t:a ng the completion permit and gett'mg the +oderal and stat+✓ Chi iiMm+�n Avis di. scusaod the time factor with mee regviirements +or a Ll%e P approVa I.S. Crr i. tin O en nnt►54 C)r5y stated that it tares 1 year far the State to approve plans• at sho had an a 5eondcess from c Oomm, ssi. ones' he condition ti on bytated t the Advisory Agoncad a �r question was «t house i ri nrzigj*or' can the condi Said that there raid o°f 'f Royce Road. The neighbor had t,hr-: path of this ac:c'�=a� road. ops on the snap i 5 shicaalf d the COmnissi.on where the road goes BI -jar)-a t';ior•t wrii.t'i the hc�u4�r� and haat there wG`t5 no problem. �•h r•�f f 5ta'l•.ed that the applicant has zgreed td #k13 at a tniti ,lation 4rtea t.Wt" e . vc+d h`! Commi, ssi onl�r L.arnbert. q secein nrdttb'/t�o�i9i lat�dsn ars lt. Pari mo sewer, sr_rvice f p yorrrwsey 401- +`),pproVcai w7.tt1 .f crl. l Caws i�,iiµements a•f CEDA have been Completed �trid the roq tan; r^a Find t-1-t kit and t: a ga'ted 1�1+"rtativc; L')s�c.,lara°ki do cr�insi.c9t-,rod ,and {:�r"loi�' � t ttir� project tr cc�itipl i o"' wi th VAAt.tc' County Co ed use will. Sind tha fa �rll.y that. p be 24-';5r,, c4':; lei i IqW Con strcict t t trb , quittor si dew; kl !• 'ar, 1 k: , den Cast Avenue to 4-lane section alone} prbpet^ty frontage. �7x Provide drainage f aci l. i t:i, s 1:a drain property and property Trontago an fast Avenue to existino storm drain. Construct left turn lane at access road and Fast Avenue„, Catine t-facility to c&rimutnity sewer and water. Cp install water main, provide easements and connections s rugLkired by CA Wats-► 6,, Submit con st.rwation plans to CA Water for review of proposed ,fatc i I i ti es. 7 ln%tall .^ firu hydrants of CIF specifications. I C, Comply with Title 24 of the CA Administrative Cade as enforced by thr-� Stere Fire Mat-shall. 1. to%t,all parking and landscapi.nq its required by F�uitte County Cade including a minimutm of Cshade trues adjacent to the west lido of the pay, kinq lot. I�►. ��►•'c.cu+n tramh receptacles from public. view. 11. Guntribi .tte a prow rata share towards i.nsfal:l,ation of a tl"affi:c sitrtna.l at 5,iwt Avenue and Cutssickl. (111) 12, C;on%tra.tct a6 ft. bricl wall. minimum 2 bricks thick along proporty'r riast Avenue frontage, ,in complirtnce with setback re-qul ati ons and iti tail l a 3/4" foam barrier with the wrath side winous of the: Int-ti.ldings for noise itterluati ono (M) 1. w5 Sri l it.n.,t of condition 12, A;ppl icant may propose an alternatewhich will attenuai a indoor noise l evt- l; s to 4$ CNE".L, eprrsttl orf racii,o cctivc mitt rials and infectittlts wastes per State F,ls�•li-h 'f�ttid�lint�s. 15. Ira incineration mechanisms pormittod on-site, 16., Appli c tot mu!r t also Comply with all other ,:applicable State and local statutO5 ardi'rances, and regulations. 17, Ptv4chase; a mini.inum of 3/4 of an aart� from ah ad.iacorit pjiA ip,21^ty owner and cimbineiithi AF 4:`"I53""y thrCutOh rt ltlhl or %tevrsier► to creLAead. 1� Coritri bt tt* :t.2g25,c:6 to 'the West Side r"ire St Ati;'ari tip-he fit FL�hd. (M) +' ....i i lBU COY] iT' P V ING, COMMM" Ask G.8.5. Properties - Permit to allow a 99pbedAsed convalescent hosative pital and Use Nursing Facility} On P �fakillod property .zoned R-3 (Medium benaity Residential) and R-4 (Maximum Density Residential Restricted Service) located on the north side of Avenue, 600 feet east of Cussick Avenue, ecl a 42-45-38, Chico, dentfi,Cj' as AP The Commission waived the reading of the staff findings. The hearing was opened to the public. Bryan Jerining� presented a detailed description of tjo� proposed Project, including the certificate of need for a Skilled Nursing Facility, a description of the proposed layout, its financin gt etc:, Commissioner Walter asked if he would go ahead with the project even if the City of Chico approved .it for only 73 beds. Mr. Jennings said he would purchase the 'lot to the north. Chairman Avis asked if the City would approve it for the 99 beds in that case)' Mr. Jennings said yes. Chairman Avis asked if he was asking this Commission to a either a 73- or 99 -bed facility; Mr. Jennings said a PA�^nve yEs••-either. Harry Gallowa , who stated he lives across the street from the proposed project, said the entire area of Pebblewood Pines is residential in nature and he fears an increase in noise and traffic. Mr. Jennings commented that the facility needs to be in s quiet area, adding that the brick wall around it is to shield its residents from the noise of East Avenue. He stated there would be 12 employees working on the day shift and month. Y one ambulance per s Probably no more than Commissioner Lambert wanted to know Why this project wasn't being required to contribute to the fire station. seemed what the boundary lines were for imposing such oaane condition,tbutnow Bettye Kircher pointed out that the condition is olio- that ;. and they Were given an o «s imposed by CAfi; opportunity st to comment on this project. Commissioner Lambert said she'd still like to have clarif,catian,• to be ears the Commission isn't wrongfully imposing this condition on other projects and not on this one. - Charles Nelson, City of Chico representative, said he had no pr't►blems with the proposed project if they work out the sew noted that the occupants of the facility ;might er ai^rangemertt.. He not like being "'walled Commissioner Vercruse observed that the wall and parking were on the satire s%de; Commissioner' Walter added that the view out the other-' side is into an orchard. The hearing was closed to the public. Commissioner Vercruse said she thought It was a good proposal. CDP} about the contribution to to find out from Bill Teie (of Commissioner Lambert. said she wanted 11 the fire station. She suggested :a f g AUNTY f%1 iiNG gO iMISSIQr� �1�I> I UTE Ah MM motion of intent to approve the project.. Chairman Av a added that the motion could state approval of "uP to 99 units. Cornmissioher,Lambert wanted to know why a 3 --year Use Permit was being requested'; Chairman Avis said it would allow the applicant time to comply with a:11 the conditions. Mr. Jennings said the time was needed to complete the constrrtaction. Bettye Kircher pointed out that if no construction occurred within one year, the Use Permit would expires adding that this Commission can always extend it if the applicant needs more time to complete the conditions Chairman Avis .asked if ;it can bo required bha:t all conciitit)ns b'e complied with before operations commence, Bettye Xircher said that Code Section 24-44 can be invoked. Commissioner Lambert made a motion of intent, seconded by 'Commissioner Vercrise and unanimously carried, as follows: A. Find that the requirements of CEQA have been completed and considered and adopt a Mitigated Negative Declaration; and 8. Find that the project complies with Butte County Code Sections 24-35 -43 and -103.3, specifically that; the proposed rise will not impaii.r the integrity of the R-3 or R-4 zones and will not be unreasonably incompatible with or injurious to surrounding properties; and C. Approve the proposed Use Permit to allow up to a 99 -bed convalescent hospital ( Skilled Nursing Facility) on Ap 42 -45.88 --portion (parcel 2 of a division of parcel 4 Book 9e of Maps, pales 59 and 60), C.B.S. Properties, subject to the following, Mitigation Measures (M) and conditions: I. Construct curb, gutter, sidewalk, and widen East Avenue to a 4 -lane section along property frontage, 2, Provide drainage facilities to drain property and, property' frontage on Bast Avenue to existing storm drain. 3. Construct 'left -burn lane at access road and East Avenue. 4. Connect facility to community sewer and water. 5. Install water, main, provide easements and connections as required by CA Water; 5. Submit construction plans to CA Water for review of proposed facilities. Install 2 fire hydrants; to CDF specifications. 8. Comply with Title 24 of the CA Administrative Codeaa. enforced by the State Fire Marshal. li C UP7T)C^ � z Q,Cc MKI- 8WR yHvumiJ41 Ank 4. Install parking and landscaping as required by }3utte county Code Section 24-35 including a minimum of 8 'shade trees adjacent to the west side of the parking lot. 10. Screen trash receptacles from public view. 11. Contribute a pro rata share towckds installation of a traffic signal at East Avenue and Cus.,i l$ along 12. Construct a b -ft. brick ronta e, inminimucompliance with ricks �ssetback property's East Avenue f g regulations and install a 3/4" foam barrier With the south side wings of the buildings for noise attenuation. (M) 3. In Lieu of condition 12, applicant may propose an alternative which will attenuate indoor noise levels to 45 CNEL. 14. Disposal of radioactive materials and infectious wastes per State health guidelines. 15. No incineration mechanisms permitted onsite. 16. ApFlicant must also comply with all other ;applicable State and 'local statutes, ordinances and regulations. rWo F7 LF- NO. AP 42-45-38 BU`I"TC COUNTY PLANNING CaOM111$SION STAFF F'INDTNCS July 25, 1965 APPLICANT e�18.9. Propertie s OtNt=it. Lowen Company REQUEST; Usel Permit wo allow a 55 bed convalescent hospital (sicilled nurtAi;ng +acilit.y) AP NO. 42-45-38 STC; 2.1. acres LOC,A'T rON On the north side of East Avenue, 600 feet east of Ct,%ssic�,Avenue--, Chico, EXISTING ZCiIWIi�iBn R-4 within 200 •ft» north of East Avenue, R-3 on remainder, Z.r:1NIPaG HISTORY: Zoned R-4 Jan. 119 1972 Ord. 1226 Zoned R-3 Nov 6, 1984 Ord. 243e SURROUNDING ZONING: R-31 , R-4, PA-C SUNROUNDIN S LAND USE;Residential, proposed chUrdh 5175 HISTORY. Subject of two T. P. M' s in 84 and (35 and a rezone can the bU-k hal+ from 9-R R to --" GENERAL. FLAN DESIGNATIONS,. tIedium Density Residential AF'PL I CADLE REGULATIONS: Butte County Code Section 24--130.3(c)' � 24-43, 24 -��; j Title 24 of the Administrative :ode, (StatO) , Nitrite. Action Plan. CirIIWM�i�"f5,�,k�CC:IViw1D P6tblic. L4.(3r'rl • Con ,tract curb Avenue tea 4�1 ane, i-ttter , si dewal w and widen ection along facilities to drain property existing Property •frahtage, 2. P"'ovide drainage and and yonge rn Gtr i storm drain 3 Conztru� East Avenue. tt left turn laneataccess road and NJkAMk Ulf"CT5 COUNTY PLANNlNO COMMISSION STAFF FINDING Ouly S, l.9A C"'age 2 nv�.r csr r�ei�t: 1�N l h,a» "No objection to Use Permit with the following conditions% 1. Connect the facility to Community sewer and Water. 2 Provide connection to storm drain." p G _ and » E. "No con+ l i ci s with qas car ex eetr c . '� -� w �.m 1t,y.„»uF�Ct�ica „The City of Chico requests full urban improVements to be installed on the East Avenue frontage. It is recommended that trees be required throughout the parking lot as part of landscaping requiroments, to shade as much of the area as passible„, "Wates service can be ptwovided - a water main extension will be necessary _ easements will probably be required over Private property to pr"ovide fire hydrants. Review of proposed constrQation necessary to determine water" requirements. Water mlins must have 1j`>' horizontal separation from storm and sanitary sewers.,, �cprmrnt�cafFbr�esy "dumber of hydrants required to hydrant spacdrant ing .aC_0 feet, hydrant size 6” clow rich 950 or-maxir�Longum yPeac C�4'7and and requirement,sed ording to Butte of ", ca water sgency.P�tbJ�iui�erl.s specification 2c:r00 gallons y q d fire flows are 9 per minute. NUNSIW6 home under the St ate Fire Marshalls Jurisdiction. p��L-YSx�e Marry aspects of convalescent hose Mal development: are controlled at the State level, including building construction, fire pr-otectian, handling of materials, and licensing. Butte County has jurisdiction aver the land use permit and infrastructure improvements. In considering a land use permit, the points to; consider are; is the location appropriate? As the development compatible with neighboring uses? Is zoninq complied wi k'h?j and is necessary i nfrasture support available'? East Avenue is a heavily travelled arterial which has had limited success in maintaining individual or small scale ►*esidr�ntial deyel.opmoh,ks, This ,project will provide a Duffer between East Avenue and adJacent residential developments-. A convalescent hospital is compatible with surror.rnding s-ingle--family and multi. -family developments and the proposed Church at East and Alamo. A 6 •ft. high brio; wall Constructed for noise attenuation will make the development appear 1 i`t o North Wood Commons, cA si hgl. e -+ami i y dovel bpmeht to the south). Both fi-4 and R-3 toning categories orie q s al1ow convalescent. hospitals With use p..rrgit The rezone and subsequent, map creat'nq this parcel were 4150 be attached to the usepermit.p " - - These Conditions, will r s Conditioned to install full urbaniM r oveMents. The only problem encountered has boon sewage disposal. Chica's Public Works Department has indicated that sewer ser -vied is available for 7 beds; not the 99 beds proposr~d ; Applicant has appealed to Chico's city Council., who will hear- the regUest August 6$ 1905, If the appeal its, denied, applicant' will attempt to purchase the adJOinino northerly lot for its development right%,,* r 1 MW Bt,1T"J'E COUNTY PLANI''�C� CCIi`1M x S,�a I (�N 8'�AF FII�ialhiCa wiul 'ate 1 1985 Pate x *1105t Of the northerly lot would be left density residential. vacant car developed with e5;reed that for Overal.:l, density on both lots combined �4uldlnak which the city could prcvi de sewer service, C-t�CL�MME�IbA1` IfiihlS Doer acti ort on this pi^ojuntil Chico -Approves r beds on this lot, car ect aPP1icc4nt urchases lt tosewer service For 9, � the north. *rho issue: shatitld be settled jariar to the August meeting. g 2nd plan annin g Commission With sewer service available for 99 beds, the ro A. Find that the requirementsp Po jed moti on i $.- considered „ considered and of CE0A have beer`s �omral eted and adapt a Mitigated Negative DectOmPl et and S. Find that the ? -3 ” pi complies with D�,tti:e County Code sections �-�, and 1()Z.:3, impair the intear it , specifit�ally that: the Proposed use will riot unreasonably;i.nro;ttpatiblehwith�orrinjuriarles and will not be Pr"operties; and us to surrounding C. Approve the c. hospital (-k,illedsnrsing�d Use ��farili ermit to allow a 99 bed convalescent Of a divisi-cin dF par el tY) on AF 42-45-,3eC i�oPer'.�ie�s 4 Docile, 98 of Par tirr7 (�parcel, 2 subject tO the mrtPs Pages 59 and br?) '". 8. S. conditions,. following owi ng t`ti ti ga;ti ort Measures (M) and l Construct' curb section alon " gt.ttter, si dewal ls, and widen East, g Pr.'operty frontage. }Venue to 4 -lane j Provide drainage 'faci1z�i on East Avenue to es to drain property and e�sa�•��;r7 property front, storm drain, �_ construct left turn lane at access road and East 4i Connect facility to commrtn,itAvenue. ,sewer and water,. Install waterma in, provide CA water. easements and rvannecti ons requi red by b Submit~ construction facilities pions to CA Water for r'eva.ew. Ofproposed 7. Install 2 fire hydrants to '«k�i~ �- 8. �peci�ficatioh. s Comp],Y with ` Title 24 Of the CA Admxnistrwat the Mate Fire Marshall. i ve Cade ss enfarc: epi by ; I BUTTE COUNTY PLANNING COMMISSION STAFF FINDING w- July 25, 1185 page 4 9. Install parking and landscaping as required by Butto Cotanty Code 24 -","5 including a minimum of S shade trees adjacent to the West side of the parking 'lot IC). Screen trash recoptical.s from public view, 11. Contribute a pro -rata shire towards installation of a traffic signal at Cast Avenue and Cussi c lc . (M) I k Construct a 6 eft. brick wall ,$ minimum2 bricks thick. along property's East Avonuo +rontagoy in compliance with setback r°ogulations and install a 5/4" foam barrier with tho %ottth side winya of the buildings for noise attenuation. iM) l.M. in lion of condition 124 applicant may propose an alternate Which will attenuate indoor nesse levels to 45 CNEL. 144 Disposal of radioactive materials and infectious vlastes per State health guidelines. M. No incineration mechanisms permitted an --site. 1.6. Applicant must also comply with all other applicable State and local. statQtes9 ordinances, and regulations. LMT :1 r^ Attachments to Commission and Cities; 'nidal Study Location Exhibit Site Plan ApPBNDIX Ia COUNTY OF BUTTE ENVIRONMENTAL CHECKLIST FARM (tote completed by I.ea Agency) Log /1 85-05-23-0 14 BACKGROUND AP42-45-38 1 Name of proponent G • 1i_. S. Properties 2. Address of proponent and representative (if applicable) G.B.S. Properties '375' C o* n a� s� g-ee-f +, o a 3, Project description Usp Pr4rmif ['T, MANDATORY FINDINGS CF SIGNIFICANCE YES 'MAYIB Np a. Does the project have the potential to degrade the quality of the environment, substantially reduce the habitat o1 a fish or wildlife species, cause a *' fish or wildlife ,population to drop below self- sustaining levels, threaten to eliminate a plant or animal community, reduce the ;number or restrict the range of a rare or endangered plant or animal or eliminate important examples of the major periods of California history or prehistory? b, Does the project have the potential to achieve short-term benefits to the detriment of long-term, environmental goals? (A short-term impact on the environme,it is one which occurs in a relatively brief period of time while long-term impacts will endure into the future.) c. Does the ,project have impacts which are individu- ally limited, but cumulatively considerable"? (A project may impact on two or more separate resources where the impact on each resource is relatively small, but where the effect of the total of those impacts on, the environment Is significant.) d, Does the 'project have environmental effects which will cause substantial adverse effects on human, beings, either directly or indirectly? M. DETERMTNATION (To be Completed by the Lead Agency) on the basis of this initial eval.uatioii: I/WF, find the proposed project COULD NOT have a significant effect on the environment, and a. NEGAT1VH DECLARATION will, be prepared. I/WV, find that although the proposed project could have a signifi- cant efffe effect e ct.t`the environment, there will be a, significant on ll ri o case because the MITIGATION MEASURI,S described on the attached sheet have been added to the project. A 100ATIVB DECLARATION will be prepared. l/Wll find the propose(] project MAY have a significant effect on b the environment, and an ENVIRONt;'I;NTAI, IMPACT REPORT is required, DATL, ,lune 21, 1985 COU TY OV BIITTI.., PLANNING DBnARTMNT -------- Taauxaac^ate Planner Rev ewed b w2_ qp IV, ENVIRONMENTAL IMPACTS - xp anations o a "yes" and "maybes' answers are required on attached sheet (s) EARTH. Will, the proposal result in significant: YY K__Unstable MAYBE No earth conditions or in changes in b. geologic substructures? Disruptions, displacements, compaction or overcovering of the soil? c. Change Ll topography or ground surface d. relief features? Destruction, covering or modification of any. unique geologic or physical features? e, Increase in Mind or water erosion of sols, f. either on or off -sate? Changes in deposition or erosion of beach sands, or changes in siltation, deposition or erosion which may modify the channel of a river or stream or the bed of the ocean or any bay, inlet or lake? g. Loss of prime agriculturally productive soils h. outside designated u --ban areas`? Exposure of p pea 1e or property to geologic hazards such as earthquakes, landslides, mud - Slides, ground failure or similar hazards? Z; AIR-. Will the proposal result in substantial T.— Air emissions or deterioration of ambient b. air quality? The creation of objectionable odors, smoke c: or fumes? Alteration of air movement, moisture, or _21% temperature, or any change in climate, locally or regionally? 3. WATER, Will the proposal result in substantial: a Changes in currents, or the course or direction of water movements in either b. marine or fresh waters? Changes in absorption rates, drainage patterns, or the rate and amount of surface runoff c. Need for off-site surface drainage improve ments, including vegetation removal, channel- d. ization or culvert installation? Alterations to the course or flow of flood e. waters? Chan e rn the amount of surface water in any f Discharge Into surface waters or in any alteration of surface water quality, including but not limited to temperature, dissolved oxygen or tu7rbiuity? g, Alteration of the direction or rate of flow "- h. Of ground waters? Change in the quantity of ground waters either through direct additions br with- ithu drawals, `drawals , or through interception of an aquifer by cuts or oxcwvations? i, Reduction in the amount of water otherwise available for public water supplies? j. Exposure of people or p property to water =-- -. related hazards such as flooding?, _ w2_ : tytS MAYBE NO 4. PLANT LIFE. Will the proposal result in substantial: a. ange in the diversity of species, or number of any species of, plants (including trees, and aquatic plants) ?, shrubs , grass, crops, b. Reduction of the numbers of any unique, rare or endangered species of plants? Introduction of new species of plants into an c. area, or in a barrier to the normal replenish- ment of existing species?._ d. Reduction in acreage of any agricultural crop? .-.- ... S. ANIMAL LIFE, Will the proposal result in substantial-* a. Change in the 'diversity of species, or numbers of any species of animals (birds, land animals including reptiles, fish and shell fishy benthic organisms or insects)? -.�-- b. Reduction in the numbers of any unique, rare JL or endangered species of animals? __ species of animals into _.,.. c.. Introduction of new an area, or result in a barrier to the migration. or movement of animals? d. ,Deterioration to existing fish or wildlife x habitat? 5. NOISE. Will the proposal result in substantial: a. Increases in existing noise levels? levels? b. Exposure of people to severe noise 7. LIGHT AND Gam. Will the proposal produce sig- nicant light and glare? 8. LAND USE. Will the proposal result in a su stantial alteration of the presentor planned land use of an area? Q. NATURAL RESOURCES: Will the proposal result in su stantial; a. Increase in the rate of use of any natural resources? ---_ b Depletion of any non-renewable natural resources? --- 10. RISTC op UPSET. Will the proposal involve: the of hazard- a. A ris c'of jxplosi.on or release ous substances (,including, but not limit , oil.., pesticides,. chemicals or radiation) in the event of an accident or upset conditions? b'. Possible interference with an emergency, response plan or emergency evacuation plan?: ..,. 11. POPULATION. Will the proposal. alter the location, the human st,lbution, density, or growth rate of population? J 12. HOUSING. Will the proposal affect existing housing, or create,.a demand for additional housing?' ` f 73-, YES MAYBE NG 13. TRANSPORTATION/CIRCULATION. Will the proposal result in a. Generation of substantial additional vehicle movement?. b. Effects on existing parking facilities, or demand for new parking?, c. Substantial impact on existing transportation systems? d. Significant alterations to present patterns of circulation or movement of people and/or goods? e. Alterations to waterborne, rail or air traffic? f. Increase in traffic hazards to motor vehicles, bicyclists or pedestrians? 14. 'PUBLIC SERVICES. Will the proposal have an effect upony or result in a need for new or altered governmental services: a. Fire protection? b. Police protection?`" c. Schools? d. Parks or other recreational facilities? e. Maintenance of public faciltiesi including roads? f. Other governmental services? 15. ENERGY. Will the proposal result in: a. UUse of substantial amounts of fuel.or energy? b. Substantial increase in demand upon existing sources of energy, or require the development of new sources of energy? � 16. UTILITIES. Will the propsal result in a need for new systems, or substantial alterations to the following a. Power or natural gas? b. Communications systems? c. Water avaalabilityi d. Sewerorseptic tank? e. Storm water drainage? f. Solid waste and disposal?. 17. HUMAN HEALTH. Will the proposal result in: a.re(, a ' n of any health hazard or potentia] health hazard (excluding mental health)? �J b. Exposure of people to potential health P hazards. 18. AtSTHETICS. Will the proposal result in the `obstruction of any scenic vista or viewopen to the public, or will the proposal result in the creation of an aesthetically offensi.v.tr site open to public view? 4 YES MAYBE NO 19. 121.CRE_ ATION. Will the proposal result in an i UI)on impact the duality or quantity of existing recreational opportunities? 20. CULTURAL RESOURCES. a. Will t 77 -proposal result in the alteration .of ox the destruction of a prehistoric or historic archaeological site? b. Will the proposal result in adverse physscal or aesthetic effects to a prehistoric or historic building, structure or object? c:. Does the proposal have the potential to cause a physical change which would affect unique ethnic cultural values? d. Will the proposal restrict existing religiousor sacred uses within the- potential 'impact area? V DISCUSSION OF ENVIRONMtNTAAL EVALUATION AP 42-45-3$ See- attached: rrtt�rON OF EN'VTRbIVM�N'A CVALUATIdN AP 42-45-3 1: Much of the 2 --acre site will be overcovered by pavement and the proposed building, Given the area's urban character, this level of overcovering is not significant. 2,a; Traffic increases will add carbon monoxide and incompletely combustod hydrocarbons to the air basin. During periods of inversion, the deterioration in air quality will be most noticeable. 3b,16e* The natural draihage regime Will be completely altered by construction. on-site stormwaters will be collected and conveyed t SUDAD facilities ae: Collection of stormwaters will convey more rainfall in a shorter amount of time to drainage channels. This impact is not significant. Sf: The first stormwaters of the season Will contain petroleum products and detergents washed off of roadway surfaces. 6a,b East Avenue is one o° Chico's primary arterials. Noise levels within 100 feet of the road are estimated to be 65-70 dB. Residential care homes are considered to be sensitive receptors. Indoor noise levels should not exceed 45 CNEL. In order to provide a suitable environment for patients, sound attenuation measures should be incorporated into the project. It is recommended that a sound attenuation wall be constructed along East Avenue's frontage. Modified construction with proven attenuation of 20 dB minimum ,is an, alternative. 7 Light and glare will be kept to a minimum by requiring it to be non-g.l.are, directed away from motorists on East Avenue.. $.: The land has been planned for medium -density residential use. A care home is of similar scale and intensity as the planned,use and complies with the General plan_ It shouted be noted that State permits Will be required to establtsh the facility. 10a,,17a" Many skilled nursing facilities lities provide X-ray services; law levels of radioactive wastes are generated. This material must be of in an acceptable manner,; under used _ disposed permit, at a Class X site p The nearest site is in Sol.ano County. 12= Numerous low- and medium --density residential developments surround the site. urban improvements shout are installed adversely affected should not b providsd that full p stalled to support the The hoaxing s ou development and wastes are disposed of properly., 1S: Average trip generation rates for this use are S.1 trips per bed or 3.'i x 99 �- 307 tris per day. In order to safely -ac,.ommodate this p increase of passenger and emergency vehicles, the fallowing roadway improvements .will be required: 1. Construct a left turn pocket at East Avenue and the acce," road (condition of map) �`A�\\1i►��►���►stOkllR'R9�YAY#l��R�►ouu�.>.msy ; .... _ _,_ �.77, Contribute a pro rato Mare towards future Installa't_,104 Of a traffic signal at, East and Cusick (condition of Map 3 Access to be off Royce Lsne (condition of reap). PubiLc Works is recommending that the frontage be Widened to h These improvements sufficiently minimize traffic••related imparts. Butte County Code requires a minimum of 34 parking ;spaces be provided. Applicant is propos,izg 57 Local transit Planners s!zIll be notified t;t4b the c)r\,vai.escexit ho.ue will employ a rn ni.raum of 32 :people. This Informatiot, tsi ll be takran into employ ra part of the needs assessment. if Warranted_ bus service may be provided. The bus now steps at East and Esplanade. 14: The State Fire Marshal enforces Title 24 of the California Administrative Code. Specific standards are established for sprinkler systems, hydrants, fire extinguishers, alarms, number of exits etc. Compliance with Pi.re Marshz l staYidards is mandatory. CDF indicates 2 fire hydrants will be required. 14'b: The cart_ home is not likely to place as many demands on po..ice services as would 2 acres of apartments. 14e: Increased traffic: particularly emergency vehicles, will, take its toll on t'he pavement. 16c,d: Community water and sewer will be provided. 16f: Solid waste facilities should be screened from public view. 7' r y Applicant'. G.B.S. Properties Assessor's Parcel #� 42-45x-38 Log' DATA SHEET A, Ebraiect Description 1. Type of Project Use Permit. 2. Brief Description.*( To allow construction of a 99 -bed skilled nursing facility. 3. Location: on the north side o'f East Avenue, 4GO feet east of its intersection with Cusick, Chico. 4 'proposed Density of Development: 99 -bed okilled nursing facility. 5. Amount of Impervious SIarfacing: Extensive• 6. Access and Nearest Public Road(s): Royce Lane, private road off East Avenue. 7. Method of Sewage Disposal: City of Chico. 8. Source of Grater Supply: California Water Service Company. 9, Proximity of Power Lines: To original parcels 10 , Potential for further land divisions and development'. None. E. �%]_yiY'o mental. Se's.{ -int Psi�^al Environmerxii 1. Terrain a. General Topographic Character: Level valley land. b. Slopes: 0-2%. C. Elevation: 175 feet above sea: level. d. Limiting Factors_ 2.. Soils a. Types and Characteristics: Vina Fine Srkndy Loath, dark brown, 2-31'a well draining, capable of supporting a wide range of agricultural crops. b. Limiting Factors: Moderate liquefaction and subsidence potential. S. Natural Hazards of the Land a. Earthquake Zone: 5.miles west of Tuscan Monoeline. b. Erosion Potential: None, c Landslide Potential: Home.. d. Fire Hazard': Unclassified. e. Expansive Sail Potential: Moderate. } Hydrology A Surface Water, Lindo Channel */-- one-half mile southe b._ Ground Water: overlies area Of extensive groundwater withdrawal. c. Drainage Characteristics: Within Shasta Union Drainage District. d. Annual Rainfall (normal). 22--24 inches,. e. Limiting Factors: None. 5. Visuallgcenic Quality: 5. Acoustic Quality: Impacted by Southern Pacific Railroad and traffic on East Avenue. =8- 7. Air (duality: Good, Bolo <ical Envirnnmen fit. Vegetation: Urban. 9 Wildlife Habitat Urban. Gultural.Environment 1o. Archaeological and Historical Resources in the area: Lasa including unknown. Huge County General 'Plan designations Medium-pensty Residential 12 Existing Zoning: R-4. 13 Existing Land Use on-site: Vacant 14. Surrounding Area a. Land Lies: Residential, proposedl.oW-Derisity Residential, church. R-3, R�--4, PA -C- b. Zoning: A -R, S�-R, C. Gen. Plan designations: Medium -Density Residential, ricultural-Residential. Low -Density Residential, Ag d;' 'Parcel Sizes: Zero lot line to 10 acres. e, Population: Developed neighborhood. is. Character of Site and Are ico. Chico urban neighborhood. Nearest Urban Area: Ch 17. Relevant Spheres of Influence: Shasta Union Drainage Districts CARDr Chico Area rreenline. is. Improvements Standards Urban Area: Pursuant to Department of Public Works. 19. Fire Protection Service: a. Nearest County (State) Fire Station: #42, #44. b. Water Availability Yeo. 2o. Schools in Area: Chico Unified School, District. APPLICATION -FOR USE VERMIT BUTTI= COUNTY PL:AWNG COMMISSION Bufl0Co,Pnn6IngC=m. IV)1AY 2W 1985 APPLICANT: Read and follow instructions as set forth on attached sheet. Orovibi (',�tl1*4, Applicant's name I, E7 (�tv '-��i - Phone No, '34 3 - 5,5 si „_...u.�,.,,_„•,,,,• Applicant's mailing address cI-ktCo, C+`•1 Applicant's interest in property (Owner, lessee, other)- EU 12Gb-,, -5lfj G r(40're %L"Z y Owner's name and address 2 WIL.i.) AA�lS_I�(?76, LAr+IlY a 6J�� `3 "i� Contact person for project (if other than appltcaht). C7,"Y AA �J jai l.! •I f� (i ' �� PIC -81 t ftt'I Cx. ice, , g2blI Cf� q c 6 4 Asdossor's parcel numbor(s) Present zoning- Location oning Location and size of parcel(s) t4.0 j�q-i k 0 15 �ScVeNjl S — FAST-- � It 015 S I C 1't: Street address Directions for travel to property (rural and mountainous areas only): J Description of proposed development and use " la7p 15 51 R`A'WTI t4" -- G,412 -C; J ..� EA C,(L i [ I w \ T t RL 4, Descrfptlon of existing land use C,AN T h-- Proposed scheduling/assoclated projects— '-:1,UtyjA4�`tZ- t=ALL, ��j�3C Cc N'e-raUC'Cton1 AnticlpSted Incremental development._ ._ ....—PFbk�SC N L4 U Building construction (state dimensions, square footage and materials used) r! a. Existing buildingsCL b, Proposed buildings.M Fn w Hazardous materials to be used (Inflammables, explosives or strong chemicals) Daily hours of operation Q"ti s Number of employees Number of off-street parking spaces provided Existing/prdposed sewage disposal matnod:C.14-eC'0 Proximity of power and phone lines, fad' "1JCf G"=t f fi lei 6ri/07 Distance to natural wager course or storm drain' VROXlvr-1?A-AIAJ Pt~' A0 AC ,Anticipated an and off-site drainage improvements:U f�-rc ,C,- lca0al--) P1 t N Fj"i`C1 i jy} Water sours.,;, -- -C6A-f- t AJI TerVL GES Coo, Proximity of water for Me fighting purposes (hydrants, ponds, etc.) � F -:`A -T 4rVi5l`1 U E7 Will excavation or grading be necessary? Cubic ard$ ostjm'ate S ie SS '}y~��CA[ Zw C`L Lro I iat and describe any other related permits and other public approvals required for this project, Including t(1ef7n required by dity, fogional, State and Federal agencies, STAZC of e',,4ri-J N!/4 f /�F'/L t� t/ Ii'= MeMDENTIAI-i include the number of units, whether units are single or multl=story in hoight, schedule of iifilt sizes, and tyP.t of household size expected. IP COMMERCIAL, Indicate the type, whether nei hborhood, city or r , yp g reg orlerrtpd, square footttje of tjnloe area, and hrrrdirig facilities, IF iNDUSTRIAL:, Indicate type, estimated employment persllift, And loading facilities, r Ip INSTITUTIONAL, Indicate the majat funcilort, astihtated employment p r;olliftr etztijnt oc u{ �tltoy, r�Adiell, aoiifti's and �rtunit S�•e,tits to ► dsrived fro tie pr j t,�c� �'aw E ie eli � M1�r' , V r LZ ao e &,''u�EIJVI O LPTA7AL, IMPACTS AND MITiGA'TION' Ilfif;gSUI3 5 identify potentially significant enviranmenkai impacts agsoma ad withlhe uuse permit," Ihat'pro e�4 d`(�' ��e���ra p 1 1 g res �rsF c�ra�",ca, �. conditions of appfcval (mitlga Ion Meesrfresare posed to aileviatepotential environmental Impacts7 G eG c�.v ENVIRONMENTAL SET-myrs-o d Describe the project site as It exists before the project, Including Information rir, topography, soil stability, plants aict ani- .-+ males, and ny ult.11'W,q hltorical or scenle aspoets, Describe any existing structures on the site, and the use of the structures,, p. Describe the surrounding properties, including information on plants and animals and any cultural, historical or Scenic Aspects, CL Indicate the type of land use (residential, commercial, etc.) intensity of lana use (single„famliy aPOft ants, shop ,depart» ment Stores, etc,), and scale of development helg frontage, setback, rear yard, eto,), ” Use separate shaet for longer responses, I hereby declare under penalty of perjury that I have read derstand the instructions and that the foregoing statements are true, �-omplete and correct to the best of my knowledge a be ef, Applicant's signature Date ,.._—Lb .--.„�~j._ Property owner's signature _. G-zc,-? Use Pannit Number >- Requ-asf; Use permit to allow Location and size of parcel(s) LID VEfilry. f W tom'' A.P. t�lumber(s) t CO* r Project Description Ownership oning and Requlremcnts Proof of Agency (it needed) l.ocatidn Description UJI 20 Copies of Prot Plan v U. Date 98ceived �r cJJ `�. $ i6('O•l �, Lao ,/ "c C�� Receipt Numper�,,,��� Q Application ;taken by_-- AN 8-06-03. APi88-06-04 Al)#8-06-05 , Charles F. Lawler 31 Pebblewood Pines Paul to Mary Krause 32 Pebblewood Pines Driv �I'Pogblawoo�i�.ter Chico, CA 95926 Chico, CA 95926 Chico, CA 959.26 AP# 8-06-06- AN 8-06-07 API/ -8-06-08 J.G. & P.A. Montgomery Scott F. Johnson Odessa Parker 34 Pebblewood Pines 35 Pebblewood Pines P.O. Box 1102 Chico, CA 95926 Chico, CA 95926 Chico, CA 15927 AN 8-06-09 API/ 8-07-Q1 AN 4-07-02 Pamela A. Dahl 37 Pebble' ood Pines Harry A. Galloway Purer Towers y Chico, CA 95927 18 Pebblewood Pines 17 Pebblewood Pines Chico, CA 95926 Chico, Cil 95926 AP# 8-07-04 APt# 8-07-05 A'Pll 8..0706 I;.rt. & S.C. Burton, etal Leo H. Kirchhoff 15 Pebblewood Pines Shina Turner Chico, CA 95926 14 Pebblewood Pines 13 ,Pebblewood Panes Chico, CA 95926 Chaco, CA 95926 AN 8-0718 API€ 8-07-19 AP9 8-07-20, Elizabeth H. Merlo Clorine 'Phomas Gladys Crandall 19 Pebblewood Pines 21 Pebblewood Panes 23 Pebblewood Pines Chico, CA 95926 Chico,, CA 9592.6 Chico, CA 95926 AN 8-07-21 API? 8-07-21 AN 8-07-22 Kate Bonny Landis Pebblewood Paries Dr Kate Denny LandisZ5 25 Pebblewood Pines Drive Duncan L. Liston, et dl Chico, CA 95926 Chico, CA 95926 29 Pebblewood Pines Chaco, CA 95926 AN 8-07-23 AN 42-45-1.3 AN 42-45-14 Ralph A. Wertheim i 5642 Chaney Lane Ray L. & Royce Bowen Sam & L.F. Sanjabi 640 Royce ;Lane Paradise, CA 95969 575 Manzanita Chico, CA 95926 Chico, CA 95926 AP# 42-45-26,27,28,29,30 AMI 42-45-1.5 AN 42-45-19 Don & Crystal Trott' etal. Gregory &7 Patricia Watso: W -5;H. F A.H. Pang` 2538 Cussi ,.k Rt 6 lox 659 Royce Lano 1088 Via Verona Chico, CA 95926 Chico, CA 95926 Chico, CA 95926 AN 42-45-20 APN 42-45-21 J.H, & K. Norris 629 Royce bane F.M. & ,Loc. Whipple Chico, CA 95926 619 Royce Lane Chico, CA 95926 AN 42-4.5.22 - AN 42--4'0-24 25 R.L. $ R.P. Bowen 575 htanzanita Shirley Go, pton 0 et al APII 44-2074 Chaco CA 95`926 X1.1 Hender: on Way Fol. om, CA 95630 Stile Shea & Associates P.O. BOX 1.422' . Chico, CA 95926'' APII 42' -4s -'A G.B.—Properties 575 Cohasset Road d Chico, CA 95926 q I Application `I.D.:Numbe Page 2 Name Wast .'View ' Facility Men©r .. ,. PROJECT TYPE (Check all that apply to your projeCt) CHANGE IN HEALTH FACILITY Construction of a new health facility .Specify License Category: SNF . Increase in bed capacity q nversion to Coa different license category Specify Curren and New Category: c ass ice beds to ra on Conversion of existing ioe Specify Current and New assific_ REQUIRED SERVICES, Skilled nursing Intermediate (:are Facilities Only or o c Activity program A Dietetic . AttacYiment A �] Pharmaceutical sed �[a Physician Skilled Nursing'(SNF) 20 Intermittent Nursing (ICF) OPTIONAL SERVICES, Skilled Nursing Intermediate Care Facilities only or Developmentally Disabled dentally Disordered Therapy RE,Occupational Physical Therapy Rehabilitation Social Work Audiolog�l a ' . 13 Speech Pathology and/ 2 Substance Abuse PROPOSED SCHEDULE FOR COMPLETION OF PROJECT' 85 be signed 1. Date owner•architect agreement will-oi� 2. Date preliminary plans will be swhmitted to the 11; $5 Department 02)-,01-86 Will be signed for completion of project , 3. Date contract rel 03 -tat -85 4. Date construction will commence g months 5. Construction period i n months 6. Date of completion of project 12-,3�6--86 7. Date of commencement o,f operation p. It% f S4 ATTACHMENT "All Optional SiarVices Provided in this facility Will be contract services emd shall, include: L. Occupational Therapy 2. Physical. Therapy 3. R-ehAbilitat.ora 4. Social Work S. Speech PathologyI ar�d/or Audiology, NOW h ATTACHMENT H The shortage og skilled nursing care services available in having to go out of the this. Area results in the patients This situation tends to cause. area for long term care. 1. Travel distance problems and expenses created by the elderly spouse and loved ones. 2. separation from environment 3. Separation from f�tmily and friends, 4o Breaking of the tie with local physicians, or making it extremely difficult for proper and reasonable medical follow -up - 5. 'Lack of control over quality and quantity of service. Due to the lack of available facilitiese there is a tendency a locthan for patients to remain longer thannecessar el of Paying for ahigher acute care facility, required. Alk The provision of skilled nursing11 c . are Locally would eliminate itemized above as theproblems of_long distance commuting minimizing of cost containment by _ and would. support the concept overuti.l zat on of acute care beds. Facility dame West view Manor Application T.D. Number �,,,�,,,�, Page 4 Facility Name WEST VIEW MANORar Application 1.0. Number. Pagci, S CERTIFIED COST ESTIMATE FOR PROJECT Instructions° Fill out for each project. , A. Planning 1� Consultant 1eGS---fir-------rrr-r---r--rr—errrr+�$ r . 2.1 Surveys and• Studies---err-----r---r------wren$ 400. 9i1D--------------------a.-r---e-----------$ 3 r Other-- ..,y, wr--w-+i---r--------r--+-mrra+r-sriiN.sw.r-./wrwnw.w�-wwrp �w`1 '4.0 0 4, Total Planning YYY B'. Administrative lLegal- r----------r-�rrrr�rr--��4i/$ 1 0 0 0 2 Otherrm----r--rr-- rr-tea.-- 3 Total Administrative-----r----alarrr�sr--wqa-mewe+wsrsrrr-www$ 1000:_ C. Financing 1 Loan Fees=--coatud-in- loam---------- -$ 2.; Interest on Loans During Construction Period---$48 3 Other r--------rw-----r-e-m+-mr----n�brm-r�om-swo$ 4. Total Financing-------r-r-a)------ $4g ,365 Site 1�� Purchasa Price of Property-------- --~r-.-�-$193,600 G. Appraisals-----w--r+r--w-r---e---air--pww-w-ager$ 3. Costs --------e---r--awr---r-mr8rr---w-mry-----e-$ - 4. Surveys -rrs-..r+-rim--r-meo-r------------- ierr-----$ 21000 5. 6.0 Total AcquisitiG,t of Site- �-s-..rrr:...--mses-r_a.-- __..-$195600 r + E. Equipment (All equipment - attach detailed list) 1. Diagnostic or Thereid a. Purchased--- P�Qa. 5+2 �J- ++w--rr-re-rs$ 10,000, b Value* of Leased Equipment (Attach Lease)--$�, 2'. Other Equipment a. Purchased ---r-s---- w-------------r-x$2.03 , 750 b.Value* of Leased Equipment (Attach Lease)--$ $213,750 3 Total Equipment +-------- -rw ----eersr---rr r------------ F. Value* of Leased Facility (Attach Lease)---- L Plans 1. Architect's Fee for Plans-r------- r----------$20 2 Building Permit Fee------r-------rr-r--e--wr---$ 3j000 0 0 0 3. Pre1i�� i eAfti o4 - $ Other ate Architecr(.QSAaZw--ww$ 20 , p 0. ------wrrr--------t ------�r-r-------w--r+-- $440000 5. Total-- *See next page Page 1 of 2 EQUIPMENT LIST PATIENT ROOMS'` 99 99 Hospital beds Mattress 37023 81661 99 Pedside Cabinets 12,443 99 Overbed Tables 8,0 9 99 Side rails 8,102 99 Pt. room chairs 11,710 54 Drapes 1,433 110 Mattress covers 550' 09,246 DIETARY 2 refrigerator-freezer 41000 1 Mixer 600; 1 Blender 300 1 Meat Grinder 40.0 1 Meat Slicer 3.50' 2 Coffee Containers 400 9 Serving racks 9,000 1 Can Opener Cooking utensils 70 11500 Silver 1,050' Dishes 2,950' Dishwasher (Contractor) 3,400 Stove (Contractor) 4,000 Garbage. Disposal (Contractor) 300 28,120 EMPLOYEE LOUNGE X20 Stack Chairs 630 , 1 'fatale 83 355 1 Sofa Lockers (Contractor) 375 1.,448 ADMINISTRATOR'S OFFICE 1 Desk 300 1 Chair 85 1 File 200 1 10 Key Machine 129 l Photo Copy Machine 31000 3,714 `ct!VITII LOUNGE; r 4 Tables 352 709 ; 2 Sofas 8 Chairs .1,244 300 2 Coffee Tablas 249 2 Corner tables 500 l 20 TV Stdck Chairs 630 3,984 Page 1 of 2 MEiIICAL RECORDS 4 1 File Cabinet ' 1, Desk 300 300 85 " Chair 900 1 Typewriter t C 1,5A5 NU RSING S7IRTION 1 Desk `Contractor,) 1.75 100 I Chart file 450 3 Medicine Carts 1 Refrigerator (Medicine) 500 2 Chairs Medical charts & Mi.sce 170 500. 1,895 DIRECTOR OI' 'NURS'ES 300 1 Desk 95 ;. Chair 385 NOUS EKEEPING 10200 300 Pillows 4,200 • 600 Sheets 1.,200 300 Pillow cases 2,400 300 Mattress Covers 4,500 300 Blaikets 2,700 300 Bedspreads 31435 57 Cublcle Curtains 6,40E 20 wheelchairs 1,300 20 walkers 1150 120 Trash Baskets 3rOOU Miscellaneous 540 12 Garbage Cann 31r.625 MAINTENANCE 800 1 Floor Butter 450 2, "Vacumns 1,000 Mise. Tools 21250 Beauty Salon Equipment 1,500 2,U00 Autoclave 2,004 Whirlpool 600 Bed St; i.,ilixer 18,000 ` 3 washer (a0 lb.) ; 7,200 3 pryer (50 lb.) , 31,300 Total estimated equipment 1943,1552 ' Miscellaneous stems* 203,750 TOTAL itemo such asbedpans, towels, washclothes, eta. M�,Jcellaneous Facility Name.'TIEST_ VIEW MANOR Application I.D. Number Page 6 CERTIFIED COST ESTIMATE FAR PROJECT (Continued) Co Constructi:on 2. -off-sty Services-----------------------__..____$ 8,900 Utility Off-site DeVelopment------------------------ 3. - ---- ---- ---- -..,..__�" � included a _-�------ __ w_--:-130 0 0 0 4 Reconstruction Development--- _ struction--- _T__.. ------__-__� ` figure In, MiEn 5. New Constr� cti.on--------------- _ _,....,.. _-J!J!20J.O00 J 6 Other-- _ ��Xt,2�-, ro_v_ement fees 23.266 y Total Construction-_-- ------------- ---------------- �_I,,132 33 2..66 I. Test (Construction and Inspection)—___r�.ow._iMrw_M_-o-w_ww_ gwl_.N-_.9 $, 25 42O 0 1, B Ci S 3 8 z a, Total - Items A through T ---------- -------- KContingencies (2% of Item J) -----------, ---------------___---_-:...___..-----s,,,,...._„_$ 37,388 L. Total Costs of Project (Item J and Item K) ------------------------- $ 1,906,769 *Use this space to describe basis for estimate of value of leased equipment and space. Explain other items as may be necessary. Use additional sheet(s) if more space is needed. CERTIFICATION BY LICENSED ARCHITECT OR ENGINEER 1 hereby submit and declare, under penalty of perjury, that the amounts listed in Sections G, H, and I above, are true and correct to the best of my knowledge and belief; NameRober)t Heaton.A •` �' I } F Architect May 3'0 , 19 Signaturec�t 1 r, .. r� r�� Titlegate�, License c: •`!/% 1. Firm Name Robert Heaton Address 2044' Palm Ave—,,Chi cA 95926 Phone (916)343-8038 n. S Facility Name Application I.D Humbey.____ _ Page 7 ski M1PPLPeTAItY DATA (A11 applicants complete the following i ems): ME e of f aci 1 ity control Nonprofit l• TYP ( Investor -Individual Investor -Partnership Investor -Corporation [j County/City District University Teaching' state Hospital �. Has the existing Facility been accredited and/or b surveyed _y YesNo Date JCAH - Joint Commission on AccrAitation of Hospitals GALS - Consolidated Accreditation and licensure Survey DMA - California Medical Association - Medica.1 Staff Survey CARP - California Association of Rehabilitation Facilities _ 3. Submit. as Attachment Aj lastest OStatement of'Deficiencies+and` Plan o�or'r a 'ti n" (SSA -2567) 4, Where, construction is involved submit Attachment 'B,, showing approximate locations of existing buildings an p optadditions.. 5. Where con is involved* provide legible single -line drawings, to an t, 1116'°.1' dated in each patient identified scale, at. least, ,identifying the functions of all rooms and the number of patients to be.accommodat room, as applicable. 6. If the proposed pr!oJect involves construction: Existing' New Type of construction Number of stories; Size of site in acres ? �� 7. For each departments, service, or program address the following items: a. Space 'program and outline drawings showing existing and proposed square footage. b, Description of how any vacated space wi11 be allocated. storage & Supplies ' Facility Name• West View Manor Application T.D:. Number--------? age O SUPPLENJOTARY DATA (Continued)' Patient Days (last fiscal year) Medi -Cal Medicare Prepaid Plan 'Other N/A 9. Submit, as Attachment C9 a resolution of the governing body approving • the project. Yes ido 10. Is the completion of this project contingent upon the granting of financial assistance by a governmental agency? 11. Submit as Attachment.0 a description of any lease, contract, or other comparable arrangement the health facility will enter into to allow others to use this project. 11 229 May ROBERT B. HEATON architect 2044 PALM AVE, CIIICQ, CALIFOW14 95926 TELEPHONE 9161343.8038 TO WHOM IT MAY CONCERN; California As site, Architect an the 99 bed ease besadvisedent Hospital all. desi,,;n work for Gladys and Bryan Jee will pleas applicable standx,�ds and performed by this office wplA�c101QrTitlesm to l22aand 24 of the californla regulations inc N. l to the construction of same. State Administrative Code as they apP ?' During the construction phases, chis office will conduct periodic inn. -.site tractor observation of the work and will di.recto���ndoruments� correct any observed deficiertcier in the approved c act S i'ncer Robert S. Heaton, Architect 29 may 1985 :fROBERT B. HEATON 2o44 PALM AVE. CHICO, CALIFORNIA 95926 TELEPHONE 916/343.8038 To WHOM IT MAY CONCERN* Please be advised that this office has prepared the CON document Conceptual Cast for the 99 Estimates of construction. included in your Hospital in Chico, California, for Gladys and bed Convalescent Bryan Jennings. It is out opinion that the estimates are reasonable the and and applicable the seasonal for the proposed type of construction, area time frame �envi.sioned. Sincerely, Roberti E. Heaton, Architect i moi, NOTICEd OVERSIZE DRAWING eu HAS BEEN REMOVED AND FILMED ON 35MM 0 3OVER FRM r -: The proposedcapital expenditure shall promote economicsand improvement in services, as evidenced by financial documentation in an acceptable uniform accounting format, including but not limited to cash flow, debt service,, affect on patient charges, depreciation and projections of future financial. position, adequate to assure successful completion and _n continuing operation of the project. This new facility will, in addition to creating new jobs; will provide patients with skilled nursing care in a new facility. We are enclosing: 1. projected fine year budget, which projects a positive cash flow the first year of operation. 2. Projected Annual Occupancy Rakes for Five Years Projected Reimbursement Rates Projected Revenues 99 beds 3. Inflation considerations 4. Cash Flow Projections W 5 years , 5. Projected Quarterly Income and Expense 6 Census for lst Year I PROJECTED EXPENSES (99 Beds) Aulb S YEAR OCCUPANCY Year 1 Year 2 Year 3 98% Year 4 99%` Year 99% 85%961 EXPENSES payroll, taxes, W' C' ins. Benefits 79$,583 838,.512 880,438 3;984 924,460 4,183 970,682 4,393' Consulting Services `telephone 3,614 43,362 3,795 45,530 45 47,806 50,197 16,732 52,707 17,569 Utilities & Ancillaries re. 14,454: 176 11,383 15,936 11,952 12,550 13,177 Laundry & Linen 10,841 10,841. 11,383' 11,952' 12,550 8,366 13,177 8 784 r Housekeeping Maintenance 71227 7,;588. 18,971 7,963' 19,920 20,9116 21,962 Nursing Supp lies 18,068 930951 98,649 103,581 108,760 2,092. 114,196 2,196 Food Kitchen Supplies 1,807 3,614 1,897 3.795 1.992 r 3,984 4,183 4,393' 4,393 Travel & Training. Office Supplies 3,614 : 3',795 1 897 31984 11992 4,183 2,092 2,196 Miscellaneous 11807 3,000 r 3,150 3,308 3,473 2,315 3,647 2,431 'insurance ccountng WIActivity 2 ,000 1,807 2,100 1,897 2,205 1,992 2,092 20,000 2,196 20,000 ' *Taxes (Real Estate) 20,000 � 265,600 20,000 265 200. 20,000 265,200 265,200 265,20 56"600 **Mortgage Debit Service 56,600 56,600 56,600 56,600 Depreciation ------ 1,360►390 1,41 ,318.r 464,794 x.,520,944 1,579,901. TOTAL EXPENSES based on 100% occupancy Based on Actual952;273 1,129,054 ].,318,315 1,444,897 1,564,102 occupancy rates ';.,,PA Debt service is calculated on 1,700,000 loan & 3 p onts zed at 15% over 30 year term. which 1,751,00 amortor **Depreciation calculated on a straight line '30 years on 1,700,000,. Projected Anrjual Occu ancy Rates for Five Years Year 1 Year 2 Year 3 Year 4 Year 70% 80% 90:% 95% 99 Projected Reimb=setelit Rates Yearly escil.aton factors Medi -Cal Medicare - 2` - 5% Private - 5%, Year 1 Year 2 Year 3 Year 4 Year 5 l 8 ' -Cal 37.06 37.80 38.56 55;13 39.33' 57.89 4.0.12 60478 Medi .Medicare.. � 51.00 50.-00 52.50 52,50 55.13 57.89 60.78 Private Promo ' e_cted Revenues -- 99 Reds Year 1 Year 2 Year 3 Year 4 Year 5 T0� Occ< 80� Occ.- 90% Occ -- 95% Occ. 99 - c�` 703,399 814,023 942,985 1;01.9,237 1,083,64.1 Medi -Cal (75%) 15,330 1;8,110 19,862 2.2t185 Medicare 12,775 (Old) 364,087 422,571, 485,987 532,433 Private. 310,250 (24%) 271.44.0 30,870 321585 33,957. Ancillaries 24,000 ---- -- 1,050,424 220 88.0 1, a 1,41.4,536 1,557 .,671 ].,672,216 TOTALS BASED ` ON ,ACTUAL OCCUPANCY RATE CENSUS FOR 1ST YEAR First Quarter Occupancy P y at quarter .:end April 35 patients May, 40 patients- 45% June 60 patients ,Second Quarter July 60 patients August 65 patients September 70 patients Third Quarter October 70 patients November 80 patients 80 December 90• patients Fourth Quarter January 90 patients February 90 patients 90 March 90 patients Occupancy end of lst year 70% COSTS PER PATIENT DAY Patient Cost/Year Consulting 3,614 Patient Day Cost utilities & Telephonc- 4.3,362 .ip 1*2.0 *Ancillaaries Rebillable 14,454 Laundry & Linen 10,841, ,40 Housekeeping 10,841 _80 Maintenance 7,227 ,30 Nursing Supplies 18,068 .30 Traver & Training 3,614 ,50 1,0 Office Supplies 3,614 Miscellaneous 1,807 +10 Activity 1,807 .05 Food 93,951 Kitchen Supplies 1,807 .05 2.60 .05' TOTAL 215,0-0-7 – 5.95 *Ancillaries Rebillable/Revenue:.includes income/expense from pharmaceutical supplies, beautician & barber services, vending machines, Medicare Part A & B, etc. Ask QUARTERLY PROJECTED INCOME AND Expt SE (9'9 Beds) YEAR ONE ,.,REVENUE ,- ,. l t 2nd 3rd 4th Medi --Cal QUARTER 113,046 QUARTER 163 QUARTER 200',971 QUARTER Medicare Private 2,053 2,966 3,650 226t092 4t106 ?ancillaries 49,861 3--- 72,,022 5,571 88,643 6,8.57 99723' t TOTAL REVENUE 168,817 243,848 .300 2 8,571 338,49.2' EXPENSES P4yrollt taxes, W,C. Inc. Benefits Consulting Services 89,841 406 129,770 159,716 179,6$1 Utilities & Telephone 4,,878 7,046 587 722 8,672 813 9,813 Ancillaries re -billable 1,626 Laundry & Linens 1,220 2,348 2,891 3f252 Housekeeping 1,220 1,"762 1,762 2,168 2,168 2,439 2,439 Maintenance Nursing Supplies 813 2,033 1,174 2_,936 1,445 1,626 Food Kitchen Supplies 10,570 203 15,267 3,61:4 18,790 4,065 21,139 Travel & Training 407 294 587 361 723 4,07 813 Office Supplies Miscellaneous 407 587 723 813 Insurance 203 750 294 750 361 750 407 750 counting Wtivity 500 500 500 50'0` Taxes (Real Estate,) 203 51000 254 5,00.0 361 5,000 407 - 50000 Mortgage Debt Service 66,300 66,300 66,300 66,300 Depreciation 141150 14,150 14,150 TOTAL EXPENSES 200,730 255T,408 _14,.150 289,415 314 PROFIT (Loss) (31,913) ( 7t560) 10,706 23,735 EXPENSES FOR IST YEAR: BREAKDOWN Utilities Garbage Disposal $ 900.00/yr. P.G. & E.- Gas 130200.00/yr. P.G. & E. Electric_ 21,462.00/yr. Telephone 4,800.00/yr. Water/Sewer 34000.00/yr. TOTAh $43,362.00/yr. Insurances Fire & Liability $ 3,000.00/yr,. Taxes 1% of assessed value approximate value $2,000,000.00, which is $ 20,000.00/yr. Leaser Lease will equal that of mortgage payment & property taxes only, which will be a triple net lease drawn up at the time of completion of project. 1, Mortgage is calculated on $1,700,000.00 loan & 3 points which is a total Loan of $7,751,000.00 at a interest rate of 15% over 30 years. Y;ith equal monthly payments of $ 22,100.00/mo. This isaaccurate assessment of what it will be dependent on the Bank, negotiation & market rates, which could be lower or higher. Mortgage will be on land, building & equipment, Depreciation calculated on a straight Line Basis, 30 years on $1,700,000.00 at a cost of approximately $56,600.00/year, MIN, PAYROLL BY DEPARTMENT Gross annual payroll of '$798,583 for lst year includes: Cost/Year Pt, cast/day Administration 8 72,270 2:.00/pt. day, Nursing 542,025 15.00/'pt. day Maintenance, Laundry Housekeeping' 92,144 2.55/pt. day Dietary 72,270 2.00/pt. day Activity 19,874 .55/pt. day ,-- TOTAL 798,583 2,2.10/pt. Y day PAYROLL FOR IST 'YEAR': BREAKDOWN GROSS COS'.�f EMPLOYERS FEDtRAI, STATE wQR,KMAN' S COMPUTER PATIENT UNEM1°. INS. VNEMP. IIS. C.iOMPENSATI0IV ;PTto"SSING & YEA'R(incl,� PORTION -?,0U- COST/YEAR,NTI COST/DAY Bpnefirs *' FICA Ful ---�. '�" ���'— 297.1'5 $ 3,706,15 r 61 769.E«3 $ 4,138.54 $ 4:42.38 $1 72 27:0.00 2.00/pt. day �t 31 039.04 3,2.88 9,728.15 27,796.15 6.,949.05 ADMINISTRATION $ , t 54Z,Oz5.00 15.00/pt. day 463,269.23 ., 4,725.33' 118]..33 NURSING 5 276.62 551.29 1,653,,87 MAINTENANCE, 92,1.44.00 2.55/pt. day 780755.56 , LAUNDRY & 5126.55 110USEKEEPING 432.38 1,297.15 3;706.15 72,270.00:. 2.00/pt. day 6`1,7G923 4,1:38.54 DIETARY x;32 1,.138.0$ ACTIVITIES 356.71 1,019.18 254.$1 118.i0 19,874.00 .5S/pts day 3. 6,986 - - --_ __,_„�. $14,333.53 $40;952.96 $10-238.2979$,583,00 22,LO�p1. day $6$:2,54.57 $45,730.82 $4,777.83 TOTAL $ - -- it Benefits include: Employee's Vacation, 11o'liday and Medical Insurance. owl y� n REVENUE FOR lst MR i Medi -Cal $703,399 = 52 Medi -Cal patients at $37.06/day X 365 days. Medicare $ 12075 = Approx. 0.69 Medicare patients at $51.00/day x 365 days. Private $310,250 = 17 private patients at $50.00/day X '365 days. Ancillary Revenue Nursing Supplies $ 3600.00/yr. Laundry 8400.00/yr. Beauty & Barber 3000,00/yr. Medicare Part B 7200.00/yr, Vending 1800.0.0/y r�� TOTAL $24000.00/yr. The proposed project will not adversely affect WW the utilization of other facilities offering health services in the service area. PRESENT AND PROJECTED' UTILIZATION OF EXISTING FACILITIES OFFERING SIMILAR HEAU-L;n CARE SERVICES,• an The Northern Galitornioocup.th SratemfoV skilied nursingServices in indicates the average o..cupancy HFPA #219 is 96.25. The utilization by facility Wass follows: Beds 1 Beverly Manor Convalescent Hospital 97.6 75 2. Crestwood Convalescent Hospital. g7.3'% 184 3. North Valley Care Convalescent Hcspital 91.9% 59 4 Riverside Convalescent Hospita 97,9 70 CAPITAL ASSETS AND OPERATING EFFECT OF THE FACILITY ON_THE_CA AND MAINTENANCE COSTS, OF OTHEFc FP;CILITIES, AND ON UNUSED CAPr. A_� Y - An, impact on the occupancy rakes of thebothir facilities from our new addition is anticipated and shot lived; the present high utilization rates indicate very strong demand. tained from #l) 1.980-1985' Hearth System Plan (date obHSA EXISTING LONG-TERM CARE FACILITIES IN, PLANNING AREA There are four facilities within HFPA #219 presently offering skilled nursing care services: 1 1. Beverly Manor Convalescent Hospital 76 Beds 2. Crestwood Convalescent Hospital 184 Beds 3. North Valley Care Convalescent Hospital 59 Beds 4. Riverside Convalescent Hospital, 70 Beds PROJECTED NEEDS AND CONFORMANCE OP PROJECT The 1985 Addendum to the Northern California Health Systems Agency Services Plan, the projections indicate a shortage of 102 skilled nursing beds through 1965. Our proposed 99 bed facility will satisfy this projected need and is_consi6ered in conformance with the Health :' <es Plan,, 4/19/85 NORTHERN CALIFORNIA HEALTH SYSTEMS AGENCY SKILLED NURSING SERVICES A. DEFINITION Skilled nursing facility means a health facility which provide nursing care and supportive care to patients whose'primary need is for availability of such services on an extended basis. A skilled nursing facility (SNF) provides 24-hour inpatient care and, as a minimum, includes an activity program and medical, nursi ng, di etary, and pharmaceutical . services. The facility must have effective arrangements, confirmed in writing, through which services required by the patients, but not regularly provided within the facility, can be obtained promptly when needed. B: BACKGROUND AND TRENDS (For a more comprehensive overview of backgrounds and trends, see NC/HSA 1984 Health Systems Plan.) Historically, skilled nursing facilities (also frequently called convalescent hospitals) have been the primary institutions providing long term care to the frail or chronically ill elderly and to persons needing prolonged convalescent or ongoing nursing care. Altgrnatives to traditional skilled nursing include a 'larger emphasis on intermediate care (see component), adult day health care (see component), home health care, hospice service, respite rare, and "clustering" multiple levels of care- includi;ng skilled nursing --in such a way as to provide a continuum of services ;geared towards meeting shifting individual needs. Skilled nursing care primarily serves individuals with chronic conditions with the purpose of improving the ability of patients to function independently or to cope with impairments and disabilities. The orientation of such care is generally not curative, but rather towards preventing deteri,orati'on of the patient's condition. Conditions requiring longterm care are chronic, 'recurrent, or incurable or of sufficient duration to distinguish them from acute and self-limited illnessess. Most skilled nursing patients are 65 or older and of these, the majority are females over 75 years of age. Much --but by no means all --of the financial costs of prow -ding long term care services to a predominantly older population has beei� assumed by the under -65 population through public programs. Medicare i,v the Federal_ hospitalization and medical insurance program for the aged and disabled, who qualify regardless of financial need. Medicaid (Modi- Cal in California) is a joint Federal -State program providing health care for the financially needy. The Medicare program covers up to 100 days of care in any siriria spell of illness in a skilled nursing facility. (A "spell of illness" begins when a person is admitted to a hospital and ends 60 days after 9 _ lTitle 22, California Administrative Code, Section 73097, SNF -1 AIL his or her last Medicare covered treatment for the same injury or illness.) In order for a person's nursing home care to be covered, the beneficiary first must be hospitalized for at least 3 days and must transfer to a nursing home within ,30 days after, release from the hospital (unless no space is available within 30 days). After the 20th day of nursing care, a patient in a SNF in 1983 must pay a co-insurance charge of $50.00 per day. In 1980, Medicare paid for only 2.0% of the nation's total annual nursing home bill The Medicaid ('Medi -Cal) program has a s.ronger orientation toward long term, non-acute, institutional care t4an does the Medicare program. Limitations on Medicaid coverage of lonq,,term care vary from state to. state. All states are required to provide skilled nursing care to all Medicaid recipients eligible for Federal assistance. States maw (but are not required to) provide intermediate nursing care to this droup of 'Medicaid eligible. (See Intermediate Care Component). to addition, they may provide both kinds of nursing home care to the mrM Bally needy, a group whose coverage is rit mandated by the Federal gs.�vernment. California has chosen to include med; TABLE SNF- LONBY HEALTH GSERVICEAAREAERHEALTNIrACiLITYAPLANj1INLS AND GUAREAGAHOMEs CALIFORNIA, CALENDAR YEAR 198 AGILITY U05506/23/8) ' OBt23i8'4 ,A 01 - NORTHERN CALIFORNIA PAGE 1 __-_6ED5----- HFPA FACILITY NAME AND CITYLICHD SET' -UP PATIENT DY5„ PATIENT TYPE SERVICE 12131 12/07 DAYS 1CENSUS LICENSED PERCENT C ARLES 2/07 BED DAYS OCCPNCY 0101 CRESCENT CITY CONVALESCENT HOSPITAL - CRESCENT CITY LTC SH -GEN 99 99 24554 112: 75 36135 68.0 0105 CRESTWOOD MANOR - EUREKA EUREKA LTC MHTL DISOR 85 85 30861 101'' 83 ' 31025 99.5 01O'S GRANADA CONVALESCENT HOSPITAL EUREKA LTC SN -GEN 87 87 31605 34 87 31755 99.5 0105 PACIFIC CONVALESCENT HOSPITAL EUREKA LTC SN-GEH EUREKA 66 66 22880 135 63 24096 95.0 0105 SCA VIEW CONVALESCENT H05P'ITAL EUREKA LTC SN -GEN 99 99 34737 10.3. 98 3613.:5- 96 ,,1 0105 SUNSET CONVALESCENT HOSPITAL EUREKA LTC SN -GEN 99 99 34467 189 97 36135 9514 x,0107 ST. LUKE MANOR FORTUNA LTC SN -GEN 58 59 21137 41 58 21170 9918 71 w 0111 SHERWOOD OAKS HEALTH CENTER FORTBRAGG LTC SN -GEN 1�0 75 25706 89 IC -GEN 4 70 27375 9319 0112 NORTH BROOK MANOR CONVALESCENT NOSpITAL LTC TOTAL 79 79 2716,6 93 4 1460 100.0 74 28835 94,2 WILLIBR SN -GEN' 70 76 24518 59' 68 25550 96.0' 0113 DRIFTWOOD CONVALESCENT HOSPITAL UKIAH LTC SN -GEN UKIAH,= 68 66 23379 107 60 24820 94.2 xi 13 UKIAH LTC HILLS LTC SN -GEN 64 64 16512 122 46 IC-GEN8 19584 84.3 ' TOTAL 72 72 18576 127 49 22032 84.3 UKIAH 0113 HACIENDA CONVALESCENT HOSPITAL -UKIAH LTC SH - 112 IC --GEN GEN 113' 101 34067 88 41245 82.6 0 12 3266 , TOTAL 113 11'30.0 37353 124 96 41245 90.5 0113 UKIAH CONVALESCENT HOSPITAL LTC SH -GEN 58 , UKIAH 58 ?.0650 57 57 21170 97.5 6115 LAKEPORT CONVALESCENT HOSPITAL LAKEP'ORT LTC SH -GEN 90 90 32279 131 $7 32850 98.3 0201 WARNERVIEW CONVALESCENT HOSPITAL LTC SN -GEN ALTURAS 59 59 20440' 60 56 21535 94.9 0203 BEVERLY MAfOR CONVALESCENT HOSPITAL - YREK LTC SH^GEN 99 99 35036 105 92 36135 97 -YREKA, 0 LONG TERI1 CARE SERVICES IN HOSPITALS AND NURSING HOMES BY HEALTH SERV�'CE AREA, HEALTH FACILITY PLANNING AREA•AND FACILITY iA 01 _ CALIFORNIA, CALENDAR YEAR 1983 U0550-1(837) NORTHERN CALIFORNIA HFPA08/23.8 FACILITY NAME AND CITY----BEDS----- PAGE 2 TYPE SERVICE LICHD SET-UP PATIENT DIS- PATIENT 12/31 12/07 DAYS CHARGCS CENSUS LICENSED 0205' WEED CONVA !3 12/07 BED DAYS OCCPNCY WEED L—CENT HOSPITAL 0207 TRINITY GENERAL HOSPITAL L'rC SN-GEN 53 RG WEAVERVILLE 53 19212 40 HOS 8N-GEN' 53 19345 99.3 0204' ANDERSON CARE CENTER. 42' ANDERSON 42 1.5002 50 so .LTC SN�GEN 0 15330 ,97,.:9 0209 , BE:VERL1' MANOR CONVALESCENT' NOS�v 85 R 6 D 0 1 H G 85 30319 t..TAL - REbb LTC 57 85 31025. 0209 CR E5TWOOD CONVALESCENT HOSPITAL SN-GEN 89 97,,7 REDDING $`9 31922. REDDING' LTC SN-GEN 90 E9 0209 HOSPITALITY HOUSE NURSING NOME 113' 113 32485 98.3 4-0675 131 111 ANDERSON LTC TC-GEN34 34 11:36 41245 98.6 1AD209 SHASTA CONVALESCENT HOSPITAL 39 BEDDING 34 1241A 96,2 7" LTC SH-GEN. 7 0210 MAYERS MEMORIAL HOSPITAL 165 16,5 59523 176 FALL RIVER MILLS 164 60225 9.8,8 HUS SN-GEN 47 0211 BRENTWOOD CONVALESCENT HOS 4$ 1756Y 61 RED BLUFF PITAL 48 17155 12,4 LTC 5H-GEN S5 0211 CEDARS CONVALESCENT HOSPITAL 55 19723 RED BLUFF 58 LTC SN"GEN52 20075 98,2 ' 5802.11 TEHAMA COUNTY HEALTH CENTER' SB 20164 53 RED BLUFF 57 2117Q 9.5.2. LTC SN-GEN 67 0213 LASSEN COMMUNITY HOSPITAL 61 17.565 6'2 SUSANVl`LLE 63 1.:8920 92 8 HOS SN-GEN 29 0213 SUSANVILLE CONVALESCENT HOSPITAL 29 10253 42 SUSAN' 29 131_9 ''05$5 g6 LTC SN-GEN 96 0215 INDIAN VALLEY HOSPITAL 96 33429 0 GREENVILLE No94 35040 95.4 021QUINcY ,18 S SN=GEN 18 6254 .;5 COHVAL'ESCENT HOSPITAL g QUINCY LTC SN-GEN 57 17 6570 95,2 0215 SENECA HOSPITAL 57 19743 56 57 2.0805 94.9 CHESTER' HOS SN-GEN 12 021.9 BEVERLY MANOR CONVALESCENT HOSPITAL CH 12 4339 13 12' 4380 99.1 CHICO IC LTC SN-GEN 76 0219 CRE"STWOOD CONVALESCENT HOSPITAL - CHICO LTC 76 27086 9tt 75 27710! 97,6 SN-G:E:,N 184 184 65329 292 i182 67160 97.3 AWL LONG TERM CARE SERVICES IN HOSPITALS AND NURSING HOMES U0550 -1(83T) BY HEALTH SERVICE .AREA, HEALTH FACILITY PLANNING AREA AND FACILITY 08/23/84 CALIFORNIA, FACIL' DAR YEAR 1983 PAGE 3 ,A 01 ^NORTHERN CALIFORNIA --_-9EQS_..__- PATIENT HPPA FACILITY NAME AND CITY TYPE LICHD SERVICE' 12/31 SE1�-UP 12/07 PATIENT DAYS DIS- CHARGES CENSUS 12/07 LICENSED' BED DAYS PERCENT OCCPNCY 0219 NORTH VALLEY CARE CONVALESCENT HOSPITAL LTC SH -68H 59 59 19780 79 59 21535 91.9 CHICO 0211 RIVERSIDE CONVALESCENT HOSPITAL _ CHICO LTC SN -GEN 70 70 25064 83 68 25550 97.9 CHICO 0220 CYPRESS ACRES LTC IC-GEH 2;9 29' 9648 30 29 1,0585 91.1 PARADISE 0220 CYPRESS ACRES CONVALESCENT HOSPITAL LTC SN -GEN' 107 1,107 35649 1144 95 37615 93.2 PARADISE 0220 EDGEWQOD CARE HOME LTC XC-IGEN 14 14 5085 8' 14 5110 99.5 PARADISE 0220 PARADISE CONVALESCENT HOSPITAL - PARADISE LTC SN -GEN 44 k4 15,939 23 43 16060 99.2 PARADISE 0221 GIsLMORE, LANE CONVALESCENT HOSPITAL LTC SH -GEN 5'0 5,0 18239 28 50 18250 99.9 7-1 OROVILLE 71 0221 LAKEVIEW NURSING HOME, INC. LTC SH -GEN 28 28 9943' 17 28 102.20 97.3 OROVILLE 02.21 OROVILLE COMMUNITY CONVALESCENT HOSPIIA'L I,TC SN -GEN 0 0 0 0 0 6478 0.0 XA OROVILLE 0221 VALLEY OAKS HEALTH CARE CENTER LTC SN -GEN 82 82 29273 83' 8? 29638 98.8 GRIDLEY 0223 W'TLLOW VIEW MANOR LTC SH -GEN 79 79 28805 54 79 28835 99,9 WILLOWS 0.225 VALLEY WE5T CONVALESCENT HOSTITAL LTC SH -GEN 59 59 21072 52 58 21535 97.9 WILLIAMS TOTAL LTS^SN-GEN. 3028 3018 10.43170 3436 17,00655 94.8 SOURC81 STATE OF CALIFORNIA,#,OFFICE OF 'STATEWIDE HEALTH_ PLANNING AND DEVELOPMENT, ` ANNUAL REPORT OF HOSPITALS AND SKILLED NURSING/INTERMEDIATE CARE' FACILITIESe 1983. *I - First licensed` in 1.983; in operation, 306 days that year., *G - Report estimated by'09HPD *A Facility 'closed but report Was received, STEP 2: Unadjusted Future Utilization Rate. Table SNF-2 lists skilled nursing patient day rates from 1980 to 1983 for each HFPA in HSA 1, along with an average for those four years: STEP 3: Adjusted Future Utilization Rates. It has been NC/HSA policy since 1979 to base long-term care resource projections upon the place of patient origin rather than st'rirtly upon utilization data from existing facilities. This allows needs to be shown in areas where resources are not currently available and it provides information as to where demand'. originates rather than where demand is fulfilled. The NC/HSA has conducted 'patient origin surveys of area long term, care facilities since 1978. Patients from each HFPA have been trackdd through five surveys over a six year period of time in order to determine how many persons are 'residents of a long term care facility in HSA 1, and if ,persons are not patients in a facility in their own HFPA, where they are located. Two interesting trends have become apparent from the surveys. (1) The actual number of persons from any given HFPA who reside in a skilled nursing facility in HSA I has not varied much over the years except for increases which are consistent with growth in the 65+ population. (2) As new beds are added in an HFPA, the dumber of persons receiving services outside their own HFPA diminish for that particular area. In addition to these patient origin trends, other factors must also be considered in examining utilization and patient day rate patterns. (1) Patient day rates are low for residents of HFPAs without skilled nursing services, even though services are available in contiguous HFPAs. (2) Patient day rates tend to be low in HFPAs with consistently high occupancy rates. (3) The patient day rates shown in Table SNF-2 all precede the i ni ti ati on of t4edi care I s new di agri.ostj c rel ated .9roi4p (DRG) reimbursement policies for hospital care.; These new policies encourage the discharge of acute care o"atients as soon as medically feasible. It is anticipated that this program will increase the demand for Sr(Ovn t .term stays in skilled nursing facilities, but the extent of increased demand is unknown. As a result of the above factors, the NC/HSA has arrived at a skilled nursing'patiennt day rate (patient days per 1000 persons 65+)based on the observed patient day rate shown in Table SNF-2, as adjusted by the migrational patterns shown in the NC/HSA's patient origin surveys. (Table SNF-3). For those HFPAs without skilled nursing services, future projections will be based on the average patient day rate for the entire health service area. SNF-6 _,. ._ ..w�w�irme�S9� Ilwlll�\Yfllllll®i'Y�1�� Table SNF-2 �. OBSERVED PATIENT DAY RATES' HFPA 1980 1981 1982 1983 Average 101 13173 12733 10781 10265 11738 103 -_- --- _ - 105 14412 16047 15792- 15403 15413 107 7951 7645 7551 7500 7662. 109 -.... .,.... ...... ...... ...... 11.1 6671 8062 9011 8303 801.2 112 18892 181.47 17756 17050 17961 113 20836 21292 21574 24799 22125 115 4031 3774 3625 3410_ 3710 201 - 17870 16789 16231 14876 16442 203- 13827 13087 12281 1162.4 12705 205 7420 7496 7345 7255 7379 11997 11873 1.1426 10824 11530 09 11673 11323 11496 11774 11566 210 10114 10017 15478 15459 12767 211 9101. 8200 8961 9035 8824 213 22281 23328 23210 21797 22654 215 20307 20275 20321 18453 19839 217 --- "-- 219 21672 23025 20002 18836 20884 220 6169 5985' 5908 5695 5939 221 7403 7129 6853 6629 7004 223 9723' 9604 9528 9380 9559 225 12217 12035 11288 10986 11632 Total 11158 11230 10986 10797 11043 i o SNS'-7 In addition to adjusted patient day rates, the NC/NSA skilled nursing bed need projection method assumes an optimal occupancy rate of 90%. Although there 0 is much discussion as to whether a 90% or 95% occupancy rate is best for skilled nursing services, use of-the 90% rate allows room for growth if the assumption of increased demand as a result of DRG reimbursement policies is accurate. The method used in this year's Plan, while similar in approach to that used in 1980-1984 nevertheless shows an increased need in terms of patient day rates in many HFPAse The reasons for this increase are as follows (1) The past methodsneverpatient days originating from out Of state; the 1983 method includes these patient days in the observed rate. (2) The past method was based entirely on adjusted patient day raises (;that i;s, only on demand as determined by place of residence)i, the current method also includes observed patient day rates (actual utilization regardless of patient origin). (3) During 1984 and 1985, the preferred occupancy rate has been 90%, prior to 1984, it was 95%. As a result, the discrepancy between 1985 projec- tions and 1983 (and earlier HSPS) is especially acute. HFPA 115 (Lakeport)° This HFPA has one of the most rapidly growing elderly populations in California. The one skilled facility in the area has been operating at maximum capacity for years. This artificial "cap" on utilization can be seen - in the decreasing observed patient day, rate: shown in SNF-2. Because of a shortage of beds, residents from this HFPA are frequently sent out of MSA 1 for SNF care and therefore are not picked up either in observed patient day rates (3710) or the adjusted rate of 4851 (which reflects migration only within HSA 1). In 1983, he NC/HSA Plan increased this rate to 7824. That rate will be maintained this ar as well. STEP 4: Calculated Resource Requirements: Table SNF-4 shows 1990 projected' patient ays for eac HVFA usi gf�naT a juste patient day rates, and the average daily census (ADC) associated with those patient days. Table QNF-5 shows licensed SNF beds as of1983, theoccbed needs associated with 990 projected' the average daily census shown in Table SNF-4 a excess/shortages, STEP 5: Effect on Other Services: Of services covered by California Certificate of Nee egis ation, increases oreCesin skilld eur�sAngincreasesinothe ava�l-� their greatest effect on acute medical/surgical servces ability of skilled beds may reduce administrative days in general acute care facilities; a decrease in skilled beds could well have the reverse effect. F. METHOD_' (1) FORMULA A) _ PORBY = SNF PT. DAYSBY x 1000' POP 65+BY Where PDR = patient days per 1000 population 65+ SNF MAYS. = Patient days in skilled nursing services POP 65+ = population 65+ BY base year SNF-9 D) 15197 X 4430 _ 67322710 67323 1000 1000^ E) 67323 = 184.45 365 F) 184.45 T, 205 .9 Table SNF -4 SKILLED (NURSING -GENERA[, 1990 Projected 1990 Projected HFPA Location Patient Days.._ AN 101 Crescent City 30790 84.36 103 Hoopa 8823 24,17 105 Eureka 121801 333.70 107 Fortuna 41736 114.35 109 Garberville 12368 33.89 111 Ft Bragg 38319 104.98 112 Willets 30944 84.78 113 Ukiah 67322 184.45 115 Lakeport: 105921 290.00 201 Alturas 30547 83.69 203 Yreka 45474 124.59' 205 Mt. Shasta 31391 86.00 207' Weavervil'le 23425 64.18 209 Redding 202866 555.78- 210 Fall River Mills 15791 43.26' 211 Red Bluff 71148 194.92 213 Susanville 41642 114.09 215 Quincy 29332 80.36 217 Portola 8967 24.57 219 Chico 161437 442.29 - 220 Paradise, 94497 258.90 221 Oroville 90716 248,55 223 Willows 38933 206..66 225 Colusa 26310 72.08 n SNF -1.1 Table SNF- 5 Aft SKILLED NURSING-GENERAL BED NEED PROJECTIONS Lic. Beds Bed Need HFPA Location 1984 *' 1990 Excess Shortage` 101 Crescent. City 99 94 5 -- 103 Hoopa 27 105 Eureka 405 371 34 _- 107 Fortuna 104 127 -- 23 109 Garberville -- 38 -- 38 III Ft Bragg 75 117 42 112 Willets 70 94 -- 24 113 Ukiah 303 205 98 -- 115 Lakeport 265 322 57 201 Alturas 73 93 -- 20 203 Yreka 99 138 -- 39 205 Mti Shasta 118 96 6 - 207 Weaverville 42 71 -- 29 209 Redding 572, 618 _.. 46 210 Fall River Mills 48 48 -- m- 211 Red Bluff 180 217 - 37 213 Susanville 127 127 -_ -- 215 Quincy 87 89 _. 2 217 Portol a 27 -- 27 219 Chico 389 491 -- a0 220 Paradise 250 288 -- 38 221 Oroville 250 276 216 223 Willows 79 119 -. 40 225 Colusa 59 80 -- 21 *Includes beds granted through the CON process but not yet available for use. SNF-17 SKILLED NURSING SERVICES COALS, OBJECTIVES AND RECOMMENDED ACTIONS GOAL SNF -1: Skilled nursing -.services should be available and accessible to meet the needs of the population in HSA 1. OBJECTIVE SNF -1a,_ Over the next five years, skilled nursing tc,3vl;es should be actively encouraged in areas With a high percentage of 75+ popu`latiorii, especially if residents are being sent to communities in excess of fifteen miles from their home. RECOMMENDED ACTION SNF-la(l): Stimulate the development of additional inpatient long term 'rare caj=-,Acity in shortage areas. GOAL SNF -2: Long term care services rooud rieleveliofdin ways hat availabletcare ensure the provision of the most app pate in terms of quality, continuity, and efficiency of operation; OBJECTIVE SNF -2a: The current utilization of long term inpatient Care should be increasingly supplemented through the provision of more appropriate and/or less costly services such as residential care, adult day health care, home health, and homemaker services. ADA RECOMMENDED ACTION SK -_2 L 1: Encourage the maintenance of established patient -physician relationships as the patient moves among various care levels and settings. GOAL SNF -3: Reimbursement levels for long term should be established in such a manner as to prtvide incentives fdeveloping high quality, patient -supportive services. OBJECTIVE SNF -3a: support as needed, state legislative and administrative efforts to improve reir�bursement criteria and 'policies for long term care services. RECOMMENDED ACTION SNF -3,a : Support the modification of restrictive regulations Which impair the economic provision of skilled nursing services, especially in rural areas. SNF -13 The project will fill an unmet community need that is identified in the Statewide Health Facilities and Services Plan or in an exist ing area plan, as provided in Section 90515, if the type of project is addressed in the plan. GEOGRAPHIC TARGET AREA The Convalesc nt Hospital will be located approximately l mile ftbm the Chino Community'Hosp �tal and 'within close proxima„ty to local doctors' offices and medical. clinics. The primary target service area is HFPA #219 and e)ncompaszes all of Butte County. The area has a strong agri=-busi.iless and industrial. economic base. Yielding crops include dairy, cattle, walnuts, almonds, peaches, grapes, hay, grains and various types of row crops: Also California State University-Chico is an ekd,11ent source of resources. The ethnic composition of the County based on the 1980 - 1985 is as follows White 91 Black 1 Spanish 5% Other 3 The City of Chico has the following composition White 91 Black 2 Am. Indian 1 Hispanic 6 Other 1% The target population identified for -skilled nursing dire facilities is people 65'years of age or older. Within HFPA #219, the estimated 1985 population of those over 65 was 26,527 in the City of Chico, and the projected 1990 pc.pulation is 30,895 in the County, of Butte. 1900-1985 Health system Plan (data obtained from HO #l) 1985 Census, Obtained from Tom Walker, Census Group Information office. Al sk sIMMWMI til 1 1l /j i � 1 I •1 I IN I i ry i yil i, 1 1 / ,�^ 9 �Y n P f r • k i yil i, }i 1 r 1 / ,�^ 9 �Y n P • k 1 T S Y � ! . r ! ' f S 1� Y r'.� ti •� l 33 1.� d .1'� �t d f � 4�IYth i 1• i- 4 ! .+Y I tI/I hot°' , i • f A { 1 •N' t i 1 1 I'� 1 i f t If i �AS'�L i yil }i 1 r 1 / �Y n P • k 1 T S . ' f S 1� Y r'.� ti •� l 33 1.� d .1'� CRITERIA TO ESTABLISH DESIRABILITY OF 'PROJECT i Submit a separate attachment for each applicable criterion below. Please:.,.. identify each attachment with the criterion number. The attachment should include evidence on every factor noted for that criterion, the source of' that evidence, and the methodology employed in projections, estimates, etch" CRITERIA IN SECTION 90901(b) t: CRITERION #1 The project will fill an unmet community need Statewide Health Facilities and Services Plan, is addressed in the Plan. identified in the, if the type of project 1. For the type of project proposed, identify the appropriate planning area need shown in the current Statewide Health Facilities and Services Plane 20 For the type of project proposed, identify the quantity of, resources which have been approved it the appropriate planning area since the date of the inventory listed in the Plan. 3. Estimate the present and projected population in the service area., r CRITERION #2 The project will be optimallyutilized within a reasonable time period in a financially feasible and economically efficient manner. The project will be optimally utilized in a financially feasible manner within a reasonable projected time. , PROJECTED UTILIZATION The need for skilled nursing faacilities, according to the health Agency System is presently 9 -&-beds. We anticipate that at the end of the first year occupancy of the new facility will. be 70% or more, as per the existing need First quarter 45% Second quarter 65% Third quarter 80 Fourth quarter90 Avg. First Year Utilization 70 it is anticipates, because of the demand and growth rate of the target population, the hospital will operate at a minimum 805 the second year, 90% the third year, 95% the fourth year and 99% for subsequent years in projecting revenues for the new facility, we assume•75% of the' census will be Medi -Cal patients, 1% of the revenue will come from Medicare patients and the rr.-;maining 24% from private pay individuals. ly Less costly alternatives for the project were evaluated and found not to be as desirable as the proposed project. Listed below are less costly alternatives that were evaluated and found to be less desirable than the proposed project; 1. Transfer of patients directly from the acute hospital out of the coiInty to other communities. This would not be desirable due to the problems described in Attachment B. 2. Transfer a patientdirectly to a Board and Care Facility. This alternative is not desirable as the patient could not obtain the necessary level of care at a Board and Care Facility. 3. Transfer the patient home, This is not a viable alterna- tive as the necessary level of care is not available. 4. Intermediate Care was not: evaluated as a less costly alter - .native beause the needs of the patients could not be met Ask in, an intermediate care facility. A Skilled Nursing Facility will alleviate unnecessary expense for patients �` occupying acute care beds. COST CONTROL' Administrator will operate this :facility within strict budget- ary guidelines. Annual budgets are prepared by the administrator... These budgets establish objectives for revenues, census, labor, fringe benefits,, supplies, food utilities and other support services. COMMUNITY INVOLVEMENT' This facility and consulting staffs, recognizes the importance of the role it plays in the provision of care in theommuni�ty. Constant effort will be made ,to communicate effectively with every aspect of the community. These efforts consist of, but are not limited to, monthly `open houses where relatives, services organizations., and concerned citizens are invited to visit the facility and discuss issues, with the administration. Additional community input is received on a continuing basis for local ombudsmen groups and ministerialgroups., ssibliY 'ect will enhance oaul.ationytotbeoserved. The pro7 health services to the P P will significantly enhance the care services by providing these The construction of this facility the commute outside of the availability of skilled nursing serv' ceS locally, thereby elimina*'eing planning area. The d�+sire for a familiar environment clostarGet age igrotxp.d friends is a characteristic' common tortthis characteristic and service locally accounts providing sof' isolation. is a major deterrent to feeling (f+tb Carbon Required} Paget of 3, '� RESIDER TIAL. PURCHASE .. -- -�.�.� AGREEMENT AND DEPOSIT RECEIPT s� ?cCEIVED from Bryan Jennings hereinaf•.erdesignated as PURCHASER, the amount set forth below as DEPOSIT on acccunt of to PURCHASE PRICE of $ ] O i 600(_]1eh ninety=three thousand Six hundred and no. JEOL ARS). for real.prope.�tyin the City of. Chi ro _ County of Butte ,State of Call orrua describedas_P__-=til 42 East- AXre ,g, t tta�irk ? 1 acre ng,-=J QPP AI ND ,upon the following TFP.i'+AS A.e!"' CONDITIONS: I. FINANCllllc`S'!"caiFAM Exhibit ('01, AP#42-45-24 through 30. - A. S 2,000.00 DEPOSIT evidenced by ❑ Cash, ❑ Cashiers Check, ❑ Note Personal )te�c ❑,Other to be deposited immediately upon acceptance with: Mia V. let T,t1e l.Cliip811 EL $ hTiA ADDITIONAL CASH DEPOSIT in escrow[]within days from acceptance. ❑uponremoval ofall continaencies. S 7 R _ ()C)() _ Ci(t BALANCE' OF CASH PAYMENT as close og acv. PROCEEDS FROM NEW g+t AH(51, conditioned upon Purchaser's ability to qualify for and obtain commitment for the fellowingfinancing within daysof acceptance, or waive this condition in writing; 1R $ NSA 1:19 LOAN, payable at approximately$ per month, with interest not toexceed_V.,at❑FixedRate, . ❑ Other: , with the balance due. not fess than -years- Loan Fee not to exceed %; plus $ Other terms- In the event the First Loan is a V.A. Loan, Seller tigress to pay discount points not to exceed Via. E. $ A SECOMO LOAM. payable at approximately$ per month ❑ or more, with interest not exceed 'Yo. at ❑ Fixed Rate: p Other. with the balance due in not than years. Loan Fee not to exceed_% plus 5 EX1573l4fts LOAR(5), of recordin the approximate 'amount(s) specified below: Conditioned upon ❑ ASSUMP71ON OF, [I SUBJECT TO: �• $ NIA giRW LOAN (approximately), payable at $ per month, with Interest currently at %, 0 Fixed Rate, ❑ Other. held by Monthly payments ❑ include, ❑ do not include Taxes and Insurance. Assumption Fee, if any, not to exceed-9,.1. C- NSA Conditioned upon E]ASSUMPTION OF, E] SUBJECT TO. SstCOND LOAM (approximately), payable at $ , per month, with interest currently at-'/., E] Fired Rate,. Other_ held by Assumption Fee, if any, not exceed %, Seller shall within - days of acceptance provide Purchaserwith copies of all Notes and Deeds of Trust orMortgagesto be assumed or taken subject to, and within days of receipt thereof Purchaser shall in writing notify Seller of his ap- proval or disapproval of such tents, which shall not unreasonably withheld_ Seller shall'fumish Purchaser a current Be neficfaryStatement on the above:loan(s) within-days of acceptance: In the event of ASSUMPTION, Purchaser shall use his best efforts to obtain the consent of the lender of record to assume the above loan(s) within days of acceptance, or waive this condition inwriting. All charges related to such Assumotion sh311 be, paid by Purchaser: ❑ ASSUMPTION OF VA LOAN WITH RELEASE OF LIABILITY. Purchaser shall assume Seller's Potential Indemnity Liability to the U.S. Govemment for the repayment of the loan. IL S 173,600 SEUXR TO CARRY., FIRST, (R SECOND„ Q THIRD LOAN, secured by the property,payable:at5 per month, ormore, incfuding %, interest, with the entire balance due years from date of conveyance or upon sale or transferof the property.A late charge of S shall be,--due on monthly payments tendered more than days late. Otherterms:- See Page 3, Items 12 and #3 FINANCIAL STATEMENT. Within days of acceptance Purchaser shall fumish Seller a customary financial statement.for the sole purpose of creditapproval, which approval shall notbe unreasonably withheld_ Purchaser authorizes Sellerto engage the services of a reputable credit reporting agency forthis purpose at Purchaser`s expense and Sellershall notify Purchaser within - - days of receipt of financial statement, of approval ordisapproval of purchaser's credit. '- $' N/A 6aLL-INCLUSIVEDEED OFTRUST; Purchaser shall execute a Note secured by an All-Inclusive Deed ofTruston the property in favor of (Seller/Lander) payable at approximately permonth; or more, with interest not to exceed1k, with the entire bal- ance dueyears from date of conveyance„ Loan Fee, if any, not to exceed %.TheAlHnclusiveDeedofTrust is subject to and subordinate to a Deed of Trust now on record in the original amount of $ in favor of ,securing a Note in the original amount, with an approximate -unpaid 'balance of$ ,_. payable at.S. hermonal including interest at-%, including Taxes and'iInsurance., with the balance due The terms ofthe AlHnclusive Note and Deed of Trust and the terms of the existing Note and Deed of Trust shall be subject to the reasonable approval of the attorneys. for each party. Failure of eltherparty tosubmit a wnttenrejerxi n.specifying the objections to any such documentswithin days of their submission to such party, shall be deemed a waiver of any ob- jection thereto. Seller shall furnish Purchaser a current Beneficiary Statement on the loan secured by the Deed of Trust of re- cord within days of acceptance. Q Additional terms of the All-Inclusive Deed of Trust, if any, an,page ,101.3! Jr '$ N%A 13O IDS O2 ASSESSMENTS of record, if assumed by Purchaser. (See Item S on page !012) - $ DIA ADDITIONAL FLEANCIAL TERMS: El Additional Financial Terms are specified under the heading ADDITIONAL TERMS'AND CONDITIONS on page 101.3. C Additional Financial Terms are contained in an ADDENDUM of same date, attached hereto. signed by both parties.' 1- $ 1�3�600 0fl TOTAL PURCHASE PRICE (not including closing costs).Any net approximate balances of encumbrances shown above; which are to be assumed or taken subject to, and theactualbaiances of said encumbrancesat close of escrow shall be adjusted tri ❑ Cash, ❑; Omer aurchaser's initials:[ _ �} L: _ t 1 Seller's Initials:[— _ )' [ ] zORM 101.1 (11-84) COPYRIGHT = ;984, BY PROFESSION,-.L PUBLISHING CORP 122PAULOR SANRAFAELL CA S49M{o�L]I PR®r-EgSr0XAL NCR (NO Carbon Required), Property Address Sarre 'n2 East Ave apd Qissick Page Zot Z. CLOSIN& OnorbeforeA11RUSt 31.,orw,�j-2a—daysofacceptance, whicheverslater. both parties shall depositwithanauthedsdEscrow Hotde to beselected by g] Purchaser, Q Seller, all funds and instruments necessary to complete the sale in accordancewith the terms hereof. Until then, Purchaser, St lerand.Brokeragree,notfodisclose t eterms oisale. Tne a rasentatfonsandwarrantiesshallnotbeterminatedbyeoriveyanc fthe property. -x/Seller, S�>�Q Seller Escrow Fee to be paid by , Documentary Transfer Tax, if any, to be paid by 3. EVIDENCE OP TITLE inthe form of [R a policy ofTrtle Insurance, ❑ Other paid by SPl l er 4. OCCUPANCY. Possession, with all treys, shall be delivered to Purchaser (check either Item [1 j cr item [2j) : K] 1. UPON recordation of the deed Q 2 AFTER recordation, but not laterthanmidnightof Unless Seiler has vacated the premises prior to recordation of ti - - - deed, Selleragrees topay Purchaser $— per!+Ay tr in recordation iodate possession is delivered arid to leave in escrow a sum equal to U above per diem amount multiplied by the number of days from date of closing to date allowed above for delivery of possession. Said sum to be disbursed the persons entitled thereto or. the (late possession is delivered. It Seller remains beyond above date, the daily amount zhall be multiplied by three. S. EXAMINATION OF TITLE. Fifteen(15)clays from date of acceptance hereof are allowed the Purchaser to examine the title to the property and to report writing any valid objections thereto. Any exceptions to the fitle,which would be disclosed by examination of the records, shall be deemed to have been accepted utile reported in writing within saififteen (15) days. If Purchaser objects to any exceptions to the title, Seller shall use due diligenceto remove such exceptions at his own e pense before close of escrow. But if such exceptions cannot be removed before' close of escrow, all rights and.obligations hereunder may, r rthe election of the Purchaser, terminate and the deposit shall be returned to Purchaser, unless he elects to purchase the property subject tosuch exceptions. 6. BONDS. The amount of any bond or assessment which is a lienshall be Q paid, ❑ assumed by T. ENCf; MBRANCE& to addition to any encumbrances referred to herein,, Purchasershall take tille to the prop" subject to: Ill Real EstateTaxes not yet dL and {21 Covenants, Conditions, Restrictions, Rights of Way, and Easements of record; if any, which do not materially affect the value cr intended use of the proper Saiddocumenisshall be deemed approved unless written notice to the contrary is delivered to Setfer or his agent within ten days of acceptance, IL CONDITIONSSATISFiEDINWRITflNCL Each condition contained herein shall be satisfied according toitstermsorwaived inwriting oyb;eparty respo slblewithin the time specified (orany extension thereof agreed to by the parties in writing). orthis agreement shall be null and void and all deposits returned to Purchas less expenses incurred by Purchaser to the date of cancellation of this transaction. This paragraph contemplates that each party shalt diligently pursue the compietir of this transaction. 9. DUE ON SALE CLAUSE. IF the note and deed of trust or mortgage for any existing loan contains an acceleration or DUE 0 SALE clause, the lender may demand full payment of the entire loan balance as a result of this transaction. Both parties a knowledge that they are not relying on any representation by the other party or the broker with respect to the enforceabili- of such a provision in existing notes and deeds of trust ormortgages, or deeds oftrust or mortgages to beexecuted in acro dance with this agreement.:' Both parties have been advised by the broker to seek independent legal advice with tespectt these matters. 10. BALLOON PAYMENT. Both parties acknowledge they have not received or relied upon any statements or representation made to them by Broker regarding availability of funds, or rate of interest atwhich;funds might be available, when Purchasi becomes obligated to refinance or pay off the remaining balance of any loan pursuant to the terms of this agreement 1. PRORATIONS. Rents, taxes, interest, and other expenses of the property to be prorated as of the date of recordation of the deed. Security deposits, advant rentals, or considerations involving future lease credits shall be credited to Purchaser. 12. INSURANCE. Pur chaser to obtain hazard insurance prepaid for one yearin an amount satisfactory to the loan holders and covering one hundred percent replac. mentcost Of improvements, and to name holders of the secured loans as additional loss payees: 13.. NOTICES. By acceptance hereof Seller warrants that he has no notice of violations relating to the property from City, County, or State agencies. 14 FIXTURES. Ail items permanently attached to the property, including attached floor coverings, draperieswith hardware, shades, Winds, window arid door screer storm sash,combinabon doors, awnings, right fixtures, television antennas, electric garagedoor openers with controls, outdoorplants and trees; are included in thepL. chase price free of liens, EXCLUDING: 15. PERSONAL PROPERTY. The following personalproperty, on the premiseswhen inspected by Purchaser, is included in the purchase price and shag be tran (erred to Purchaser by a Warranty Bill of Sale at close of escrow. No warranty is implied as to the condition of said property, - 16., MA114TEMANCW Seller covenants that the heating, air-conditioning (if any), electrical, sewer, drainage, spnnkfer (ifany), and plumbing systems including 11 6 water heater, as well as built-in appliances and other mechanical apparatus sha I be in normal working order on the date occupancy is defivered. Seller shall replace ai cracked or broken glass including windows, mirrors, shower and tub enclosures. Until occuparzy is delivered Seller shall maintain landscaping, grounds and pool any). The following items are specifically excluded from, the above• 27.. ACCESS TO PROPERTY. Seller agrees to provide reasonable access to the property to Purchaser and inspectors representing Purchaser as provided and any item of paragraph [181. and to representatives of lending institutions for appraisal purposes, 113._ PROVISIONS, ON THE REVERSE SIDE. The provisions checked below are included in this agreement on the reverse side. Q A Pest Control Inspection, paid by ❑ Purchaser,, ❑Seller Q J. Contingent upon the sale of Q B. Existing Pest Control Report by • Dated . Q K. Inspection of Physical Condition and Energy Efficiency ❑ C."As is," but Subjectto Purchaser's Approval ❑ L VA Appraisal Clause Q D_ Waiverof Pest Control Inspection ❑ ,M. FHA Appraisal' Clause Q E. 'Roof Inspection within days of acceptance E] N. Smoke Detectors, provided by F. City and County Inspections ❑ 0. Flood Hazard Zone. Q❑ G Condominium Disclosure Q 'P. Special Studies Zone ❑ H. Home' Protection Contract,' paid by for S- - - ❑ L Maintenance Reserve of!3 19. DEFAULT. In the event that Purchaser shall default in the performance of this agreement, unless the parties have agreed to:a provision for liquidated damage Seller may, subject to any rights of the Broker herein, retain Purchasers deposit on account of damages sustained and may take such actonsas he deems appropria to collect such:additional damages as may have been actually sustained, and Purchasershall have the ngtii to take such action as hedeemsappropnatetorecoversui portion of the depositas may be allowed bylaw. In the event that Purchasershall so default, unless Purchaser and Seller have agreed to liquidated damages. Purchas : agrees 'to'pay the Broker(s)l entitled thereto such commissions as would be payable by Seller in the absence of such default: Purchaser -'ligation to said Broker( shall be in addition to any rights which said Broker(s) may have against Seller in the event of default In the event legal action is instituted L e Broker(s), orany par to this agreement, or ansing out of the execution of this agreement or the sale, or to collect commissions, the prevailing party shall be ent areceive fromthe oth, party reasonableattorney fee to be determined by the court in which such action is brought. 20. LIQUIDATED DAMAGES. Byinitialing this provision Purchaser: [ ]'and Seller: [ ] agreethati the event Purchaser defaults in the performance of this agreement, Seller.:hall retain the amount of deposit, or three percer of the purchase price, whichever is the lesser, as liquidated damages for such default. The remainder of the deposit, if an, shall be refunded to Purchaser. The parties agree to confirm this provision upon making the additional deposit with the e. - crow holder. 21. REASSESSMENT DISCLOSURE. The property will be reassessed as of date of conveyance which may result in a tax increase. / Purchaser's lnitl j! ' ] j ] Seller's Initials [�� ,] [ _j (CONTINUED ON REVERSE SIDE) FORA. 101.2CAL (10$3) COPYRIGiir a 19&, SY PROFESSIONAL PU0Li5HING CORP 122PAULDR s;"A;FA--- # ,Y3 PROFESSIONAL. 1fGR(NoCarbon Requued}. Property Addesg: Pit-rpl9? ''acf Atsp anri ('itcg=CV Page;,of3 ` iiiGiat Ty OISCL®SUR—E STATEMENT.- Purchaser TA'f'icMENT:Purchaser has received,and reviewed a copy of a Property Disclosure Statement prepared and signed by Selig. Upon dativeryof the accepted offer orcminter offer. Purchasefshall receive a Property Disclosure Statement prepared and signed by Seller It Purchaser is not satisfied with any, condition disclosed in the statement previously unknown to Purchaser, he may rescind the offer by written notice de- livered to Sellers agentwithin72hoursofreceipt of'Sellersstatement or notifySeller,nwnhngw;Lhinsa;d72hoursofPurchaser'selection write rnotic e- inspections of the propertyby appropriate professionals. If Purchaser is not satisfied with the result of such inspections, he may rescind the offer by written notice delivered to Seder`s agent, together wih copies of the inspection reports, within ten days of receipt of Sellers' Property Disclosure Statement: Purchaser understands thattSellor s Property Disclosure Statement is no substitute for inspections by professionals, including but not iimited to engineers; architects, general contractors,, and structural pest control operators,, and Purchaser may wish to consider retaining such professionals of his choice. Purch- aser understandsl-�atthe agents cannot warrant the condition of the property or guarantee that al defects have been disclosed. Seller agrees to hold all brokers and agents in this transaction harmless from any damage or expense, including reasonable attomey sfees, on account of anyomission oralleged omission from said statement. BROKER REPR EStNTiNG BATH PARTIES. By placing their initials here: Purchaser. [ aid Seller, [ ] [ ] acknowledge that ] [ ] thebroker in this transaction, represents. both partiessand Purchaser and Seller consent.. thereto. AMPiTIONAL TERMS AND CONDITIONS. - .—Contingent -u a bt Ring-a-ose-pertn t --ani eerti£ication- oma--need-€Fr-1a --� . �'�—' one; Sel� M. P, 3. Sol] I ntf and: 4. BuyE luL;ai auLnorities , _plans: to approve t into coripfeti prior to seller prior to cl and correct by an w M.P.P. a second note :y a note and first deed of trust on subject. interest- _pger annum _ able monthly in interest cable in 4 gears from _close of escrow or sooner. of said note from North Vallev oil Company tis offer. --- e - �d of trust in the amount of -66,100, at l0% torose only{ payments -of 350.83. All due LLLacnPQ TIACYPc & nnrf '1° ent-i ,tel p.i "EXbi hi t- err to a performance ipmrovempnt 1- nm ,.Ti i i >-- --+.,,a x�uuu Roe r -o exceed one(l) 3 e, ADDENDUM., The following addendum of same date. signed by Purchaser and Seller, attached hereto„ is an integral part of this. agreement, Items- bttrrough�o DlEFIialTIOPaISa As used herein the term "Broker" includes cooperating hrokers and all salespersons, and the term -days" meanscafendardays unless, otttrwise specified TIME Timo is of the essence of this agreement All modifications and extensions shall be to writing and signed by all parties- E7IP IRATIOM This offer shall expire unless a copywith,Ssilees written acceptance is delivered to Purchaser or his agent within -I- dals from date. The undersigned Purchaser has read th!s agreement and hereby aknowledges receipt of a copy of pages 1,2, 2a and 3. Purchasere,—'—.owfed�gvss further that he has not received or relled, upon statements or representaticas y .e undersfyred Brokerwhich are net?*P-' �+ _ ,Jrer . aX�ts3sett. Fran Shpl tort R AScnri ^ tpc E n Purchasers Broker A D:3"I LIZ +�- lay �c-cz_ Pu 8rokecsln;tials ;Dated: s Pair_: ACCEPTANCE IANC Seller accepts the forggoing offerand3grees to sell the herein described property, for the price and on the ter ; - and conditions herein specified, I4 COMISSION. Seller hereby agrees to. pay to Ftnn Shelton F, ASSO a , enc Me Broker to this transaction, tn.Cashfrom proceeds at dose of escrow, for services rendered: In the event that Purchaserdefaults and faits to complete the sae, the Brokershall be entitled to receive one-"Ifof Purchaser's deposit, but not more than the commission earned; withoufprejud;ceto Brokers rightsto recover the t -Rance of the commission from Purchaser. The, mutual rescission of this agreement by Purchaserand Seller shall not relieve said parties of theirobl igations to Broker hereunder.This agreement shat, not limit the rights of Broker provided for in any listing or other agreement which maybe in effect between Seller and Broker. except that the amount of the commission shall be as specified herein. The undersigned Seller hereby acknowledges receipt of a copy of pages 1,2,2a and 3 of this agreement and authorizes, Broker to deliver a signed copy to Purchase. SellersBroker DATED: _ j�'�!�> TIME: 3 30�',. r -t, By, ='� ( Seller Broker'slmt:als, Daled *P1 YZ Seller The undersignea Furchaser hereby acknowledges receipt of a copy of the accepted agreement DATE. #ME: Purchaser FORM 101.3 -CAL (1148) - COPXAIGNT c 1W ay PROFESSIONAL FUBUSHiNP cOAP_ 772P,�t7LDA, SANWASL CA 949963- �PROFESSIONAL PUBLISHING ADDENDUM TO PURCHASE AGREEMENT In: reference to Purchase Agreement and Deposit Receipt between . , ;cyan Jennings and Lowen ;ileal Estate �- . .............. the'PurChaser, ' dated May %� L985 _ .... .. _ ............................ the Seller, '" covering: the r -. _.;......_,_.., eat Property Parcel 2� Fast Ave ,and Cussi.ck p perty commonly known as AP>42 24 through 30 the'undersigjx#�.d Purchaser and Seller hereby agree to the following: ----------- -7 ...... Buyex. Agr'2- s __11) -ke-e -seller---f __ ' --------------------------- -- ----- .-- __-•---- � Y zn�Qrtr�ed_��__h�;� B o es� - . }}mi ;zn•.a_cguirng nacessary - - �le�ley___fn35hed pt'?yate road_ on west_ sz�e _of_ _-_._ .and south side o - parcel " _- expense ---- __---provide buyer with a ----- --- road ma.nten - -- - -- -- _ ' - •- _ _ ante __agreement - ------------•,----_-�-.. both buyer and seller well as ---------------- _? _- Deal authorit'p ------------------- 9 Seller to Cz to at his expo it - --__ ----- -_ ---- _ _ - ----------------- items: -__ ---- - ase ems -- through. I7 and 1 through 4 on attached.` ----- _ and 9. -- -- e that sell a licensed - - --- .--_-_ _�?Yan away Seller is erased'. ----- - real es tate --- --------�>hex._ani,.5sw�lex�a�ee_��_��grt^�__��11Q�t�,_fnancal clZselosure statement_ _".__._� ___--_------ tr_ ------ ----- - ----- -------- = �' - - -- - - - -- -- -- -- ---- - >»r` --- ----------- -"------ ----------------- .,.,. The herein: agreement, Upon its execution by both parties, is here%vitf' - mentioned.AgreeMentofSafe. 'Trade -an integral part: of the afore= i ......... _ ... TIME .......... ._ T►t,AE. ............................ — -- --------- Selter ................. Purchaser=1"�,,.� Vritness. , ....... ��� �/ ... Seller .... ' ..,.,.,....-....:............... Agent wiir�ss ,�_.. ..... ....... ........ ... ....... ..... Ages;t: FORM. 101 pt;82t P2GQPYRlG4rt9829YP%fESsirNALPU8LiSiiMGL`6API 122PA1"W& 5ANWARCS94sa3 AL€RrNtSAE5F1iYft a •.u• Gni _" N r , w 1 r •. p & `�01 i. T, i The Lowen Company, TYR, `4 parcels on the northeast corner of East five.. and L'ussick Ave. intersection:. Chico area. AF 42-45-24 through 30- Engineer:- RFC Surveyors Fublic forks conditions,; 1. Frontage on. Cussick Avenue to be cons-trucird to RS- -Lt)-1 I standard, i.e., curb, gutter, sidewalk and requiredstreet section for parcels with gross :acreage oi: one acre or lens . Subm.i t d rainage QlUt's tC) the dept.. of Puul3c Works fe)r approval and 3s)ut;tll_ required Xaci:l.iti;r_s. 2. Indicate e 55 ft. buildingg.setback from the centerline of East _ Ave. and u: 50 ft. building setback Late frf:)te th•: r_nrterl.ine of t'ussick Ave 3. Show all casements of -recore, on the final. HVIP. 4. Provide permanent so"ution: for drairu ge. 5. Pay off Hssessmeats. 6. Pay ,any delinquent taxes -or current taxes; as required: 'j. ' Meet the requirements of tlsr. Butte: cg-)unty i'i -t! 1)(.- 8. Pay $900 pur acre for Cussick Ave. stuns drain. - Construct East Avenue frontage to fourS-:'-A standard w i L1i vertical curb,, gutter and i(-'.ewalk.. vtrutelral section to; Y,e,: 1.-" Glass. 2 aggregate base with 3"' Type 11 asphalt concrete. 10. provide 1 ft. no access strip along lust. Ave. Trontagre Vxcept. at .,t) 1'G, Z%vuj way opening 1;eslth Dept, conditions; i _I 11. PCavide a .letter or other' documentation 3':rom CaUl'irniu Wat.er rvicQ - Company :.t Sting: that theyfare wilting anal al)le to m1pPly (it -..-maria waLcr L;u parcels 1,; 2, 3 and 12. Provide a letter or other documentation from the City of Oda') : trf t 11g that they' are: willing and able to supply ::ewer ncrvice: to j):trC(:1s I, 2s 3 and 1t,. Planning Dept. ctinii.tions 13., Contribute U pro rata share towards the future instn.11atiCin of a ' traffic :: isnal at the intersection of Last and Missick Averme.q. Purchase�eQs initgls. Seller's Initt is (j j`) . •gra Page 9 TIDE LOWEN COMPANY, Ti i= 34.. Access off East to be located as far from .the intersection of East and. Cussick as possible. 15. Vehicular access to the property from'Cussick.Avenue shall be an extension of Royce Lane (existing., 16. All structures abutting the northerly property lie of the original parcel to be set back 25 feet. 17. Record 'a 1 ft. no access easement. along East Avenue frontage breaking at the one approved access at Royce. Lane r_xtension and 'East Avenue.. The following mitigation measures are also requires: 1. Utilize good construction practices to miriimzze erosion., 2.; Construct an engineered underground drainage ,system :to existing S•U.D.A.D. ditch (north) subject to approval by Public Works. 3. All. lighting i'o be ;non-gl&re, directed away from motorists on East Avenue.. h. Construct a left turn pocket on East Avenue at the entrance to Lhepropc,rt.y. — 5• Hook up to city of Chico sewer. i i_ I I I' Pur -chaser's Initals Seller's Initals 'n s;. a r h 0'. r + r r ,.s a w ra a r 6 I�•j6 a b l t � 4 a l• t I 1 3kN.:! qt Y N 1 i } {471 4a Y t i 'r r�T AI fy f ip A i kla� r,' ,� • # SL v� ' of � 'et `•. d� ��+ f, ' 1 yyf. i i � •,'. t a r � M1•.. �M �i 1 ' ul I r s A k t r A II •} P�� r L• UPY 4� E1 ZIN. t 1 fAl � s' Ip I 1 ti. y; .1 f �J 1 r I .i ➢ C i n 17 � yk 1 I �l J^ a�.� • a J Y•- .'. t l a ti �a t �;� � 1 � J '�'� �-' '. �1 r i � � r i �' I it a � .,1 1 r a r ,C A � i " 1, .'' • � , � W, i i4 a Y 1 ,� a __J_r• �s __Sw A_' .... a� .—} i_ ..._.-JW11L . ._ __�. .i»� �.,i_ ✓,,��L—_�.—e_t i_ '�a .�. _ _,—_.�..�1 a• .i ! r' � , .�lr. y _�_ y Facility Name Westview Manor Application I.D. Number, page 1?. !CERTIFICPX OF NEED (437.10) APPLICATION CALIFORNIA WIRONMENTAL'QUALITY ACT (CEQA) REQUIREMENTS 1 Has this rneatEnbeen vi�°onmentaldQualty Acta(CEQA)?Exemit"° frnfromrequiY^ements of the Calif Yes No 3, if. "Yes," by what agency? Name Address Phone (_ ) 3. Has an "Environmental Impact Report" (EIR) or "'Negative Declaration" been prepared for this project? Yes ® No ❑ I If "yes," which? EIR Negative ®claration El 1 4. If "yes, what agency is the "Lead Agency" for the project? Name Butte County --- Address 7 County Center 'Drive ..;. Oroville. CF 95.965 Phone (916 891-2751 5. If a "Negative Declaration" or an ""EIR"' has been prepared, submit a copy with _ this application. FOR OSHPD USE Z D J eL ,cc 4 r APPLICATIONFOR USE PERI' BUTTE COUNTY PLANNING COMMISSION f APPLICANT:- Read and follow Instructions as set forth on attached sheet. Applicant's name 2L b',�.dP Phone No. Applicant's mailing address 5 C.o - SgiS 1' JZ0,*QCi(C.0fir,i +i T Applicant's Interest In property (Owner, lessee, ather)1 �--- LoIN�J -' 1�.>~1MSI�.W G.�4Nt 2 �► Owner's name and address .--■------w 1 Contact person for protect (if other than applident) l' 0,4,P. CAI C-0 Com, 2 A(L � hi Pre r Ttrt Assessor's Parcel numbetts) '` ! p R'GL''� sent zoning Location and'size of parcel(s) ,��,� c.,. �.a.STCtG- Ac00A) C W�� t 6 f✓ 5 (. ISI Street address ; Directions for travel to property (rural and mountainous areas only):: Description of proposed development and use _ EACA I-rq .-W1T4 rr4v�tNCr t Description of existing land use VHS #N`J '' Proposed scheduling/associated projects_ :3UNtAAC-1/L 1_,41L. , (Jas C005"raur_Tt;oitil: Anticipated incremental development Q1V6 MA�e 0 N L`I funding construction (state dimensions, square footage and materials used) a, Existing buildings T — b. Proposed buildings (il/EMG7 F%�� f S/nstTt.t✓ SY�]`/P/t-� if '� fa,5! 2 Sc�. �r Hazardous materials to be used (Inflammables, explosives or strong chemicals) %���'✓� Dally hours of operation IL ¢ �� S Number of employees Number of off-street parking spaces provided Existing/proposed sewage disposal method .t%�DF'dS GlTy F CWCO _SAIVIT.4�Y Prnxlmlty of power and phone lines: --'`" T / U'& SS 14bc, Distance to natural ;water course or storm drain: 670 PA -AW P1'PG A01AA1CJ8.1V Anticipated on and off-site drainage Improvements:-'UNIaE'n-G'fLooAto FI M 96--70 sto"W -OAtj (ld� t fy F't PI N G t"•�4(� I Foe: -,Jia r -reX S� t_.w�� E5 CO,Water source. l.�.A Proximity of water for fire fighting purposes (hydrants, ponds, etc.) t t i rV e- &-Ssevr1At.t.y ,t,&VGL FtA?' Will excavation or grading be necessary? Cubic yards (as, ime e), 9 List and describe any other related permits and other public approvals required for this project, Including those require city, regional, State and Federal agencies' STATE CW CA1.4 f'O/Z.t sRAftr/�'P�po44 , 9E G AZ IF RESIDENTIAL, include the number of units, Whether units are single or multi -story in height, schedule of unit sizes, and type of household size expected. , IF COMMERCIAL, Indicate the type, Whether neighborhood, city or regionally oriented, itquare footage of sales aide, and loading facilities. IF INDUSTiIAL, indicate type, estimated employment per shift, and loading facilities. iF INSTITUTIONAL, indicate the major function, estimated employment per shift, estimated occupancy, loading facilitlos, and community benefits to be derived from the projdct, ENVIRONMENTAL_ IMPACT$ AND MITIGATION MEASURES'* identify potentially significant environmental Impacts associated with the use permit; What projectdesignfeatures or special conditions of approval (mitigation measures) are proposed to alleviate potential environmental Impacts?` ENVIRONMENTAL SETTING* Describe the project site as It exists before the project, including information on topography, soil stability, plants and anl- mals, and any cultural, historical or scenic aspects. Describ- any existing structures on the site, and the use of the structures. Descrl�je the surrounding properties, including information on plants and animals and any cultural, historical or scenic aspects.. ,alcate the type of land use (residential, commercial, etc.) intensity of land use ,(single-family, apartments, shops, depart- ment stores, etc.), and scale of development (height, frontage, setback, rear yard, etc.). * Ilse, separate sheet for longer responses. I hereby declare under penalty of perlury that i have read" derstam are true, completeandcorrect to the best of my knowledge a ba ef. Dated 1�� Applicant's signatu Date 3 7-0 ` Y4' Property owner's signature the instructions and that the foregoing statements Use Permit Number__ Request, Use permit to allow Z Location and size of parcel(s) CD VEF(IFY ILL) A.P. Number(s) Project Description' ti Ownership Zoning and Requirements �.._ Proof of Agency (if needed) Location Description 20 Copies of Plot Plan 1 LL Date Received $ _ Receipt Number U _ CD Application taken by r .,y INSTRUCTIONS TO USE PERMIT APPLICANTS l• If applicant is not the owner, cyrtkten authorization by the ow mer or other proof of a be submitted }it order for the applicant to legally sign the application. Application shall be gency must considered void if not signed by the owner or legal agent, '. All items on application 411,111 be filled in as completely as possible. (f all ikom is no cable, please indicate by the term "NA"% t appli- i. 3. It is important that the applicant supply an accurate description of the lacat(an u({hc Proposed project, including the following. p p sed r a. xlssessnr`K Parcel number(s) (from the tax bills or Assessor's maps), h. .Slr0o1 ndahe +�6 t (if uvitihtlaltt)', �r. I)i+tnn0ea Wild dirc!rli�it.rK to named sU•cots, bodies of water or railroads, 4. Twenty (20) copies of ,a detailed plot plan of adequate settle to clearly show proposed inns and intprnvt oleate folded In 8!i r 11 inches, shall accompany and be made part of the P p d build-'° "�Ipplieati+in far ll.p i'erntil If ilia use permit is approved, the plot plan becomes! the ap Proved develupnuinl ishan fill Iota prtiperty.'I'lte plot plata slit, 11 include the following Information., scaled driiwin'g of tile. parvel(s) Itoundaries: b. 1,0calinn and dimensions of all exist}n and including; buiidingj, tl:ivewa s g proposed improvements on the property, v. I.oviuiciu and 11111110 of bordering psttee s,ng aacce�ss rloads,enearbyptic nc o srks oadst strums, bodies of wilier and railrnuds. , reams, d. North arrow and settle of drawing, 5. 'Che "Applivatinn for Ilse permlt" is subject to public hearings and appPlroval Cmm�lrs,4ian• ,any speciatl enntlitinns of approval shall he made a Putt of the ay trovedanning I'rriilil" Hurl sbltll Iry binding on the applicant. 'I'he proP procedures for County action on use Per - fail nppiivat ons urn, 40uled in (;hapten 2•> of the fiuY Code. Count PP (,'se l: 'I'll(' Plunnitig; (:linuulssion, on Ilia basis of the evidentse submitted at thepubi}c hearing, grant use P�intil talion }t •find,4 hat the proposed uses of the property will not ar air he erns, may integrity anal chsn•u.•ter of the zone in which the land lies and that the use would notba un. luulrrentiiin.lhl)' Int*uuilinllhli! Willi or injurious to surrounding properties nor detrimental to the ll and general Welfare of the persons residing or working in the neighborhood no general health, safety' and welfare of 1110 county, r to the f• In approving 11 11,46 permit, the Planning Commission may include such conditions as are deemed reasonably and necessary under the circumstances t•harovler fit the Gant, and to secure k}ie general to preserve the integrity and and C.'ltttpiei +3.1, of the Butte County Code. Such conditionsmayin.clude,.buttare General tight-uf wav, jail sheet und�lri►inaPe }m rove , , p ration fencing, dedication to to time limitations, development plan ap(raaal ,hours of o e f Ilse pernilt must lie reasonably tainted' to he use efor whichdthe permi011s t requested suance of a a 8. Applivatioil fees t,of �� �4 (°l�j j . I 411 t er nlu(date) are $ 01v (tr paid in Bash nr by cheat: made payable to "Treasurer of Butte County", Yr �• Hefore Submitting it use permit a )ication applicant pp , tlttestinn,4 11110111 application requirenments, CountypraceducQeuzoneing provisions with staff all vondillotis of approval,i and possible w Haas.■�. - „_ _ ' _. — _ gra►: �,. 4 ARPLI A' °i AI NNECION INDUSTRIAL VASTE PERM27 Ag&CITY OF I Paft A-Application Permit Application Al. Applicant Business Name _ , Address 375 GVlAXGS(e T KD, C• A2. Address of premises discharging wastewater AF 4'2- 4.57- 36 -�� - 2.I A A3. Appropriate corporate.officer/Owner A. Name C Y A N J eW N I N G-5 ....� _ B. Title f f:e51pswT C. Address 3-75 60kASSeT 9,P • _C 4t (� _O, !'A►,;61. -L—Co_ A4. Person to be contacted about this application 1��.nnE A5 4600E � s� A. Name C7C R-r PJ H-15d -T<=)f J B. Title A&Ck11"'TeQ-r C. Phony X4'3-803 A5. Person to be contacted in case of emergency A. Name '� i�YA4 JON A/ I Nf & 5 e B. Title. ij'Zs1 D r - Day Phone '34'3- cl-S;q5 Night Phone 34S- S5q S A6 CERTIFICATION. I certify that it,formation above and on the following Parts is true of correct to the best of my knowl d 15 S gnature Date 6MY A ►-J. e; N N I N J"S .r. , r nt Name t e �...-w----------------------------------------------d-------------------�------------�-- o- -� PERMIT AUTHORIZATION: The above-named applicant is hereby authorized to discharge wastewater to the sewer system Subject to compliance with the provisions of the Chico Municipal Code, payment of all required fees and the following requirements; i 1. The apNlicant shall be responsible for payment of costs incurred for sampling and analysis of wastewater by an authorized laboratory as required by the DirectDr from time to time. 2. The applicant sh.11 report to the Director any changes (permanent or temporary) to the premises or operations that significantly change the qquality or volume of the wastewater discharge or deviate from the terms and conditions under which this permit is granted. 3. The applicaht shall understand that this Permit is issued subject to any changes required by local, state or federal regulations. (For additional requirements, if any, see attached Exhibit "All) Effective Daterp on Date: Ex irati ate Director of Pub"fic Ivor s c 1 NOTIM Any person argrievedby any provision of this permit has the right of appeal pursuant to Section 15.36.320 of the Chico Municipal Code, , � r » ... Y: ,„�,x,r,,}'^:j��}W'nq'ii�t'n.�Y,n�.r{tn•,ta;.wJef - .. APPLICATION FOR SANITARY SEWER CONNECTION p� INDUSTRIAL WASTE PERMIT CIyTY F Part B - Business Description Purpose—The Businoss Description is primarily used to determine substances uvhich may enter into the wastewaterdi'scharge from the Business Activity. The production quantities are neceso sary for State and Federal Reports, B1, Business Activity --(Complete a separate Part B for each major business activity occurring on the premise.) ACTIVITY N u 1� s (N 6- 46 A G eller 66 t5.s (a) Products..., SIG ouAN'TITISS' TYPE OF PRODUCTS (Brand Namol PAST CALENDAR YEAR @STfMATI10 THIS CALENDAR YEAIt Amount.. _._._ �� I Amount Avg. Max Units A;;.—j Max Units (b) Description --Describe the wastewater generating operations. Indicate variations in production and opera• tlons during the year. (Use additional sheets as necessary) 6-'a ErJUV (c) Substances Proposed to be Discharged—Give common and technical names of any materials discharged or proposer; to be discharged to the sower. Briefly describe the physical and chemical properties of each sA. stance and product, NAME DESCRIPTION 02. Dischargo period e� � B3. Variation of Operation (a) Discharge occurs daily: from T Ind�ic�ate whether the business activiiy is: (h) Circle f ho days of the wtnek that the discharge i,�l Continuous throughout thr year, or occurs: S M T W T F S - ( ) Seasonal—Circle the 'months of the year lGV eg.:y pAy which discharge occurs: J F M A M J JA S O N D f_nmlitir�ntrt. .,, S4, Otlier Liquid Wastes --List tho type and volumX'3 of liquid waslus removedfrom the premises by means other than coi-011"Jolly sowers and rP rosin sit(?. neat^lPtiON �`CrIW/nr; (sqE/rvo,) ft}M,')VLD 4Vlnamo and a�ldrost) DISPOSAL SIT i oil a's'-.-".lJ,w'{'a�•,wy:tif' +'.'„'-s��RMiI ���M + �M�,a A �Lt A�r ywR'Tf , INDUSTRIAL WASTE PERMIT CITY I Par C — Water Source & Use Purpose --Tho- Water 'Source and Use information will enable the Director to determine the volumes and sources of wastewater discharged to the sewer, Hl. `Nater Use and Disposition --Average quantity of water received and wastewater discharged daily. NOTE-, Show on separate sheet the method and calculations, used to determine the quantities on table. SUPPLY FROM DISCHMMD To Other 111 BIdU+ Sowor othor i21 -- olda Source fln� nY° Ditch. To WATER USED FgRi�� s °Y s, Y Sonitgry -- Processes ----_--___.�. N h4 Boiler _....._._ Cooling Washing �— Irrigation Product Uther(3) Metas: , (1) Enter the quantity and the appropriate code lefta:' indicating the source: . �. a. Well, b. creek, c. estuary, d, bay, e. stormwater, f. reclaimed water (2) Cuter the quantity and the appropriate code letter indicating the discharge point: a. well, ba creek, c. estuary, d. bay, e. stormdrain, f. rain truck, barge, g. evaporation, h. producf. (3) Describe; -- ---- q rr .�n- + .�a,uvrr rt t w Inti ki�iJ �hfiJA i'�r,.i . ?i!A+}'�'�!i'i. APPLICATION FOR SANITARY SEWE-R CONNECTION INDUSTRIAL WASTE PERMIT Part F -Bu lding Sever Discharge Purposa--The. Building Sewer Discharge information will identify the variation in flow rate and the type of constituents and characteristics of the discharge for each side sewer. Sampling Location Fl. Building Sewer No,.�._.�.�.�.--(From Part p) F2. Wastewater Flow Pate PEAK HOURLY I MA%. DAILY ANNUAL DAILY AVG. i IF OPER�I. 14S ARE SEASONAL AVERAGO gAILY. pALLONS/DAYI�)�__ gallons/minute gallons/day . _._ sollons/day seasonal min, id onal:num Fa, If Batch Discharge, Indicate; a, Number of batch discharges: per month b. Time of batch dischorges•,.�,_._._., , d., (Deys of Weakl (Hours of Day) c. Average quantity per watch- gallons, d. Flow Rate., gallons/minute. F4', Wastewater Constituents—Indicate if any of the following constituents, characteristics or substances :is or can be present -(Y,) in your wastewater discharge as a result of your operations. ., CC -DE CQN5117U KITS CoDrr CONSTITUENTS — CODE S CONSTITUENTS A,L13C I` Algicides* FORMA Formaldehyde RAD Radioactivity* `L Nurnlnum HC Hydrocarbons* SE Selaniurri _ it3N —Ammonia 1• iodide � AG Silver ;s AS AntimonyI Arsenic �, � I G P3; _Iron NA Lead SOLV I Sodium Solvents" wry Barium MG, Magnesium SO4— Sulfate BE B Beryllium Boron PvMI HG Manganese Mercury S=T S03= Sulfide Sulfite: BK- CDCD CA Bromide Cadmium .may Calcium / MO N1 O&G M Molybdenum Nickel Oil & Grease M64 Or' ;) MBAS _ ?EMP TEMP Surfoctants;MRAS Temp.Incre4 Temp. Decrease CL2 Cl.- Chlorine Chloride O&G T PESTC Oil & Grease (Tot TI Titanium Pesticides _ SN _ Tin CR CO Chromium Cobuit PH PH pH Increase (+) pH Decrease (--) — V TVA Vanadium Volcltile Acids CU Copper PHENL Phenols ZN Zinc Cl� Cyanide I P Phosphorus•- F. Fluoride -- !I K Potassium �� ' !11 .. .Wl.r�4'•{Vii; •w M1wr.•l. y yriy: � ''Ai�t'L+i�N: k•`li. PART P (Cont'd) F5. Wastewater Strength Estimates—Enter the average annual and n•:aximum wastewater strength for this building for each of the following elements of wastewater strength for the period covered by the permit. ANY SIGNIFICANT DEVIATION FROM THESE VALUES CAN RESULT IN TERMINATION OF THE PERMIT, ELEMENTS OF WASTEWATER STRENGTH UNIT CODE 1 AVERAGE J tAMMUM' Suspended Solids ..- mg/I TSS Total Chemical Ox ygen Demand mg/t - CQDT Filtered' Chem. Oxygen Demand mg/I CODE Oil and Grease mg/I O> Chlorine Demand (Sae instructions) mg/I CL21) Biochemical Oxygen Demand (Five-day) mg/I BODS ....-� It nota troth a commercial laboratory was used to determine the values, please give the name and address of the laboratory. r Name... �� v i;::: d _ .. Address Fb. Pollution Abatement Practices a. Wastewater Pretreatment --Check the type of treatment, if any, given wastewater from this building sewer before it is discharged to the sewer: none, ❑ holding tank, ❑ grease trap, ❑ oil and water separator, ❑ grinding, [] sedimentation, ❑ pH adjustment, Q biological treatment, ❑' screening, ❑ chlorination, or ❑ other. Description. Deacribe the loading rates, design capacity, physical size, etc. of each pretreatment facility checked above. NMI b. Plohiiing Wastewater Pretreatment Improvements—Describe any changes in treatment or disposal methods planned or under construction for the wastewater carried by this building sewer. F-7. I).1orniwater Ar v Towl Ates in :quare feet expwo Ocl to storm water and draining to this buildloo sevrera The project shall, where applicable, have effective quality control Procedures. ---------------- QUALITY CARE ASSURANCE CONTROLS There will be daily team meetings to discuss each individual Prospective patient. The Director of Nursing Servioe$ assures appropriate patient placement. The following quality control Procedures will be in effect. 1. Scheduled daily patient rounds by Director of Nurses. 2 Continuous Registered Nurse supervision with daily follow --up 3. Problem related patient care conferences with appropriate Professional disciplines. `. Ongoing audit of Charts and Patient Care Plans. S. Medical Care Evaluation studies, i.e., employee turnover, accidents, admitting diagnosis, etc. 6. Monthly Interdisciplinary Team meetings. 7. Monthly meetings with Medical Director to discuss problems, $. Committee meetings: Patient Care Policy, Infection Control, Pharmacy, Safety, Weekly Rehabilitation meetings. 9. A Utilization Review Committee, composed of members of the San Joaquin County Medical society, will meet on a monthly basis to assure maintenance of quality high u g ality patient care and effective utilization of services., in addition to quality controls at the facility level, there are annual quality assurance reviews conducted by qualified divisional Personnel, and all other committees as required by law. Ask The project will be optimally utilized in a financially feasible manner within a reasonable projected time, PROJECTED UTILIZATION The meed for skilled nursing facilities, according to the health Agency System is presently 102 beds. We anticipate that at the end of the first year occupancy of the new facility will be 70% or more, as per the existing need. First quarter, 45 Second quarter 55 Third quarter 80 Fourth quarter 90 Avg. First Year Utilization 70' it is anticipated, because of the demand and growth rate of the target population, the hospital will operate at a minimum 80% the. second year, 90% the third year, 95% the fourth year and 99% for subsequent years. in projecting revenues for the new facility, we assume 75% of the from census will be Medi -Cal patients, 1% of the revenue will come Medicare patients and the remaining 24% from private pay individuals. UTILIZATION REVIEW PLAN MODEL The Utilization Review Plan's overall objective will be the main- tenance of high quality patient care and effective utilization of the services offered by this facility. This plan will be developed and approved by a group composed of physicians, ,professional staff, director of nurses and administrator of the facility. The plan will be reviewed and evaluated as necessary for possible revision. Committee ComEosition This committee will be composed of three physicians, and alternating consulting professional staff. Administrative and nursing staff assist committee member as nece,,psary. The medical care evaluation studies need not be performed by the same committee. No member on the committee will be_employed by or have financial interest in a skilled nursing facility operation. No committee member will review any case which he is professionally involved. The committee chairmanship will be reassigned on an annual basis. MEETINGS: The full committee will meet regularly each calendar month and be notified by administration. Interim reviews will conducted as necessary to accomplish.Exte:nded. Stay reviews,. Committee Functions In order to promote the highest quality of patient care, the Alk committee is responsible for or conducting Medical Care Evalxation Studies, Extended Duration, and consideration of any other cases brought to its Attention. The committee will also review discharge 2 UTILIZATION REVIEW PLAN (Con't) plans ,for individual patients Medical Care Evaluation Studies_(MCE) The committee will conduct studies to identify and analyze patterns of patient care for the purpose of maintai'.ning consistant quality service. There studies may , Y Pertain to medical or adma,ni,strative factors relating to patient care in this facility. These studies, as determined by the committee, on a sample or other basis, will include but need not be Limited to the following categories: admissions, duration of stay, and profeSsi,o1zal services furnished. The committee will analyze the data gathered for each study and, after reaching a conclusion on the results will make recommendations-to administration. Administration will report back to the committee on action taken, changes and results. As least one study will be in progress at any giventime, and at least one study WI-11 be completed each year. The studies will be accomplished by using any of the following resources; 1. Facility personnel using medical records or other appropriate data. 2. External organizations which compile statistics, design profiles and produce other comparative data. 3. PSRO'S,,fiscal intermediaries, providers of service or appropriate agencies Extended Stay Review: Periodic review will be made of all Title 18 inpatient SNE beneficiary cases of continuous extneded duration. The purpose is to determine whetherfurther inpatient stay is AMML medically necessary.; The initial extended stay review takes place prior to or at the j 3 UTILIZATION REVIEW PLAN (Con't) end of the period of extended duration as specified' .n this plan. When a finding is made, that medically the patient continues to need inpatient skilled nursing care, an. additional stayis approved for an appropriate period. Reviews aremadeat Least every 30 days for the first 90 days and at least every 90 days thereafter as long as medical necessity for stay exists. Before the expiration of each new period the case will be reviewed again in like manner, Further Stay Not Medically Necessary; A final determination that nan admission or extended stay is not medically necessary, is made by two physician members of the. committee. (see option) Exception: A final determination may be made by one physician member where the attending physican, when given an opportunity to express his views, does not do so, or does not contest the decision. When this committee, _or its nonphysician representative (see option) has reason to believe based -on case review, that further stay is no longer medically necessary, the patient's attending physician will be CQATUlted and given an opportunity to present his views before making a final determination, If the finPI determination of the committee is that further stay is no longer medically necessar y, written notification of the finding is given to the facility, the attending physician an , d the patient no later than two days after such final determination is made, and in no event in the case of extended duration later than three working days after the end of the extended duration period. _ 4 41�wdaurw� _, . UTILIZATIQI':T REVIEW PLAN (Con't) Aeatinistrative Re..S]2onsibil ties c The Administrator will: a. Give support and assistance by acting upon the recom- mendations of the committee b. Report b.Ack to the committee any changes relating to those recommendations. c. Coordinate functions with appropriate r.T -&lional f;i:f members by arranging meetings and notifying members. d. Provide assistance in maintaining records. e. Delegate responsibility for discharge punning, maintain a written discharge planning program and provide adequate resource information for discharge. Utilization Review Records: The committee will maintain written records of all its activities. 40F. Appropriate reports signed by the committee chairman are made reg-- ularly to the administrative staff in the form of minutes. Minutes r" each committee meeting shall be documented and will include: A. The name of the committee B. The date and duration of -the meeting C. The names of the committee members present and absent D. AA description of its activities in the following areas: 1. Medical Care Evaluation Studies: Report on current study. a. Subject b. Reason for study c. Date started d. Date of expected completion e. Summary of completed study f. Conclusion g. Recommendation h. Follow-up on implementation or recommendations made.from previous studies. UTILIZATION REVIEW PLAN(Can't) 2. A summary of Extended Stay Cases reviewed since previous minutes which will include; " a. Number of cases. b. Case identification by number. c>. Admission and review dates.' d. The decisions reached including the medical reason for making such de'.ermination e. The action taken on cases not approved for Extended Stay - notification letter distr. ibution, f. Status of discharge plan. 3. Record of other gases reviewed with recommendation and action taken. Worksheets shall be kept in separate folder and available to the committee as necessary., The committee will honor all, requests for information from claims administration of third party payors. Records will be kept confidential and maintained in permanent form Ask qW by the administration of this facility. Discharge Planning: The URC in evaluation the current status of extended duration cases will review the discharge planning and periodic evaluations of each: case in accordahce,with the discharge planning program. The discharge plannign program has been approved by this committee. The committee will assure that assistance is available to the patient and the attending physician in dishcarge planning. Approved by the following members: date: Chairman 4 OPTIONAL REVIEW AREAS' � 1. Non-Physician Screening of _,Extend dStay Review sc rCase � will -, of the .__ ___ --------w---- be screezieci by a qualfFFe-d noii-�physlca.an ,repre,��_ntat�wo not employed by the Oinr� committee. Definition A person �facilitY involved with the patent, Employed meafts professionally a paycheck and withholding d.educt.ed. (recommend medical records consultant) The URC has authorized as their non--physiciAt screening member to review cases r using' criteria established by the physic:i.ax„ members :of the committee referred to a, in lieu of they full committee review, uses are for further review when it apprears that physician member Pat.-Lentthe no longer requires further irp,atient care ;in the sane Dee attacha manner as further stay not medically necessary. ,criteria material) . 2„ Certifications and Recertificat :ons: Review will be made of _...� _�. comp. �..:i a n c e _.__,_ . _-•---...o_� . r -- - _.� S 5 L11: k: physician Certifications on a z eo ul.ar basis; to requirements. with federal and sta't'e :reimbursement 3. The UR physicians will. complete subsequent recertificetions has the initial CP_rti-• after the attending physician completed fi.catic)n and .first recerti..f ?.cation. - . 4. ,valu.eti cn of Alternate 2h sician Visit_ Schedules The ftr;i] _...��.y,��.,.....Y.._.r. r,...�.....,..�.......�. txst] ?-16atlolls for c"%1 tP_rIlate puysician Ct XtUll� ttee wa.1 �. re.vlew j documentedin the individual, patient charts . � Approval schedules may be given for alternate schedules not to exceed. 60 days between of visits. if the committee does not concur in the schedules than 30 day.,,, the alternate schedule visits at intervals of more '• will, not be acceptable. The alterl%at.e schedule will not apply for patients who have been specialized re- in the facility for fess than 90 days or require habi,litative services. 5. Admission Review: The committee will review admissions for medical necessx.ty of con.tsnued stay. days NOTE: The extended duration review def erlength cif stnition of ayeforfpatient should coincide with the g1. diffe?rerit number of clays for for that level: of care or a. each disease categOry PATIENT CARE POLICIES' PAGE ADMISSION POLICY 4 ADMISSION REFUSAL 6 AUTOMATIC S'L'OP ORDER POLICY 19' CHANGE IN PATIENT'S CONDITION 34 CLINICAL RECORDS 38 DEATH POLICIES '- DENTAL SERVICES" DIAGNOSTIC SERVICES DIETARY SERVICES POLICY 31 DISCHARGE PLANNING 44 EMERGENCY PROCEDURES 33 GREIVANCE POLICIES 48 INFECTION CONTROL COMMITTEE 50 NURSING -• RESTORATIVE CARE 15 NURSING SERVICE 13 NURSING SERVICE - ADMISSION POLICY 17 NURSING SERVICE _ 'IN-SERVICE TRAINING 24 NURSING SERVICE - MEDICATION POLICY 18 _ NURSING SERVICE - SAFETY POLICIES 20 PATIENT ACTIVITIES 37 PATIENT CARE PLAN 22 PATIENT CARE POLICY OBJECTIVES 2 PATIENT'S RIGHTS AND RESPONSIBILITIES 46 PHARMACEUTICAL SERVICES COMMITTEE 28 PHARMACEUTICAL SERVICES COMMITTEE 51 PHYSICIAN SERVICES 11 REHABILITATIVE SERVICES 26 SAFETY DEVICE (RESTRAINT) ;POLICIES; 21A SMOKING POLICY 43 SOCIAL SERVICES 36 - TRANSFER AGREEMENT 41 TRANSFER - E14ERGENCY 9" TRANSFER - TO MORTUARY 10, TRANSFER - TO OTHER FACILITIES 8 TRANSPORTATION UTILIZATION REVIEW 53 VISITING HOURS 42 e OBJECTIVES Primary objective is to provide nursing care for each patient that is of the highest quality, the kind of care each patient requires; how ,it can best be accomplished and what methods ;and approaches are believed to be the most successful to ensure -the best results, These objeclAives are promulgated for the purpose of specifying basic principles, procedures and services considered essential for' the comprehensive and continued care of the patient Patient Care Policies reflect awareness of and provision for meeting the total needs of the patie11c. These policies covers physicians services, nursing serviq�eF,, dietary services, pharm aceutical services, diagnostic. services, emergency services, dental services, social ser.rir,�is, activities, clinical records, transfer agreement, util'.,�.?Ation review, discharge planning, Infection Control Comru.',:.tltee, Pharmaceutical Services Committee and the Patient's Rights and Responsibilities. These Patient Care Policies will be provided for the guidance of all members of the staff ip their conduct regarding every aspect of patient care and service. Any activities undertaken in this facility will be reflective of these policies. The responsibility for implementation of the total policies rests with tie Administrator.. The implementation of the policies apply inq to the direct patient care is the responsibility of the Di- wm.,,ctQr of Nursing S',ervicces 3 ADMa SSION POLICY All patients are admitted upon the recommendation of a qualified licensed physician without regard to race, Color, 01• national origin, with the exceptions provided by the li- cense within the State of that particular facility. Each patient must be under the supervision of a physician who accepts responsibility for his medical care. Each patient may choose his own physician whose name, address, and phone number, and -that of his alternate, will be recorded'. Similar information will be recorded, when applicabl_, for the patient's dentist, pharmacy, optometrist, and others as necessary, to care for the patient's needs. The following information shall accompany each patient upon admission: 1. Current written physician's orders and physical examination, including chest x-ray. If immediate orders are not avail- able from the patient's personal, physician, or his alter- nate, the physician responsible for emergency care will give temporary orders.* Other information required within 48 hours includesr 1.. Rehabilitation potential. 2. d s n Ph siciaorders of a comprehensive Physician's � e nature which will include orders for medications for a specified number of days or number of doses, or standing orders for a maximum of 30 days until reordered in writing. Treatments, limited restorative servicesdiet, special as above- rest , e, s p procedures for health and safety p of the atient' , and other plans for a continuingcarewill be obtained upon admission. 4 3 . summary of hospital treatment. Trane f er summary sheet Y will accompany each patient transferred from an acute facility. The attending physician will be notified immediately of the patient's admission to the facility. When a patient is admitted from home, the attending physi- cian will provide a medical summary that will includo reason(s) for admission, diagnosis (indicate if patient has knowledge of his diagnosis), medical findings and consultations, course of treatment, orders for immediate care, restorative potential, special characteristics such as disabilities (amputee, paralysis,, contractures, decubiti), incontinence (bladder, bowel, saliva), impairments (mental, speech, hearing, vision), special appli- ances (prosthesis, catheter, colostomy), behavior (alcohol'ic, belligerent, senile, noisy, withdrawn), locomotion (wheelchair, walking-aides, walker crutch, cane), mental status (alert, for- getful, confused), self.-care status and communication status. , if the patient is admitted as a Medicare patient and has been discharged less than 14 days from an acute care hospital., every effort will be made to obtain necessary information from the hospital from which he had been discharged. Upon admission, if requested by the patient or the respon- Bible parry, the facility will accept the responsibility of acting as the custodian of any ,monies placed with it by the pat- ient This responsibility will only apply to funds deposited for safekeeping within the facility. The facility will not be responsible for any monies or property Located outside the phys- ical confines' of the facility. For more information, see Item "under Patients s Rights. Telep hone orders will be accepted from a physician onlyby, v TRANSPORTATION When necessary, transportation arrangements can be made for patients requiring such services. These arrangements should be made in conjunction, therefore, with the efforts of the family. Such arrangements might be necessary when the services Of a dentist, or other specialist required will be is required. The service plainly indicated in writing and pertinent information in the form of chart materials, will be -sent with the patient for the direction of the physician or other person Providing service where appropriate. Charts, orders, prescrip- tions and other materials returning with the patient from a doctor's appointment, will be given to the licensed nursr�,n- charge immediately upon return to the facility, 7 TRANSFER TO OTHER HEAi;TH FACILITIES 1. Patient may be transferred to other health facilities , as ordered by the attending physician and in harmony with the wishes of the patient and/or the responsible person. In the event a at' no longer be served effectively b the facility, patient can Y Y � � Yr the facility's administrator, the Director of Nursing �' g Service or the Social. Worker will discuss the problem with the patient's physician and the to work out an acceptable solution. Recommendations from t family Committee w411 be followed as closelyas he LT:R. possible. 2: Patients are never transferred but of the facility or discharged from care without the authority of the attending physician, nor Without notice being given to the responsible party. 3. A transfer form filled out b the nurse -in -charge, Y g r will be for- warded with each patient. who. is` transferred to another facility. 4. In the case of permanent transfers, all personal belongings and' valuables will be arranged in order, checked and signed for by the responsible party or the patient. 5: Transfers are to be made as cheerfully, kindly and xsxquietlY as pots-- ` ible. Th -d desires of the patient, family and/or responsible p ble party W ill be given full consideration in eahc daze. 61 Drugs will bexvren to the . g� patient upon discharge if so ordered by the physician, in written form. Drugs so transferred will be recorded on the patient's chart with the date and full signature of the nurse in eharge. The person receiving the drugs will be asked to sign a receipt which will, be attached to the patient's record: 8 EMERGENCY TRANSFERS ;PHYSICIANS SERVICE Physician visits are requested by the charge nurse for any change in the patient's condition, or as requested by the patient or the responsible person. Patients will be seen by a physician within 48 hours of admittance and at least every 30 days there,- afteki and all findings, progress notes, any change in diagnosis, prognosis, and orders shall be dated and recordedc on a monthly basis, the nurse -in -charge and the physician will review and update each patient's medications. This may take the form of: (1) a written summary by the charge nurse of all existing physician's orders or (2) a listing provided on the patient's Medication Sheet. Existing physician's orders will be reviewed by the physician with the charge nurse on a monthly basis. The date and signature of the physician are req!xired to show his approval. However, maximum period of four (4) months is established in which physi- cian's orders are renewed by doctor's signature and date; i.e., written summaries of all existing physician's orders must be re- corded at least every four (4) months by the charge nurse. Progress notes will be 5igned by the physician at each visit. Patient's physician will advise the unit of his anticipated absence and indicate his replacement. Such notation will be recorded in the clinical record by the physician, one or more physicians are available, .to furnish necessary medical cure in case of an emergency if the patient's physician or alternate is not immediately available. A schedule listing the names of "'on-- call" physicians and each emergency service should be posted'at each nursing station. Also posted ateach station will be the names and phone numbers of the Administrator and the Director of Nursing Service. The physician's orders and progress notes will be used by the nursing staff to plan a total program bf care for the patient, ex- pressed in, the patient's care plan and revised, at i.nte,rvals appro- priated to the patient's needs. ntormat on on the rehabil4.tation potential (prognosis) of the patient and a summary of the course of treatment followed in the transferring facility are transmitted to the admitting facility at the time of admission or at least within 48 hours after admission. The physician must inform the patient of his medical condition, unless medically contraindicated. if contraindicated, the physician must document the decision and'the reasons for it in the patient's record, The planned regimen of medical care is discussed with the patient by the physician, and patients are advised of alternative courses and the consequences when such alternatives are available. The patient's preference about alternatives should be elicited and considered in deciding on the plan of care. 12 NURSING SUVICE Nursing care will be provided by or under the supervision of a full time professional nurse. The nursing department has the responsibility and authority for the practice of nursing in the health care facility* Nursing care shall be based on medical orders ar,1d ,nursing procedures and practices which will assure patient privacy, safety physical and emotional health, independence and mobility within the patient's capability. Nursing personnel may consist of Registered nurses, licensed practical nurses, Aidesand/or orderlies; duty assignments shall be consistent with training and experience. The Director of Nursing Service will be responsible for nursing service policy implementation and for maintaining correct procedures for nursing care and treatment. There will be at least one registered professional nurse or, qualified licensed vocational nurse on duty at all times ,in charge of nursing activities.. Whenever unlicensed persons; such as Aides and Orderlies who are functioning under the supervision of licensed personnel., can safely meet patient needs, they may by employed to supplement the services of :Licensed nurses. A'professional nurse will make daily rounds to all patients on each shift with other rounds being made as necessary. Each patient shall receive treatment, medicine as, prescribed, receive proper care to prevent decubiti and deformities., be kept comfortable, clean and well-groomed. Each patient will be protected from accident and injury 'by the adoption of all indicated safety measures. Each patient will be treated with kindness and respect'. 13 emIAU ERId'7SOA!}R One of the goals of the. Nursing Department shall be to pro- XF vide a therapeutic atmosphere, A Manual of Policies and Procedures covering' currentnursing Practices shall be maintained, and all'additional materials or up- dated pages shall be put into the manual promptly upon adoption of a change. Currently, authoritative reference materials are to be available in each facilitY use th far by e nursing 'staff.. These shall include; Medical Dictionary, Iowa State Diet Manual, and Physician's Desk Reference. - Treatments and specific therapies as ordered by the physician are performed in the manner prescribed. Requisitions for equipment and supplies shall be made by the charge nurse and submitted to the Director of Nursing Service, whose responsibility it shall be to see that adequate supplies and equipment are available. 1 RESTORATIVE NURSING CARE Restorative nursing care is directed toward assisting each Patient to achieve and maintain an optimal level of self care ..and independence.. The long-range goal is to return the patient to his role in the family and the community after an. injury, or if return to -the usual, activities is not llness or possible, :the Patient is assisted to maintain his maximum potential. Restorative nursing techniques are included in the Orienta- tion and staff-deuelcpmenu ta- programs, and these techniques are used consistently for all patients in order to: 1. Maintain function. 2. Prevent further trauma or disability. 3. Restore function in as far as Possible. Nursing personnel routinely Perform restorative measures and practice them in their daily care of patients. These mea- sures include , ea-- l• Maintaining good body alignment and Proper positioning: 2. Encouraging and assisting bed patients to change positions at least every two hours day and night to stimulate cit- culation and to Prevent decubitus ulcers and deformities. 3. Making every effort to keep Patients active and out of bed for reasonable periods of time, and encouraging patients to achieve independence in activities of daily living by teaching self care; transfer, and stimula.tian activities. 4 assisting patients to adjust to their disabilities- t o use their prosthetic devices, and to redirect their interest, if necessary. NURSING SERVICE ADMISSION PO,ICY X Upon admission, the charge nurse and a designated; staff member shall be assigned to welcome assist and g ► orient each new ► �, pat- ient. Included in these duties shall be: a. Identification and listing of all prosthetic devices and appliances on B/E 306A Form, b. T.P.R., blood pressure, and weight are to be taken and '7 recorded. c. Observation for skin condition and recording of same,. 2. Contact patient's physician. 3. Set up chart. 4 • Begin patient care plan. n. Se Order medications and make out medication card. 6• An admission summary will be made by the Professional nurse of her observations of the patient's condition and characteristics These will include means of admission. Person accompanying pat- ient, patient's reaction, his ability to communicate, ambulation status, personal appearance, appliances used ► Proper functioning Of appliances, patient's expression ' s of anxiety ar 7. I complaints, etc Appropriate orentataon Of s.Patient to his new surroundings and to other patients Will be dome. This will include such items as h ow y the Call r works System where wash basin or emesis basin ed xs stored where the bathroom is,, how to store clothing, what wearing apparel will be needed, etc. 17 ". Imo- �. .:..... .. O NURSING SERVICE MEDICATION POLICY All medications are to be handled, used, administered and disposed of in accordance with applicable state and federal. laws Medications are given only uponthe written order of the physician and administered precisely by the nursing staff. Patients shall not be permitted to keep drugs in their possess- ion except upon specific written order by the physician. Upon discharget drugs may he given to the patient upon written author- ization by the physician, and it will be so recorded on the patient's. record with date and full signature of the ,charge nurse. A Medication Sheet, B/E 307, listing each medication currently being used is at- tached to each patient's chart. The hour when medication is given and the name of the administering nurse ,is entered appropriatelyby initial. An ,individual narcotic sheet is accurately maintained for each narcotic prescribed. "Stop Order" policies in regard to Medications are developed and implemented by the Pharmaceutical Services Committee and are strictly adhered to by the administering nurse. The Automatic Stop Order Policy is listed on the next page. The Nurse who prepares medications also administers them and assures herself that the patient has taken the medication. 18 1 AUTOMATIC STOP ORDERS All physicians with patients in the facility will be notified Of stop order policies. Federal and State regulations require that each Patient's therapybe reviewed and reordered at least monthly, � ► therefore-, all drugs unlessreordered by the patient's physician will be stopped after 30 days, All drugs which have run the course of a specific dosage reg- imen, when so ordered on the chart, will, be stopped Specific stop orders are to be listed and maintained by acOOPerative effort of the medical staff, administration, and Pharmacy Consultant. A copy of the stop -order policy will be posted in each medicine room of the facility. Specific Order Limitations Anticoagulants All patients receiving daily doses of anticoagulants should have a prothrombin time at regular intervals, as or- dered by the physician or at least every 30 days, if pro- thrombin time 'is falling below 20 percent or rising above 30 percent, the physician must -be notified immediately for further, orders. (A11 action of this nature must be charted in detail on nurse's notes) Experimental Injectables It will be the policy that the following injectable drugs will be administered to the patients onl' b y y' the attending Physician.. The nursing staff will assist in the preparation of. - 19 N�\;:��,�:":;\ the patient and provide any and all equipment or solutions necessary for the procedure, but the actual'injection of the medication must be performed by the attending physician. some examples: Cosmegen, Cytoxin, Fluorouracil (5 FU), Leu- keran, Mustargen, Thio-Tepa, Triethylene Melamine, Uracil Mustard preparations, Velban. Digitalis and Derivatives Each patient receiving digitalis (or any derivative form of the drug shall have his apical pulse checked daily before adminis- tration and recorded on the medication sheet. if the apical pulse is below 60 per minute, the drug is -to be withheld and reported immediately to the Charge Nurse: she will in turn alert the physician and receive further instructions Any action of this nature must be recorded by a "circle" around ' the nurse's initials to denote a dose not received by the patient I # and an explanation should be part of the nursing notes. Some examples: Cedilanid, Crystodigin, Digitoxin, Lanoxin, Purodig3:n, etc. Levophed To provide maximum protection,for the patient as well as the nursing personnel, it will be the policy that any patient who has orders to receive Levophed wall be transferred to a hospital, if more than one dose is to be given, unless adminis- tered by the attending physician. Narcotics ' Class I1 controlled drugs required hand-written prescrap- - tions each time they are ordered. This federal requirement thenautomatically determines that the drug therapy must be nal re-ordered by the physician when the orginumber of does 19A ordered have been administered. Phenylbutazone and`Combinations' All patients receiving continuous doses of phonylbutazone and combinations containing phenylbutazone should have a C8C run every 14 days. The results should be called to the physi- cian. (All action of-this nature must be charted in aetail oft. the n-arse's notes). some examples Azolid, AZOjid-A, Butu- zol.idn, Butazolidin Alka. Aft NURSING SERVICE SAFETY_ POLICIES 1. The total.environment furniture,' r _services, equipment and supplies shall be kept clean, safe and in good repair. 2. No patient shall be abused, punished, or neglected:. When a patient's condition or his behavior makes the use of restraints necessary, the restraint shall be applied in such a manner as to prevent injury or deformity. During periods of restraint the patient shall be Observed vigilantly and appropriate recording be made on the patient's record.. The physician will be notified and an order for the: restraint obtained immediately after the first use. 3. The patient diagnosed as having, or suspected as having, an infectious or communicable disease after 'admission to the facility shall be immediately transferred to the Isolation. Room; and nursing procedures, conforming to the control of the specific disease and the proteciton of the other persons, shall be instituted and consistently maintained until such time as the patient is released fromisolationby the physician. 4i Cleaning agents and other dangerous substances shall be stored in such a way that patients do not have access to them,. 5. Every accident and every in however slight, occurring to the patient shall be reported to the charge nurse. The incident' should be fully described in the narrative section of the nursing notes The incident report shall be signed by the personal physi- ian and then filed in the Administrator's office. 5 The facility ty staff is instructed that in time of sudden 'crisis, the following steps should be taken,- 20 aken:20 a. First aid to thepatient who is endangered or in distress. b. Obtain assistance and advice from the nurse in charge, Putting into practice the provisions for "special patient care" in the Manual. P. Notify, as necessary, family, physician., etc; as described in "Notification of Changes in Patient Status". d. All necessary reports as required in the Administrator's Manual and Nursing Manual are to be prepared depending on the nature or the crisis, 7. The policies covering use of Safety Devic es ('AeStraints) are noted on 22. r, SAFETY DEVICE (RESTRAINT) POLICIES Safety devices (restraints) may soinetimes be required to protect the patient from in ury to himself or to others. When such a need arises, the following steps should be taken: 1. In an emergency, oft safety di g y• a yevce may y be used until the Physician is contacted. 2. Safety device (restraint)must be authorized by the patient's Physician and his orders srould specify: a. Type of necessary safety device. b. Why needed: c. Length of time to' be used. 3. Only soft safety devices and breesline Posey jackets will be used in this facility. 4. If the patient is ambo?.atory, he is allowed out of chair'on a regular basis to walk in the corridor, not less than 10 minutes during each 2 hours in which the device is used, except at night, S. If the patient is a'bed patient, he is released and exercised in bed at regular intervals; 6. Re--orders for safety devices (,restraints) are not requested until theeen reviewed atient's condition has b P wed with the physician. 7. These devices should always, be used for safety, never as a form of punishment by or convenience of, the staff. 22'- There is to be a written patient care plan for each patient based on the nature of illness, treatment Prescribed and other Pertinent information. The Patient, Care Plan is a personalized plan for the individual patient. it indicates what nursing care is needed, how it can best be accompl.:shed, how the patient likes things done and what methods or aPProaches are most successful. 2» Patient Care Plans will be available for use b all Y nursing personnel. 3. Patient Care .Plans will be reviewed and revised as need 4 A clinical record will'be established containingall ed. fox- warded information and current findings and care required. 5. The pati»ent, according to his n`eds., and insofar asos - p sbl.e, Will be assigned quarters in close proximity to those se r- vices which will encourage independent date -bathrooms,dining and activity areas. 6. An admission summary will be made ,by the Professional 1jurse Of her Observations of the patient's corlition and charas teristics. These will include means of admission r person accompanying patient, patient's reaction, his ability to communicate ambulation statUs, personal appearance, appliances used, proper functioning of appliancesj Patient's expressions Of anxiety or complaints, etc. 7. Daily care will include: a. Personal hygiene - bathing as appropriate (preferably 23 - out of bed), oral hygiene, grooming, etc. b. General observar4ion such as; patient's skin for abrasions, irritated areas, dryness, edema, discolor- ation; other signs and symptoms; physical as well as as :behavioral and emotional changes. c. Bladder and bowel control and training for continency. d< Exercise - out of bed for as long as possible, wheel- chair and walking exercises with or without personnel or device assistance. e. Intake and Output recording as indicated. f. Treatments as ordered by the physician. g Therapy as indicated by therapists from doctors orders and within the capability of nursing service-., • h. Medications: given as directed b ' Y physician. Nursing staff to be alert and aware of the administration and dosages of medications given: for allergies, effective- ness of medications also side and/or continued reactions. i. Diet: as prescribed. Edentulous patients will have food cubed, minced F , pureed or strained to meet individ- ndivd-ualneeds. ual needs.Table ser-,rice is provided where it is needed. j. Activities: Patients are encouraged to participate in those activities suited to their needs and°interests through involvement of nursing with the ,"activity De- partment in.patient. ward activities. 24 NURSING SERVICL,'IN-SFRV12E TRAIN A continuing in-service education.prograzn will all nursing b e in effect foxy ., person�,iel. Lectures and discussion periods may be held by the Director of Nursing Service, guesthvsi `' P ., dans r paramedical consultants, and other exp erts The in-service Education program shall consist .of three different efforts: 1. Orientation of new employees. All new nursing personnel in the facility should be required to read in detail., through. the appropriate Portions of the Nursing Department Manual. 2. Basic skill training or review of basic skills. The skill training portion of the in-servicema ram ro P g � Y include demon- stration, supervised practice, and perhaps return demo tions nstra- f simple nursing procedures which are a the facility. pplicable. in 3• Continuing :education.. to keep all�' per.,onne up -dated in the health care field. The Director of Nursing SerVice shall Pre_)are dated records of in-service education n g� ving the subject matter, the name of the instructor, the title of th/ .instructor. a , and the time involved in the program. Each participant shall sign his own name indicatingarti ' The in -•service p c�-Potion, Program shall be conducted on z once a week basis, for 20 minutes to each shift of,nursin At times tillsg personnel. Progrdir. Y be varied may b reason of Y special ' education techni 'es For'ans techniques4 incidental ''teacxiing done on a one -for .one, or one -to two basis for certain top;,cs will be more a PPropriate than a group Program. Records are -c be kept specifically of such teaching_so our records of each emPloyeFI`s preparation may be complete. 25 Orientation topics where new employees are conoe,rned, should include a review of the job description and duty list for the specific Position. It should also include information about the standards of performance required for the job. It should include lusts of com- munication and authority within the facility. It Should include a review of any appropriate house rules cr regulations Abid specifically should include responsibilities of the employee to the facility, to the staff of 4 -,he facility, to the facility's patients and to the patients' families. Mention .should be madeof causes for discharge and emergency procedures to be used in difference situations, especially in case, of fire. Personnel policy should be reviewed and the procedure for the use of the time clock, sign --in ;sheets and other such items should be covered. All patient -care Personnel, both licensed and non -licensed, should be in4-truucted and supervised in the care of the emotionally disturbed and confused patient and should be helped to understand the social aspects of, patient care. Each new employee should be fully instructed in the Patient's Rights and Responsibilities to more readily assist the patients in exercising their rights. 26 IQ � REHABILITATIVESERVICE'S Specialized, reha.bil itZLtive services will be provided by quaji,fi ed therapist; i.e., Physical therapy and speech Pathology, as needed by patients to imPrr,)ve and maintain fullctioning Rehabilitative services are px?videcl upon 4writtC:n care of P].an initiated by the attending,physician, and developed in consultation with appropriate therapist(s). Written orders of the patient's a .tEnding physician will include modlalit:ie;s to be usetj e frequency, and anticipated goals; Safe and adequate space and equipment are available; commensurcate with the services offered. A report of the patient's progress will be commuizicated 4,,o the attending physician within two weeks of the in:i.tiatio l of specialized rehabilitative services. The patient's progress will thereafter be reviewed regularly, and the plan of rehabilitative care Ire -evaluated az necessary, but at least every 30 days by the phi rsic an and t he therapy according to t'V� prescrwbed regulations The physiciaon's orders,the plan of rehabilitative rare, services rendered, evaluation of progress; and other pertinent 'information will be recorded in the patient's medical; record, and shall be dated and: signed by the physician ordering the service and the person who provided the service. Nursing staff, through the directions of the therapist, should also assist patients to carry our prescribed therapy exercises be- tween visits of the professional therapist. -27= PHARMACEUTICAL SER�GES All medications administered to patients of the fmoilit will ll be given upon written orders of the physician. The proscription should be procured from a registered pharmacist. Telephone orders may be given by the physician in an emergency to a licensed nurse, recorded in the patient's record, and signed by the nurse to b confirmed in writinge b y the physician within 48 hours. The procedure for use of the telephone order blanks, includes writingl-0 order on the blame, attaching the duplicate, til-0 telephone p yellow copy of the physi- clan's order sheet and mailing the white original to bis cop to the he physician returned by mail for the Patient's s chart with the physician's Oignature within 48 hours. Each physician should be notified stop order of the Policy within the facility and should be contacted for :renewal of such orders so that continuity of the patient' Promptly s theca- Peutic routine is not interrupted. Each medication room will have areas labeled for internal med- is fines, external, Use only medications, and poison. Beside this marking, there will, btu marked, locked areas in the utility room for Poisonous substances. Controlled drugs will be secured un double lock in the medication room. der All drugs with soiled, damaged, or improper labels should b returned to the i�ssuing pharmacy forrelabela e g. Baolocals g�, w .. 1 . n ' � and other drugs requiring refrigeration should be stored in a refrigerator in separate, covered, water -proofed receptacles. A thermometer should e checked by the supervising rvz sing nurse on a reAskgular basis'to be sure : that the refrigeration mechanism is maintaining Proper;story temperatures. ge Medications no longer in use: are; disposed of or destroyed i Y n 29 p accordance with State and Federal laws and regulations the Medication Routine in the Nursing Department Manual .ons as,a�oL�d in fac- ility. All cvzitrolled drugs shall be counted, jointly by the nurse .nual of the. going off duty and the nurse coming on duty - the. date., hour, and full signature of both nurses be.gn affixed ,to each record count an the facility. If the count is incorrect; facilit are to be followed; Y Procedures natir"yng the Director of Nursing ser�rce and the Administrator. The pharmaceutical services are under the general supervision Of a qualified pharmacist who is responsible to Ad developing, Administration for evelo P g, coordinating, and Supervising g all pharmaceutical services. During regularly scheduled visits, he rev,:ws the drug regimen of each patient monthly and reports any irregularities to Admnistr' If there is a potentia], atop. Problem with a patient's drug 1qWreports this to the attending regimen, he physician. The consulting pharmacist submits a written report.,: at ]:east, quarterly, to the Pharmaceutical Services Committee on the st Of the facil,i.t s atus Y' pharmaceutical servoe and staff COPY of this report is also sent to the Administrator, A ator, tion kit, approved by the fac' An emergencymedication .lit �s p ceut�.cal Services Committee and maintained in a'se separate y karma-. ..drawer, is kept readily available, p e box or An ..inventory of this box should be affixed on top and be available in the Kara formation., and ex for physician in - ted b pos _Y the telephone for handy reference when talking to a Physician. Mediratons are assumed to be ordered for thirt unless otherwise specified.by Y (30� days y the physician.. Medications wall be released to patients on_disch upon written authorization of the a+ discharge, only patient's s physician, o 30 a DIETARY SERVICESPOLICY The facility will have an organized dietary department with established lines of authority, clearly defined job assignments and responsible supervision over a period of twelve hours or more each day. The Food Service Supervisor is incharge of Lhe dietary de— partment. A consultant dietitian, who is a member of the American Dietetic Association, will visit on a regularly scheduled basis and assist the Food Service Supervisor in all phases of the kitchen operat -. Dietary personnel are screened and interviewed by the Food _- Service Supervisor. The Food Service Supervisor, with the approval . of the Administrator, hires as needed. The Food Service Su pervisor is then responsible for training the new employee. A work schedule of all kitchen personnel will be posted in advance. Any changes will be made known to the affected employee in advance. Special attention will be given to the ,following: 1. Cleanliness, 2. Proper and adequate refrigeration. 3i Storage. 4. Dish washing. 5. Garbage and trash disposal.. 6. Safety procedures. 74 PersoLal hygiene of all dietary employes. Menus will be based on a 'four (4) week cycle and changed twice yearly. A copy of the current week's menu shall be posted in the, kitchen 32 at Least three (3) days prior to the period covered If any moai served varies from the planned menu, the change shall be noted. in the written menu. A copy of the menu, as s•{ .erved shat be kept on file fox a period of at least four4 (` ) weeks Dietary records are correlated with pati r lt medical reco Physician res= prescribed therapeutic diets are to be specific, compiee and in writing. The regillar and special diets wi,1l m6et . tional needs of the the hutrii- patients. in accordance with clirren{, recommen;,l,qd; dietary allowances of the National Research Council All diets are correlated with the needs and/or desires of the patients as within the context of the doctor's orders.permitted A current record of dai lY Purchases showing the kinds and amounts Of food purchased will- be kept on file. The Administrator is to see to it that all meals shall be served in an efficient and attractive manner, and that provision made to serve hot foods hot and cold foods cold. s shall be Deals will be served at regu':ar times each da than a ,14 hour ..span between 'a substantial Y with not more. anta.al evening meal and breakfast. Between -meal snacks and bed -time snacks wi.11 be offered Patients will be encouraged at every Opportunityto employ em P,.oy good nutritional practices and habits. 33 EMERGENCY,' PROCEDURES A disaster ;plan, complete in marked folder, shall be available to all personnel. A fire plan ill also be available in the same folder. Clearly available posted at. eachstation.., will be a plan for evacuation of the facility. This evacuation Plan would be followed in case of fire or other disasters Regular drills will be heldr called by the Administrator and recorded with permanent record. The fire and disaster plans specify the Persons who are to be notified, the locations of alarm signals, and extinguishers, the evacuation routes, procedures for evacuation of helpless patients, the frequency of fire drills, the personnel assignment to specific tasks and the responsibilities of each level of personnel of each shift. Facility employees who are injured, while on duty will receive emergency first aid as required, and the services of a physician 'Will be secured as needed. Full reports are required for such incidents. AMk _` 34 ,_ DENTAL SERVICES Dentist preference will be asked 'by the admission clerk of the patient and/or family and recorded on admission sheet along with phone number; Racility patients shall be ass5ated to obtain regular and emergency dental. care. The facility will have made arrangements with an advisory dentist to provide consultation, to participate in in-service education, to recommend policies concerning oral hygiene, and to be available in case of an emergency. All patients will have an annual oral examination by a dentist of their choice or one of the facility's consulting dentists, if they have: no 'personal dentist. The facility shall assist ,in arranging transportation to a dentist's office and shall follow the dental recommendations while consulting with the attending physician. The patient's physician will be consulted regarding the need for dental work and the order will come from his initially for dentist involvement. Involvement of family memebers to assist in transporting to the dentist's office will be encouraged; .9 Zahi 35 PATI.�NT ACTIVITIES In this facilit yi a staff member is responsible on a full or part-time basis for patient activities:. If not according to Federal regulations, the qualified .staff member consultatireceives regular Lon from a qualified person. No patient is forced to Participate or attend. Tactful persuasion; however, can usually accomplish attendance at group activities. Written orders by the.. PhYSician will reflect the absence of conflict of the activit Program with his established treatment plan. Y The facility will make available a variety of supplies equip:nent adequate to satisfy the individual needs and and of patients. Examples of such su i, interests PF�ies and equipment are: books the, like.. and magazines, daily newspapers, games, stationery, radio, TV, and «' Patients who wish to attend religious services will be afforded all the assistance available and be made to have regularly scheduled ' ,religious servicEes held in the facility and, where services g reflect the various religious be" Possible, have fiefs of the Patients. liePendin g upon the medical condition, patients will be encouraged u o ao attend services outside the facility as well. 5 IRW 37— I CLINIC-AL RECORDS All records in'- t>;,:7 . facility shall be maintained completely; Patient chart records are to be accurate and legible_ The should be written: in ink, ' dated and Signedb Y Y the responsible person. All clinical records of this facility, Shall. include: 1. Admission records, identification and summary sheet(s) including patient's name, social security number, marital status, age, sex, home address, occupation or former occupation, and religion; names, addresses and telephone numbers of referral agency (including hospital from Am which admitted), Personal physician, dentist and next of kin or other responsible person; ;admitting Oiagnosis; final diagnosis, condition on discharge, and di;opo- sition; and any other information needed to meet State requirements, - 2. Initial medical evaluation including medical history, physicial exams.nation, dsa nasi s and estimation of restoration potential. 3. Authentication o:° hospital diagnosis, in the form of a p. hos�.t p' al summary discharge r g ,_beet.., or a report from. ,.the Physician who attended the patient in the hospital, or a transfer form used under a transfer agreement, such as the Briggs form #822. 4• Physician's orders, including all medication, tte t a ments, diet, restorative and special medical procedures rIe uixed for the safety and well--be,inq of the patient. -3;g EMN 5• phys,cian'S progress motes describing significant•changes in the patient's condition, written at the tame of each visit,, 6. Nurse's notes containing observations made by the nursing personnel. 7. Medication and treatment record including all medicationsr treatments and special procedureserfo p rmed for the safety and well: -being of the patient. 8. Laboratory and x-ray reports. 9. Consultation reports. 10 Social Service reports. 11. Occupational and physical therapy records. 12. Miscellaneous forms, All information contained within the record is to be regarded as -confidential and disclosed only to authorized Personn- el. Failure to comply with this policy shall be cause for term- ination by the Administrator of the facility. Patient's clinical records are retained and are available for a period of at least seven years after the date of dischar e. g Prov;,ion is made by the facility for retnetion of records in safe storage with a certified storage agency in the event the facility should cease to function as a medical care facility. Upon discharge, and ,after being full completed r Y p ed the patients clinical record is dis- assembled and sent to the Director of Nursing Service or'staff member assigned to Medical Records to be put into order and given to the Administrator for safe -keeping and for filing. A staff member is assigned the responsibility of maintain- ing Medical Records. if the staff member Is not a qualified MR ._ y Ask practitionere they receive regular consultation from a person so qualified. Clinical records of discharged patients are completed promptlyand are filed and retained. The facility menus are considered part of the official facility records and are retained; in corrected form,, as ustid, fok six months, Medical records are indexed as follows., 1. By patient name. a. This index will containr at least, the full name of the patient, address, date, of birth, ind the medical record number 2_. By Diagnosis a Index should contain medical rc-�cord number, na ne,. age, sex, ,physician,, and length of stay in days. Patients may approve or refuse the release of their medical records to any individual they wish ;except, in, case of his transfer to another facility, or as required by law or third party payment contract. -.40w VISITING HOURS Normal visiting hours will be established and posted at conspicuous places throughout the facility; they will be: From: 10:,00 ASM. to 8:O0 p.M. Visiting hours are established for the convenience and Privacy of patients and staff. Although the hours naurs are estab- lished', they are not rigid in times of criticial illness or when other personal or family considerations require deviations. Any such deviations from the established visiting hours requires the approval of the administrator, the director of Nursing, or the charge nurse, in their. absence. The facility reserves the right to restrict visiting privil- eges at any time when it is apparent that the welfare or safety Of any patient is threatened, u �42-� Smoking by employees is to be ailowed only in designated areas. Employees are net permitted to smoke in the corridors, living rooms, patient rooms, nursing stations,, or in the dietary area. Smoking by visitors is to be limited to the same areas . designated for employees; except: they may smoke it patient's rooms, where smoking is permitted, while visiting with, or supervising authorized smoking by a patient. If a 22LLent is a confirmed smoker and is permitted by his physician to smoke, the administration will attempt to accommodate him in a room where smoking will be permitted and acceptable.. Any smoking in bed must be allowed only under observation of a staff member. (Matches or lighters`are not to' be left with bedfast patients.) Smoking or open flame is prohibited in all rooms or spaces where oxygen is being administered or stored. No smoking signs are to be prominently posted in these areas as a warning. 43- A centralized, coordinated discharge planning program will be furnished, to ensure that each patient has a planned program of post. -facility continuing care that will meet the patient's post -discharge needs. This program will be under the direct supervision of the facility's Director of Nurses with the assistance of the advisory physician. Discharge planning is initiated at the time of admission by the Director of Nurses, who will discuss those needs with the family or responsible party. An initial assessment of the direc- tion to take will be based on post -discharge plans and/or their capabilities to meet those needs. In the absence of family or Okfriends, the Director of Nurses will determine the need for services of community agencies or medical-assistance-programs,fnr post -facility placement and care. The function of discharge planning will be conducted by the U.R. Committee. The committee will plan and coordinate the discharge format. A review for redetermination of the patient's discharge plan will be made periodically. The Discharge plan will be filed in the patient -'s record. The attending physician will give the order for discharge, preferably well in advance of actual discharge.. At that time, the Director of Nurses will contact responsible parties, if any,, and Will put into implementation plans that have been made for the discharge, A discharge summary or transfer referral or a combination of both will accompany the patient upon discharge. i The key to effective discharge planning is to have `all plans -44 The following� patient's rights policies will be established by the governing body and the facility as .required by law and as adopted and administered according to f -e cy Poli Manual, it is the responsibility of the facilityand Procedure administrator to see that these patient's rights are made available to patients, to any guardians, next to; kin sponsoring agencies or represen- tative payees and to the , public. The articles which follow are to be posted in conspicuous places in the facility, 1. You have the right to be treated with di nit an individual who has g Y and respect; as and requirements, personal needs, fellings preferences,. 2. You have the rightto f„ .and in the fulfillmentpofvacy in your treatment your personal needs. ` in Your care, `d 51 You have the right to be fully informed of available to .you in the facility and of any charll ges services• g for those 4. You have the right to be fully informed of Patient and of all rules and regulations your. rights as a conduct as a governing your Patient in this fac lity. S• YOU have the right to manage g your personal financial affairs. If you desire assistance, the facility maintains a patient trust account and will administer -according to authorization Your funds deposited' therein Ari accounting Ycfrall �financialtransactia d instructiois behalf will be given youPeriodically, ons made on your (at least every three monthsjod calX and upon your request 6• You have the right to know about your medical Your physician, for medical reasons, choose not unless You, and so indicates in inform right to participate in thedevelopmentrecords.' You have the 7. You have the right to refuse treatment your treatment plan: by law, and to be informed of the medical consehe xuenc tent permitted this action . q _ es of 8. YOU have the right to ref mental research. use to participate in any Pxperi- 9• You have the right to continuity of ca You will + ` scharged or transfer., ll not bo, di e 1 except for medical reasons, for -4'6 your personal welfare, for the welfare of others, or for your failure to pay for services. Should your discharge or transfer become necessary, you will be given reasonable advance notice, unless 'an emergency situation exists. 10. You have the right to voice g grievances and recommend changes in policies and services offered by the facility, without fear of .restraint, interference, coercion, discrimination, or reprisal. 11. You have the right to be free from physical, chemical, and mental abuse. Physical and chemical restraintg may only be applied when ordered by your physician in writing and for a specific, limited period of time, except when: necessary to Protect you from injury to yourself or others. .12 You have the right to confidential treatment of your personal, and medical records. Information from these sources will not be released without your prior consent, except in your trans-' ferto another health rare facility, or as required by law, or under third party payment contracts. 13 You have the right to refuse to perform any services for the facility, or for other patients, unless they are part of your therapeutic plan of treatment, which you have approved. 14. You have the right to retain and use your personal clothing and belongings, as space permits, unless to do so would infringe upon the rights and safety of others, or be contrary, to your written plan of treatment. 15. You have the r,ght to participate in the activities of social, religious,, and community groups of your choice unless your physician, for medical reasons, considers such activities contrary to your weifare and so indicates in your medical records. 16. You have the right of, choice of persons with whom you asso- ciate and communicate, publicly and privately, unless your physician feels some, or All such associations, are detri- mental to your welfare and so indicates in your medical records. 17,. You have the right of privacy during Vislt8 by your spouse, family, clergy, and others. If you and your spouse are both patients in the facility, and your physician approves, you will be allowed to share a room with your spouse, when such accommodations are available; 18. You have the right to receive visitors at times other than the established visiting hours,particularly at times of crib; ;,-,l illness, or for other pressing personal reasons, 194 You have the right to reasonable access to a telephone, both to make and receive confidential calls, 20 To be permitted to purchase drugs or rent or purchase medical -47a^ supplies or equipment in accordance with the provisions of Section 1320 of the Health and Safety Code. (a) A patient's rights as set for th in Section 72523 a they pertain to a patient adjudicated incompetent in-accord- ance with state law, to a patient who is found Physician to be medically incapable of understandings these rights, or to be a patient whoexhibits a communication barrier, shall devolve to such kin, sponsoring agency or representatiire guardian; next of payed, (b) A patient's rights as set forth in Sect.�,ozi 72523 (a) may be denied :for good cause only by the at72y Denial of such rights shall be documented b tending physician Physician in the patients health record;' h a tiand�r: GRIEVANCE Patients may register opinions or comments relating to pro- cedures or policies withinthefacility without fear of interference, coercion or restraint on the part of the facility. Patients at this facility will be encouraged to pursue their 3a,fights as ind-viduals and citizens and patients. If assistance is i needed to take advantage of these rights, the patient will be advised to contact the social Worker of his, choice, A referral list wi1l be available. The facility will. assist patients in their rights, such as voting, ' obtaining legal advise, etci such requests must be documented as being valid, and the patient should understand the facility will assume no financial liability for such requests. 48 r TIEATIi 1OEIC- .S When a patient apparently expires, the nurse ' pati r after fo�:l.owi�r:g Proper procedures, shall contact the attending,, p-lys,i,c.i.an or his alternate and inform the physician of the details„ The phYs cjar is informed of two possible procedures to conform with pc�lici�.,s and prgcedureG of the, facility, 1. If theh scia.n ..hooses P Y to follow one method, hod ,, he C'a request the body be; sent to the previously, assigned - mortuary, and he can make his own arrangements as to signing of the death certificatei if this method is followed, the time of death shall be the time noted on the record by the nurse when the Patient apparently expired 2,, If the physician chooses to follow the alternate MkIt., d and pronounce the patient dead within the facility, he shall do so immediately after the notification, no matter what the hour of the day or night i 49 INFECTIONCONTROL, COMMITTEE POLICIES An Infection Control Committee will be formed to effectively carryout the responsibilities as set forth in this policy. The I.C.C.'.4 will meet quarterly. The Committee will be com- prised of om-prised'of at least one Physician, the Administrator, the Director of Nursing, the Maintenance Supervisor and a representative of the dietary department. There will be an Infections Control Officer appointed who will carry out the policies of the facility. The I.C,C will be responsible for the overall Infection Control in the facility. The I.C.C. will oversee the housekeeping and -maintenance services, to maintain a sanitary and comfortable environment and to help prevent the development and transmission of infection, The I.C.C. oversees isolation and aseptic techniques used by personnel. The I.C.C. will oversee the techniques used by personnel in the handling of Linen. The I.C.C. will make certain the facility is free of any pests' which could spread infections disease, The I.C.C. will investigate suspect hospital-acquired infections_ and take appropriate measures for their control. The T . C ..0 . will follow the procedures for Infection Control: as set forth in the book GUIDE FOR THE CONTROL OF INFECTIONS.AND THE MANAGEMENT OF COMMUNICABLE DISEASES IN 1,NSTITUTION8, published by the Orange County Health Department 1971. 5O PHARMACEUTICAL SERVICES COMMITTEE The facility will have a Pharmaceutical Services Committee composed of the following: 1. Pharmaceutical Consultant 2.Physician 36 Director of Nursing Service 46 Administrator. The Pharmaceutical Services Committee will meet at least quarterly or more frecuent y if' the Chairman deems it necessary, Minutes will be kept and recommendations made to Administration. The purpose of the Committee will be to supervise and oversee the pharmaceutical services of the facility. Procedures of the Committee will be to: 1. Review drug handling and distribution to prevent outside' usage. 2. Set tip procedures for accounting of all received and disposed ' drugs , particularly those subject to Comprehensive Drug Abuse Prevention & Control Act of 1970, 3. Recommend, method to assure the appropriateness of con r t-inued drug therapy, 6. Determines the contents of the emergency medication kit. The contents of the kit must comply with State law and regulations. 7 Develop a list of abbreviations and chemical symbols that are approved for use in ordering medications in the facility. 8. Pevelo p policies and procedures for the safe procurement, storage, distribution and use of drugs and biologicals. _ 52 yap,:, vI`^ ,V•' r.� •,� r ��5 - �r• r e r � r' r,r y �r ;4 ?' 0. ,t 1. 4 r ` pry � � } w r � '• , �. ; r As applicable, the project shall emphasize comprehensive, continuous services and have coordinated cost effective linkages with facilities providing health services within the immediate community and with facilities providing special services in adjacent areas. DISCHARGE pLA1*JING The Director of Nursing Services acts as Discharge Coordinator, who is assigned the responsibility of discharge planning. The Discharge Coordinator serves as Chairman of the Discharge Coor- dination Committee, which provides the various professional• disciplines an opportunity � when ortunit to discuss specific patient need; they are discharged to home or another level of care. The Discharge Coordinator will coordinate discharge kr home ies, and physicians to ins:.•;e continuity health agencies, famil of care once a patient, leaves the facility. The Discharge. Coordinator also becomes invq1vad in individual and group meeting!! with patients' responsible parties and friends Please refer ko page 44 of the Patient (2are Policy in the previous section 'for a detailed policy on pischarge planning in order to facilitate continuity of care and the timely transfer of patients and records betw-a-en local hospitals and the skilled nursinghome, transfer agreements similar to pages attached will be executed to best serve the needs of the patients. 54 TRANSFER AGREEMENT Aft BETWEEN Address) City, State .and Z! p Code AND w Address) (City, State and Zip Code) To facilitate continuity of care and the timely transfer of patients and records between the hospital and the skilled nursing facility, the parties named above agree as follows: 1. When a patient's need for transfer from one of the above institutions to the other has been determined and substantiated by the patient's physician, the institution to which transfer is to be made agrees to admit the patient as promptly as possible, pvovided admission requirements in accordance with Federal and State laws and regulations are meta Z. The transferring institution will send with each patient at the time of transfer, or in the case of emergency, g p g y, as promptly as Possible, the completed transfer and referral forms mutually agreed upon to provide the medical and administrative information necessary to determine the appropriateness of the placement and to enable continuing care to the patient. The transfer and referral forms will include such information as current medical findings, diagnosis, rehabilitation :potential, a brief summary of the course of treatment followed in the transferring institution, nursing and. dietary information, ambulation status,and pertinent admiriistra-. tine and social information. 3. The hospital shall make available its diagnostic and therapeutic services, including emergency dental care, on an dft outpatient basis as ordered by the attending to Federal and State laws and regulations. physician subject 4. The inst tution responsible for the; patient ;shall be accountable for the recognition of need; for social services and for -55-- prompt reporting of s`ach need to the local welfare department or other appropriate sources. 5. The transferring institution will be responsible for the transfer or other appropriate dispostion of personal effects, particularly money and valuables, and ihformation related to these items. 6. The transferring institution will be responsible for effecting the transfer of the patient, including arranging for appropriate and safe transportation and rare of the patient during the transfer in accordance with applicable Federal and State laws and regulations, 7. Charges for services performed by either facility shall be collected by the institution rendering such services, directly from the patient, third-party payor or other sources normally billed by the, institution. Neither facility shall have any lia- bility to the other for such charges. 8. The Governing Sody of each facility shall have exclusive control of policies, management, assets and affairs of its respec- tive institutions. Neither institution shall assume any liability by virtue of the agreement for any debts or other obligations incurred by the other party to this agreement. 9. Nothing in this agreement shall be construed as limiting the rights of either institution tc; contract with any other facility on a limited or general basis. A 10. This agreement shall be in effect no longer than one year from the date effected. However, it may be terminated by either facility upon 30 days written notice, with copies to the Bureau of Health Facilities Licensing and Certification, State Department of Public Health, 744 P Street, Sacramento, California 95.814. The agreement shall be automatically terminated should either facility fail to maintain its 'licensure or certification. 11.. This agreement shall be renewed at least annually in writing and shall be maintained in the facility's files with a copy of the renewed agreement sent to the Certification Unit, Department of Health Care Services, 714 P Street, Sacramento, California 95814. 12. This agreement shall cover the period through (Name of Skilled Nursing TAdminigUator Date, Facility` Name of Hospital) Date dmanstratary -56- ,M1 STAFFING REQUIREMENTS Classification: Administrative hrs./wk. Administrator 40 Office Manager 40` Medical Records'' AssistantOfficeManager 40 Staff Developer 40 160 hrs/wk Nursing Director of Nurses 40 Registered Nurse 72 Licensed vocational Nurse 280 Nurses Aide 1.344 1736 hrs/wk. Dietary Supervisor 40 Cooks 144 Kitchen Help 138 322 hrs/wk. Plant Maintenance Maintenance Supervisor 40 Janitors/Housekeeper 168 Laundry 112 320 hrs,/wk . Activities Activity Director 40 Assistant Activity Director 20 60 hrs/wk.- Exhibit 1' f SUMMARY gF ;'dRSING DEPARTMENT STAFFING BY 041IFT 99 Bed Facility A.M. p - �l Registerediurse iI GHTS TOTAL TO AL HOURS/DAYS EQUIV. HOUR5/DAY (D. 0. rT.) Registered Nurse l _z Licensed 'locational Nurse 2; 2 8 56 Aides l 5 40 80 13 TOTAL 7 4 24 192 1012 _ 17 9 5 31 544 Patients per AideM 7.62 14.14 24.75 ...... ter: Equivalent Nursing Hours per Patient ,Day 34.4.7 * includes Director of Nurses **Exculdes Director of Nurses Exhibit 2 The applicant possesses competent management and organizational skills, both responsive.to community needs and capable of completing and operating the project, ' ORGANIZATIONA:j STRUCTURE Gladys Jennings° & Bryan Jennings, her son, presently Ow11 and operate the Riverside Convalescent, in Chico; Paradj,se Convalescent Hospital, Paradise, Ca., and Bechthold Convalescent Hospital, Lodi, Ca., and. reflect their ability to operate convalescent centers in a most efficient and cost-effective manner. Resumes of the education and experience of Gladys Jennings and Bryan Jennings are a.ncluded. Gladys Jennings, who is experienced in long-term health care and is licensed by the State of California, will use the organiza- tional chart showing day to day management of the facility. It shall, be the direct responsibility of -the Administrator .to see that the chart is followed- Professional consultants will visit the facility on a regular basis to maintain compliance with standards of quality and to educate departmental employees in the most ,recent operational and patient care techniques, including a registered dietitian, an activity coordinator, medical director, medical records consultant, staff development consultant acy consultant, dentist consultant and therapy' ' pharm- acy consultant. Although the administrator has complete facility control, this control is subject to policy guidelines which are clearly defined in a set of Policies and Procedures Manuals encompassing the following subjects: (l) forms, (2) dietary, (3) Personnel, (4) Nursing services, (5) nursing procedures, (6) purchasing, (7) housekeeping, (8) pharmay, and (9) billing and accounts. The Patient Care Policy Manual will be used, including Such policies ad admissions, discharge planning, g, patient activities, transfers, inservice training, patient's rights, utilization review, etc. These policies reflect awareness of and provision for meeting the total needs of the patient. ra.n y y Jennings will. be licensee of the proposed facility. & Gladys The project will be adequately staffed by qualified personnel. STAFFING REQUIREMENTS a_o Attached as 'Exhibit 1, is a table indicating proposed staffing for this proposed 99 bed facility.* b. Attached as Exhibit 2, i.s a table indicating nurse staffing° by shift for, the facili,t:y. SOURCES AND HOW OBTAINED Staffing requirements will be achieved through advertisement in newspapers and health service publications, employment agencies and schools of nursing. The facility will implement a, nurses aide certifi.cat::ion program;. Although the shortage of Licensed Registered Nurses is a problem for all. providers,, this facility will offer various incentives and fringe benefits which iwll result in successful recruiting .. COMPLIANCE WITH EQUa 11, EMPLOYMENT OPPORTUNITY ACT 1. To recruit, hire, train and promote persons in all job classifications without regard to race, color,,religion,, national origin, age, physical handicap or sex, including pregnancy, childbirth and related medical conditions 2. To insure that personnel actions with reference to such matters as compensation, benefits, transfers, layoffs, recall from layoff; company-sponsored training and education, tuition assistance and other personnel programs will be administered without regard_ to race, color, religion, national origin, age, physical hand- icap or .sex, including 'pregnancy, childbirth, and related medical conditions. Staffing more than meets state requirements. THE DEPARTMENT OF HEALTH SERVICES IN ACCORDANCE WITH FEDERAL AND STATE LAWS, HEREBY DECLARES THAT, "NO PERSON 1N THE STATE OF CALIFORNIA SHALL; SOLELY ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, RELIGION, SEX, AGE, DISABILITY, BE EXCLUDED FROM PARTICIPATION IN, DENIED THE BENEFITS OF, OR SUBJECTED TO DISCRIMINATION UNDER ANY PROGRAM OR ACTIVITY THAT IS FUNDED DIRECTLY BY THE DEPARTMENT OF HEALTH SERVICES OR RECEIVES ANY FINANCIAL ASSISTANCE FROM THE DEPARTMENT OF HEALTH SERVICES;' EACH DEPARTMENT OF HEALTH SERVICES EMPLOYEE SHALL INCORPORATE THE CONCEPT OF EQUAL EMPLOYMENT OPPORTUNITY AND EQUALITY bN THE DELIV•- ERY OF HEALTH CARE SERVICES IN ALL WORK ACTIVITIES AND SHALL BE HELD ACCOUNTABLE FOR IMPLEMENTATION OF PROGRAMS AND ACTIVITIES PURSU- ANT TO THIS POLICY. IF YOU. NEED ADDITIONAL INFORMATION OR FEEL THAT YOU HAVE BEEN DIS• CAIMINATED AGAINST, CALL OR WRITE TO: CHIEF, OFFICE OF CMI. RIGHTS DEPARTMENT OF HEALTH SERVICES - 714 4" STREETi ROOM "1050 SACRAMENTO, CALIFORNIA 95814 PUBLIC NUMBER: (916) 445.0578 AT88 NUMBER: 485.0576` 0 • , ,1 t CL- Beverlee A Myers f. ( , Director ti RIVERSIDE. CONVALESCENT HOSPITAL, Pledges to provide equal employment opportunities without regard to race, creed, or national origin. This pledge, made in support of and in compliance with Executive Order 11245 of theFederal Government applies to all em. ployees and applicants for employment in connection with: - Hiring, placement, upgrading, or demotion, re- crating, advertisind, or solicitation for employment, rate of pay or other forms of compensation, selection for training, including apprenticeship, and lay-off or termination. f �p�ie5 a a AayY A—lkie5 4ezd' r 7 i•;; h. t r ----------------- The project will benefit the terms of cion in ost containment, serviceaiprove mentsf coverage of special Poulati health delivery system improvements.ons' or The shortage of skilled nursing tare services in this area results in the available Of the; area for long term care.Tents having to go out cause:This situation tends to Tra1. thPvel elderltance problems and expenses created Y spouse and loved ones. by 2. Separation from environment. 3'• Breaking of the tie with local physicians o making it extremely difficult for proper and reasonable medical follow-up. 4. Separation from family and friends. 5. Lack of control over quality and service. quantity of Due to the lark of available facilities, there is tendency for patients to remain longer than necessary in the local acute care facility,aer Level of care than required. Paying for a higher The provision of skilled nursing carWould eliminate the problems of °long e locally Woudistance covin ld as temized'above, and would support cost containment b the concept of Y minimiz acute care beds. Minimizing overuti],zati.on of a WAWAM The project will not adverse].' indigent.POpulation of the area. the INDIGENT CARE There will be no adverse itivaffect on the indigent Of the area. gent facility will be licensedebaffec Call be that ,the Provision of skilled nursing services to the : the new to allow for the Papulation. It shall be the low-income serve the indigent Policy of this facility to Population of the area. Since this is a record. Proposed new facilit We will provide fur thea Y, we have no track Medi -Care patients: This facilithssion of Mcdi,..CaS Patient cafe to be that of Medi -Care andrMedi-Ca , the next 5 years. affect the yeaindrs.ntShow:ing that this l; over. Positive way. Population of thipra�eatexcep ll not . Pt in a • PHONN 3424don R60"We Colivalement 44otpiterl 990 COMMsaT'Mai CHM6. CALIFORNIA-p$b$ TO ALL PATIENTS ELIGIBLC TO RECEIVE PUBLIC ASSISTANCE: If tile Patient is on•SSI (receiving the gold check) it is necessary that the Social: Security office be notified that they are in a Convalescent Fi Hospital. The gold check received the first of the Month after admission to our facility should be retuned to Social Security and not cashed. The responsible person should make a PPl.ication.at the County Welfare. Office, immediately, so there will be no delay in the receipt of the Medi-Cal Identification Card. We urge you - do not delay in making this application. Until the aPPlication is made and accepted by the Welfare Department you, are required to Pay us all but $25.00 of your total monthly income Social Security, pension, etc.s as deposit toward the Share of Cost to be set by the Welfare De Pa rtmen t. This deposit is due in advance the first of each month. If' our office can be of assistance Please do not hesitate to usi call on RIV' ID E CONVALESCENT HOSPITAL Bookkeeping Department ° The proposed� project will not adversely affect the utilization of other facilities offer" health services in the service area, PRESENT AND PROJECTED UTILIZATION OF EXISTING F' SIMILA —MALTH CARE-19—ERV-1—CM" ACILxTIE� OEr� NG ---- -- The Northern California Health Systems Agency Services indicates the average occupancy rate for skilled vices ple\n H.FPA #7.l5 is 96.2 , The utilization by facility, Was as follows: Beds 1. Beverly _Manor Convalescent Hospital 97.6% 76 2,. Crestwood Convalescent Hospital 97.3% 184 S. North Valley Care Convalescent Hospital. 91.9% 59 4 Riverside Convalescent Hospital 97.9 70 EFFECT OF THE FACILITY ON THE CAPITAL ASSETS AND OPERATING AND MAINTENANCE COSTS OF OTHER' FA°CTLITIES, AND ON UUIUSED CAPACITY. �. Any impact on the occupancy rates of the oth from olxr new addition is er facilities anticipated to be Minor and short- lived; the liv Present high utilization rates indicate very ung demand'. 1980-1955 Health System Plan (date obtained froM HSA #1)_, The project will benefit the terms of cost containment, serviceaimprove- tion merits, coverage of special health delivery system improvomentsons, or The shortage of skilled nursin in this area results in the g Gare services availably Of the area for long term care. Thishaving to out si.tuationgtends to cause; 1. Travel distance problems and expenses'created by the elderly spouse and loved ones. Separation from environment. 3. Breaking of the tie with local physicians, or making it extremely difficult for proper and . easo,iable medical follow-up. 4. Separation from family and friends. 5. Lack of control over quality and quantity of service. Due to the lack of available facilities, there is a tendency for patients to remain longer than necessary in the local acute care facility, level of care than required, paying fo:r a,higher The provision of skilled nursing care locally would' eliminate the problems of long distance commuting as itemized above, and would su cost containment by minimizing ouerutilizatxonpofog acute care beds. �„�y� > � •�'^ctar��^�'S ',h Q4 �k ���'�"'a, � ,t'w "c"Jr �,. '{ lYy�, ?f.. c. +F t.,., ��fi�, .+:%1-.%+ �itt��,i' - •�`!My� ' �r ���+s f��'< �Y +i.•y�t« « f + .tti�. � ¢�'ti� ss°'.u. \'"�.'+i •', - ;��' yd,� 1'+,l-K,� :{� • � y �,!!� � * * , \ f 3� , •� ,�, i p' , ' ;` . � . y �' ' �:S �' k •5f� r" .3' '�, e �' �"' r «,Y' - �S � � ! ,.+k .t.,.;{ . . Y e,.. *. � t i � •+ , � . « v . '. n. r r °d .'••;�..+ �'� .�, h :� • �. •�. , .,; � h � .� '�. ?!.1 li r •fir• �i x' „y. .. , - •++S �+ 4„s . f .� f� r• .%.,.. 4 d.`., ' C'u♦. °f,: ff ` •k`:i \ ^x.. . S tt ` i t.. v . . ' 1. r , I w^ �(.• .1,�///....� s ` •, �/A . �. ♦ « k' t\ r` .;`r, .�--'--�' Com` 'r-'� �� -� � l ` ;� / ter. ✓ , t r `•'' , , f , '.. ,. ,� •�', ,. '.. «i ,w. a. 9.,. , .. . + «« ..fir ,•!' � �, v� J,r�: ',p/�.. �': Y" ♦ti. ,�'� ., .e . o 7, t CUSSICK AREA NEIGHBORHOOD COUNCIL July 21, 1986 Butte County Planning Commission 7 County Center Drive Oroville, California 95965 Dear Commissioners: The Executive Committee of the Cussick Area 'Neighborhood Council met with Mr. Brian ,Jennings to review the proposed 99 bed skilled nursing facility and the Counter staff recommenda- tions concerning it. As a result of this review, the Neighborhood Council supports the concept of a skilled nursing facility at this location, and concurs in the conditions recommended by the County staff. The Neighborhood Council recommends two additional conditions 1) that the masonry wall along East Avenue be modified at the entrance to the private street to afford a safe sight distance for southbound vehicles, and 2) that parking signs prohibiting parking along the entire frontage of the private street be required. The NeighborhoodCouncil is aware that. the City of Chico has recommended that an allocation of sewer capacity to this pro- ject be limited to that generated by 73 beds, unless acqusi tion of development rights or,some other arrangement concern- ing the 3.8 acre parcel to the north can be made. The equitable- ness of the proposal is a problem ,for the applicant to address;, but piecemeal allocation policy does concern the Neighborhood Council. We strongly support the requirement that all projects be connected to the sewer system, and if the available capacity is pre-empted by a few large projects, continuing orderly development of the entire area will be adversely affected. Sincerly, A. R. Schoenfq✓ d Chairman, Executive Committee cc; Brian Jennings Tom Lando 2840 Rodeo Drive Chico, California, July 11, 1985 To Whom It May Concern Re - . Need for Additional Convalescent Facilities in t Chico, Butte County, California Area he As a person, most interested in facilities for. the care of the elderly in the Chico and surrounding area, I wo like to express my concern and observations regarding uld for additional facilties ,in the area. ga rd.ing the need y conservatee confined in a local conal Y am mo hospital on a mit mt ha convalescent PPY with the care which she is receiving.y .S and number of years last pa On the other hated I am and have for a tst, been employed as a legal secretary in Chico, California: We have a number of clients who are confined in local convalescent hDspitals and all 1600 often I have involved with families;tnd friends of thea become endeavor in trying to find facilities availableetoscain retfor their parent%friend. We often find they expect to to provide the "magic We r attorney for Provide immediate came.. S whereby they can secure admittance in an attempt to aid hemeineOf securingSa facility), we run into e brick wall 4nd find put forth every effort space for ,care in a convalescent there IS ° a too often just I S NOT an available Chico, Not only is this frustratfnsPit l atbutemneeded tomd in person with the actual problem. I feel most fortunate in having been able to lace' my conservatee howt_-ver, all too often I see the other ,Fide of the picture and witness the frustration which arise Tamil trying p s within a Y ryin to lace a relative or friendin a convalescent hospital who can no longer be cared for ' in the home and the need is NOW --not: some time down tte road. .. I would strongly urge additional pro vxs3on made for facile facilities in the Chaco area for those person convalescent care, chow be Our area is growin F ss requiring and the need for additional convalescent facilities is 'thus NOW. g, people are living longer, Respectfully submitted ellne Addy_ ;r NLOE HOSPITAL JAMES P. SWEENEY aecutrve Director A CALIFORNIA NONPROFIT CORPORATION" Approved by the Joint Cotrllrilasinn (916') 891.7300 Accreditation of Hoslalinitt W, 5th Avenue and The Esplanade CHICO. CALIFORNIA 95925 June 21, 1985 Mr. Bryan Jennings Riverside Convalescent Hospital 375 Cohassett Lane; Chico, CA 95926 Dear Mr. Jennings; Y am writing in support of need for approval of additional SNF b Chico, Butte County. The Social Service Department at Fnloe HoseitaTn recently prepared a study on discharge delays due to lack Of SNF beds. The study included themonths of January through March of 1984 and January through March of 1985. The results indicated; tla_ nuarv-March 1984 Januar,rcf 1985 Total Patient Days Delayed; 296 461 Average Delay: 6.3 days 6.8` days Longest Stays 50 days 57 days Our concern is with the cost to taxpayers for Medi -cal Patients SNF` placement,, and the difficulty for patients and families awaitingiting Placement. Another concern is the unnecessary utilization of acute beds and the lack of choice for patient and family. Please let me know if further information would be helpful with o request for additional beds, y ur Respectfully, _ r L VICKI' TULLIUS, MSW Supervisor, Social Services VT/dap cc NM File Chico 1I11111lti1% 560 Cohosset ROW p r Chico, Californitl 95926 Hospi tca 1 (910) 345-2411 June 28, 1985 To Whom it May Concern MY position at Chico Community Hospital is Utilization Manager and I coordinate discharge Planning. I find a need for more Skilled N wire Z8 total da s used b Nursing beds in our area, Last month there Y patients in the hospital wa „in a Skilled Nursing iting for bed availability .Facility,:. At the present time we have sixatients wai told by the local Skilled Nursing f:ac litiestthatftheor reaismnbtbed daarel;being In the last few months we have sent several patients out of our area, ?'nra from their families and physicians due to lack of bed availability here. y m One we had to send as far away as the Bay Area. Sincerely, L r7 Jane Etz R , Utilization Review Manager ri �+arionai Nedteal Enterprises H'aalth Care �'dctilly Accrcdtred by r/re ✓Dint ConiMIZiOn do Accredit NO 0IROspirals v!s r July 16, 1985 To Whom It May Concern This letter is written in support Jennings application to construct a new skilled Sharo nursing facility in Chico, California. In my opinion, there is extreme need to have more nursing home beds in this city. In recent weeks thea have been prolonged periods of time when beds have been available for transferred from acute hospital care no nursing home t"a skilled nursing to be facility. This o has resulted in economic hardship, and emotional trauma on the part of patients and their families, as well as extreme frustration on the Of local hospital discharge planners. part It is certainly not appropriate for ptients to be sent as far away as the Bay Areaa becausetof haveofthe of nursing home beds. It ot Appropriate for local acute care hospitals also to keep patients two or three weeks longer in an acute facility than is medically necessary. care' I hope you will give favorable consideration Jennings request to coto the facility ;in Chico. nstruct a new skilled. nursing 1` AW NJATU9AA1„T1'1 A1'91) 0,LAa:TY PLANNING COMMISSION 7 COUNTY CENTERDRIVE - OROVILLE, CALIFORNIA 95965.3397 PHONE: Y&X 538-7601 ` January lei, 1987 G. B. S Properties 375 Cohasset Road Chicon Ca. 95926 Re: Use Permit, - AP 42/ �- �5-38 , UP#85-68 Gentlemen: On September 17, 1985 the Butte County Board of Supervisors adopted Ordinance 2484 requiring that all use ,permits be signed and returned to the Butte County Planning Department within 30 days of the expiration of the appeal. period. Sn addition any preNiously approved Use Permits not signed by October 17 1985 are deemed invalid. This letter is official notice that your previouslyapproved permit is no longer valid, Tf you wash to pursue oure Use You must first obtain a new 'Use Permit. y protect Should you have any questions regarding thismatter please contact this office between 10.00 a.m. and 3., 00 p.m: Sincerely, tS Kircher Director of Planning BAK'lr ec: Building Department Environmental Health I + .., ..♦ a: r... _ w ,.. r.vr...wrrs+avr.A, nxr .n vmi...'dpe.+e+•'r..r.vs:M1-Y>.w°T.'k.Wr..w+urK+Wt/se.i.x..,. :i.r. .._.r...v.., Aft ow LAND OF NATUP,AL WCAI,rH AND BCAUTY PLANNING COMMISSION 7 COUNTY CENTER DRIVE - OROYILL9, CALIFORNIA 95965.3397 PHONES 534.4601 G. B. S. Properties September 11# 1985 375 Cohasset Road Chico; Ca. 95926 Re, Use Permit, ,AP 42-45-38 Gentlemen: Enclosed are the original and one copy of your Use Permit No. 85-68 to allow up to a 99 bed skilled nursing facility on the north side of East Avenue, 600 feet east of Cussick Avenue, Chico: Please sign both copies and return them to us. We will then have them validated by the Chairman of the Butte County Planning Commission and tr-,, original will be returned to you for your records. The Use Permit is deemed granted when this permit has been signed by the applicant, with the counter signature of the Chairman of the Plantling Commission, and said permit is•received by the applicant by registered mail. Should you have any questions regarding this matter, please feel free to contact this office. sincerely, A. ircher Director of Planning BAK:lr' Enc. _ rJR����` �0ir.4i `• ..yam Y r LAME) Of NATURAL WL"ALTH ANO BEAUTY PLANNING COMMIS>ION 7 COUNTY CENTER DRIVE OROVILL11i CALIFORNIA 95965.3397 PHONE! $34,4661 G.B.S. Properties 375 Cohasset Road August 91 1985 Chico, Ca, 95926 Re: Use Permit, AP. 42-G5-38 Gentlemen. At the regular meeting of the Butte County Planning Commission held August 8, 1985 your request for a Use Permit to allow up to a 99-bed skilled h,,nursing facility on the ncrth side of Bast Avenue, 600 feet aaeast of condi ti Cussick Avenue, Chico' was approved Pproved subject to the following 1. Construct curb gutter, sidewalk, and widen East Avenue to 4-lane section along property frontage. 2. Provide drainage facilities to drain property and property frontage on East Avenue to existing storm drain. 3. Construct left turn lane at access road and East Avenue: 4. Connect facility to community sewer and water. 5. Install water main, provide easements and connections as required by CA Water. 6. Submit construction plans to CA Water for review of proposed facilities: 7. Install 2 fire hydrants to CDF specifications. 8. Comply with Title 24 of the CA Administrative Code as enforced by the State Fire Marshall:; 9. Install parking and landscaping as required by Butte County Code 24-35 including a min mum of 8 shade trees adjacent to the west side of the panting lot. 10. Screen trash recepticl:es from public view. 11. Contribute a pro-rata share towards installation of a traff at East Avenue and Cussick (ht) ic signal i r _ GBS Properties Page _2 , August 9, 1985 12. Construct a 6 ft. brick wall, minimum 2 bricks thick along property16 East Avenue frontage, in compliance with setback regulations and install a 3/4" foam barrier with the south side wings of the buildings for noise attenuation. (M) 13. In lieu of condition 12, applicant may propose an alternate which will attenuate indoor noise levels to 45 CNSL, 14. Disposal of radioactive materials and infectious wastes per State health guidelines: 15 No incineration mechanisms permitted on-site. 16. Applicant must also comply with all other applicable State and local statutes, ordinances, and regulations, 17. Purchase a minimum of 3/4 of an acre from an adjacent property owner and combine with 42-45-38 through a BLM yr Reversion to Acreage. 18. Contribute $2925„00 to the West Side Fire Station Ben,rit Fund. Should you desire to appeal any of the conditions imposed by the Planning Commission, you must do so in writing to the Clerk of the Board of Supervisors, 25 County Center Drive, Oroville, California, prior to 5;00 p.m., Friday, August 16, 1985. If you do not appeal and if there are no other appeals within the 8 -day appeal. period, your Use Permit will be issued after August 22, 1985, the date of the official approval of the minutes of the Planning Commission for their meeting or August 8, 1985. Should you have any questions regarding this matter, please contact this office. Sincerely, B. A. Kircher Director of Planning Stephen A. Streeter Senior Planner SASilr � Y LAND OF NATURAL WEALTH AN[) DGAUTY PLANNING COMMISSION 7 COUNTY CENTER DRIVE = OROYILLR, CALIFORNIA 95965.3347 PNONEt 534.4601 August 9, 1985 Ms. Pat f+1erwin Statewide Health Planning is Development 1600 Ninth Street Sacramento, CA 95811 Re: G.B.S. Properties' proposed 99-bed Skilled Nursing Facility Dear Ms. . Merwin At its regularly scheduled meeting of August 8, 1985, the Butte Cou,tty Planning Commissionapproved a conditional Use Permit on AP No. 42-45-38 (G.B.S.) to allow a 99-bed Skilled Nursing Facility. A ]Mitigated Negative Declaration was adopted and will be issued once the minutes are conformed on August 22, 1985• Call if I can be of further assistance. Sincerely, Laura M. Tuttle Associate Planner LMT/ss r f inter-DepartmentalMemorandum to Bettye Kircher, Planning Department Attn: Lauren Tuttle PROM, William C. Teie, County Fire Warden sU13JEGTa 9270 Fire Safety & Land Use Planning/GBS Properti:ris/AP# 42-45-38 DATE: August 6, 19$5 GBS Properties proprses to develop a 99 bed convalescent hospital on property zoned R4 and R3 located on the north side of East Avenue, 600 feet east 0,9 Cussick Avenue, Chico;: As you know, the need for a fire station in the west side area of Chico has been previously identified.. A mitigation fee system was established to help fund the fire station. Developers are assessed a $75 per parcel fee. Although this proposal only involves one parcel, the occupancy will. house 99 people in a supervised care home. We feel that a fire station mitigation fee should be assessed based on a multi-parcel. development. Using a 2.536 average per paid occupancy factor for 99 occupants and the. $75/parcel occupancy factor, a mitigation fee of 2,925.00 should be assessed. Thank you: C. TELE county's re Warden Jc cc R. Tiller Rufiia Co. Planting Caamm: l' i en.aq Memorandum TO; Bill Teie, C D. F FROM; Laura Tuttle, Planning susrtcn, Fire Station Improvement Fees O&M 7/26/85 A 99 bed skilled nursing facility has been proposed for AP# 42-45-38, at East and Cussij� t140 fire Hydrants and compliance with Title indicated. that was q. cd. If fare stationimprovement fees by memo. The use permit will be are needed }onl8/22/85dic to considered LT/ell LAND -,,..OF NATURAL WEALTH AND BEAUr`f -: PLANNING CnMMIS$IaN 7 COUNTY CENTER DRIV8 - OROVILLE, CALIPORNIA 95704397 July 26, 19$5 PHONEr 034.4601 C.B.S. properties 375 Cohasset Road Chico, CA 95926 }let Use Permit, AP 42-45-38 Gentlemen; At the regular meeting of .the Butte County Planning Commission hto eld approve25, 19855, the Commission passed a motion of I 'o s cues for a Use Prmit to allow up to a 99'-bed Ift Skilled Nursing Facility on the north side of Past A-no, 600 feet east of Cussick Avenue, Chico, subject to the f in conditions and mitigation maasures (M), to be comple in to occupancy: ' I. Construct curb-. gutter; sidewalk, and widen East Avenue to a 4-lane section along property frontage. 2. Provide drainage facilities to drain frontage on Past Avenue to existing _starmedray nnd P'operty 3. Construct left turn lane at access road and Fast Avenue. 4. Connect facility to community sewer and water. S. Install water main, provide easements and: connections as required by California Water Service Company, 6. Submit construction plans to California `Water ServiceCom a far review'of proposed facilities. P ny 7. Install, two fare hydrants to CDP specifications. S= Comply with Title 24 of the Calaforx�ia Administrative Code as enforced by the State Fire Marshal:. 9. Install parking and landscaping as required by Butte Count Code Section 24--35 including a minimum of eight shade trees adjacent to the west' side of the Parking lot-, 10• Screen trash receptacles`f'rom public view. G.B.S. Properties Page -2,- July 260 1985 114 Contribute a pro -rata share towards installation of a traffic signal at East Avenue and Cussick, (M) 12. (;anstruct a 6 -foot brick wall, minimum 2 bricks thick, along property's East Avenue frontage, in compliance with setback regulations and install a 3/4" foam barrier with the south side wings of the buildings for noise attenuation. (M) 13, In lieu of condition 12, applicant may propose an alternative which will attenuate indoor noise levels to 45 CN'RL 14. Disposal of .radioactive materials and infectious wastes must comply with State Health Guidelines. 5. No incineration mechanisms permitted on site, 16. Applicant ninst also:comply with all other applicable State and local statutes, ordinances, and regulations. This hearing has been continued closed to August 8, 1985 at 7:00 P.m. The meeting will be held in the Board of Supervisors' Room, 25 County Center Drive, Oroville, California, Should, you have any questions regarding this matter, please contact this office, Sincerely, B. A; Kirche Director of Planning BAK*lr � ,,� —�;,.w�wv�ryw�ahw7n11,�rA®a�FSAVdII�'6fAladi��'Ati���1',Nau�, � CUSSTCK AREA NEIGHBORHOOD COUNCIL x, Butte Ca Mu►Yninga»►r�. July 21, 1985 JUL 43 7985 Butte County Planning Commissiont1Ha, caia..1" 7 County Center Drive Oroville, California 95965 Dear Commissioners: The Executive Committee of the Cu.ssick Area Neighborhood Council met with Mr. Brian Jennings -to review thO proposed 99 bed skilled nursing facility and the Co tiOns concerning it. unty staff xecommencla- As acresult of t of this ireview,heiNeig 1borhood Counc:�il supports nursing,facility at this .location and concurs in the, conditions recommended by the County staff. The Neighborhood Council recommends two additional conditions l.) that the masonry wall along Fast Avenue be modified at the entrance to the private street to afford s safe sight distance for southbound vehicle$, and 2) that parking signs prohibiting parking along the entire fr'oritage of the private street be required. The Neighborhood Council is aware that the City of Chico has recommended that an allocation of sewer capacity to this pro- ject be limited to that generated by 73 bedsx unless acqusl_ tion of development rights or some other arrangement concern- ing the 3.8 acre parcel to the north can be made. The equitable- ness of the proposal is a problem for'the applicant to address, but piecemeal allocation policy does concern the Neighborhood Council.. We strongly support the requirement that all projects be connected to the sewer system, and if `the available capacity is pre-empted by a few large }projects, continuing orderly development of the entire area will. adversely affected. be Sincerly, A. R. Schoenf d Chairman, Executive Committee cc: Brian Jennings Tom Lando_ rite, a�'yr LAND OF NATURAL WEALTH AND BEAUTY PLANNING COMMISSION 7 COUNTY CENTER DRIVE — OROVILI:E, CALIFORNIA 9596$.3397 PHONE: 534.4601 G.B.S. Properties July 1.6, 1985 315 Cohasset Road Chico, Ca. 95926 Re Use Permit, AP 42-45-38 Gentlemen: Enclosed is A copy of the Staff Findings concerning your application for a UsP Permit to allow a 99 bed convalescent hospital (skilled nursing facility) on property zoned R-4 and R-5 located on the north side of East Avenue, 600 feet east of Cussick Avenue, Chico. A public hearing has been set for July 25, 1985 at'8:00 p.m. This meeting will beheld in the Board of Supervisors' Room, 25 County Center Drive, Oroville. Should you have any questions regarding this matter, please contact this office. Sincerely, i B. A. Kircher Director of Planning Laura M: Tuttle Associate Planner LMT: lrr Enc. } � � y:: ;,�. � ,' ^ r:i '�l. ;�`.r ,;+,J'S, ,, �: d�, �'l:�� 1. �,!." }.+,. ,; is :�i y a: :'r, �rr ���i �'. �... ; is 4„tip, MUNICIPAL BUILDING p.o; Box 3420 Suite Co. punning Comm. CITYarCHICO Chico, CA 95927 INC a+rr a------- J U L 1. C► � � � ��'� a.v� � c.� � d �. s• � v �` o vt`c.�w �n. s :Clrovilly, C.vlii�or»Iq �'u�`-•�, qtr. •e., � � l C.cz � C,� ?� w.. � Bryan Jennings 375 Cohassetggoad -,. Chico, CA 95926 Date: June 12, 1585 Re; Sewer Application # 2520 l The above noted Bearer Application submitted b Department of Public Works ard� c'cv is Y you has b en "processed by the�ut attention is directed to the "REMARKSaCSection Your nUparPf3ronce and use. vour It contains information about the availability of sewer serythe ice tnp�hea ndi Property. catea The "REMARKS" Section indicates that sewer service is not available. fees quoted on the Application form are for enera} informaton" If you wish to discuss the matter furth,,r The v ----_...__ roses onl convenience �MunicipaT Building, 2nd floor,p5thsand�htaintoff ce a1 your The "REMARKS" Section indicates that sewer_service is availab Streets, 895w48i2j, L--1 Application will indicate the sewer c'on -------- le• The attached the event You determine to Proceed withtheQ•onne�ti�nyableThe tquoted City in fees are valid for a period of SIXTY (60) DAYS from the date of this nnecton or Until the effective date of any amendment to the City's Sewer fie- letter whichever is longer. Any amendments to the City's -Sewer Connectiones' become effective, on or about July 1st of each Peen then action marked with an "X",below. !then these actions are Should take thc< Y Permits from the Plumbing n y P_ sec you may necessary with a liceens0ee Department contractor, who may then secure th desired connection. P meet of Public Works and roc e proceed with the. Annexation to the City of Chico or execution of an :Anexati Agreement is a condition of obtaining sewer service, Contact Office in the Municipal Building, 5th and Main Streets, and Sewer Service on a if your property is pal BUble you Will be the City Planning phone 895-4x51. Also, Permits for construction (CMC 16,04.160), required to secure City building , Pay the computed connection fees, prior to securing necessary the Department of Public Works, second floor, permits from. Main Streets. In this re and ou ma desire taunaC� he 6Q31din9, 5th and become-effettive ono v' connection fees now in order to avo3d"'h� nabout Jul hi het.'. sewer connection fees.. which ma deci� d� a not to proceed with this pro ect�'ofavou may.�. 11 If_at a later date ou refund_of sewer connection tees aid. e�uest to receive:a' +_ This office has determined that you are eligible f of sewer connection fees quoted herein, or the in compliance with deferred payment Council' policy. The Agreement would allow you to connect current City to the City sewer system now and pay the sewer connection fur property 5 year .period.ees Pleasecontactthis office if you Pursuingt are interestedVin a his option. Page'1 of 2 a.a ra 84°t".i 14aY�7RfiYfii` $n • :.� iy FF Construction of a sewer main extension --- _ as shown on the attached p1 at i a Your responsibility in addition to paying the connection fees as r.1pted4 (In this regard, you may desire to execute with the Cit Reimbursement Agreement". If so pat "Sewer Of Works about such an agreement prir e or to�commencementof Department public No further action is necessary since sewer connection fees Iuere previously Paid, except to secure required permits from the Department of Public Works, DIRECTOR OF PUBLIC WORKS By.- Admin y:Admin strat `vd Assistant Phone: 895-4872 AJS Jw Attachment: Sewer Application Distr. SS App]. Chrono File System Building Folder: ,vacant AP? -4 (X� Planning Office DPW 12/84 Page 2 of 2 � � � y ...i;, rt 41 A 'i;n kiE�14'ti!•'a'�" >. . Amok r11 ! ItIC 1 RT '1! i F•Ul'�!!►1 I (' W! 1tni ' 'r' f r c, 'r t K SEWER toml TION NON- RES1013vN7� t� lAt (I I1K.MANI I'f) MIA11ro 15.J6 OF TIiF CIIICO MUN'ICIPAt CORE) A TIIE SEk'ER CONNECTION CEIARGES OUOTED HEREIN Y5 THAT FEE PAYABLE TO -------- THE TC? THE CITY SEYIER SYSTEM AND A5 REIMBURSEMENT TO T{IE CITY FOR ITS CAPITAL THE PRESENT SEWER SYSTEM THE CITY OF C{!Yr0 FOR.CONNICTtNC ADDITIONAL COSTS WHICH THEAAPPLICANT MAY IONS THERETO, T DOES I!I CON5TROCTING INSTALLATION OP NECESSARY MAIN LINE OR LATER.L EXTENSIONS, MANHOLES IT DOES NOT INCLUDE STRUCTURES AS MAY BE REQUYRED. NOT AND SIMILAR APPURTENANT' THE SEWER CONNECTION CHARGES QUOTED HEREIN SHALI. BE VALID FOR A PERIOD OF S' LONGER. ANY AMENDMENTS DATE OF ANY AMENDMENT TO THE CITY'S SEWER CQNNF.CTIO UNTIL THE EFFECT JULY 1 OF YEAR, TO THE CITY'S SEWER CONNECTION CHARGES BECOIIg EFFECTIVE O O) DAYS OR EACH YEAR, N CfIAitGL9 .w}{ICNEVER lam" OR ABOUT ri'�,, ome '7 Address:�.7 j - F'hane: "�^.» s i.� , Bus .:-�..,..-.•_::. Phone !3> Applicant: !3'+1/ FYI ,.-j r �.1 �•: Home ..�, , ^� Address,., 32s— , Phone; Bus. C. Reason £or Initiating Application: Phone - 0 Application for Plan Check General Information Building Plan No. D• Property to be Served; Address: i f v 'w� 2. A. P. NO (s) j�9j 1f -Q-11 r a 1 3. Existf g, Use; ---- Vacant ❑ Resident;tal NO. of Ilnits: [� Commercial/10stitutional Q Industrial* (Describe) ❑ Other (Describe) 4,. Propose se, Commercial/Institutional Car.W _kt ospital/Canvalescent Haspital No. Of, Stalls; ❑ Hotel/Hotel Na. Qf Beds: ❑ Dormitory/Group Dwelling of Roomsj Boarding House V No. of, Rooms; No. of Oc 1 • 0`MarkeC/Bakeries. cupants; ❑ 'Restaurant No, of sq. Fc. f, Type. ❑ D'ine-inNO. of Sq, Ft.: ❑ Take-out ❑ Both,` ❑ D[h�+r (I)t!;crihtr) No: n ( Sq, Fc:, 1 Itu1Us4t trrl+a - Reda. 110011m _- �f�tr4 t lilll� F '�Itltirlr.l t" r.i j r7 ,r•P�, ..•.._.,,�,,,�.«,_,,..�. ..�.L,w !dlt�,t,(q.a,t ,r 4- �^ t •Ilan t"rrrt7ytler6P,lti w . ..rj f'i .''f.i .".l i'i ill2ti�. r•n'.ik" - _.. ''•il1, i Y� t +' .liar.' ..1 {• if'1. , r t I 1: ,cF•t,(t, •iirr lee I lot tl Irirtf G. Application Fee Paid-,$ G,41) "" fi iOJ ROceipC. No. ' 7 i,,/ Datta SRCTION ILI - DEPARTMENT OF PUBLIC WORKS USC•: A. Property I,nf,ormationr 14 In City...:.........x.....:,....,....::. , [) Yos)!o In City as of June 19; 1982 (Including Annexation No. 384)-.. [] yes 3- Within City Sower Service Amar .......0...... You No 4. Annexable: ..:..... ............... .. . ,�1 ............ es I No CJS DNA . S. Existing zoning: (JLtG'! .P61 J. 6. SowerMain ',Front Footage: _l.f. (Total all frontage) Property Area: _ 2 aches 8. No. of Residential Units Presently Connected to Sewer: 9. No. of Non--Rosidential 6crea Presently Connected to Sawari 10,. Property in a Sewer Assessment District: to No 0 Yes. Name:�� 11. Subject to NECSAD Reimbursement Agroement: ❑ No f.O Yes; 12. Main Extension Requixedr`No [� Yes. EstimatedpQCost S ( 9 7, -50 13._ Estimated Volume Discharge to Sewer Systamr_ fief/Mo. 14. Sewer Connection Fee Creditss a. Trunk Line Capacity Feer No.. of Unitsof Acres'_ /Payments S » b. Water Pollution Control Plant Feet No.. of Units .r INo;. of Acres. /Payments c, Sewer .Ma n Installation Poet Front Footage Subject Lo Additior:ai Sewer Connection Fees fort a. Trunk Line Capacity peaPyr�� No, of Units, No. of Acres b. Water Pollution Control Plant Fee: No. of Units_ 7 �1 bS� No. of Acres C. St:wor M-lin Installation Fee; �,, t'ratir Footagr+ ��1. C. f j DNA (Main ro tension ltoquiro(l) }t,i rl.l:• 35 �.r •r a+FS.�d�Cf► I h' �.r lt. ' f R ;f� a ._ .. ...... .. - 1ta �'t�I11111SIi►� lnl(r•ul /1flf l„,' Il*li�l�1,. ... f •/}i,:,, I'ruuk I.init C,sh.yVIty I; L} a S'laindard Ratosi! I ii � fr, $ Is. Special RatQlaf (11e1013, btutala, llosptt*Ils, CefYVlJle9el2►►t hospitals, Groul+ 1)VIOII tnry}►1 Less Credit for Prior P.iymelit ( from A. 14.a. abovo) 2. Water Pollution Control Plant Capacity bier a. Standard Ratess I _ X $3229 Acres b. Spacial Rates: (IloteIs,mote Is. Hospitals, Convalescent Hospitals, Croup Dwellings) Less Credit for Prior Payment (from A.14.b above) ${ 1-310 «...—..� S 3. Sewer Main Installation Charge: 522/front foot X2 t�v l,f. $_„r,:5 i A 96 ❑- See REMARKS Section, Item No. 3 4. Less Application Feet (IF CONNECTION FEES PAID WITHIN 60 DAYS OF THE DATE-OF CTT—y— RESPONSE LET':ERl, $( i S. NET ADDITIONAL SEWER CONNECTION FEEz $� C. Estimated Additional Monthly Sewer Service Fee: $3.40 —� Ccf X Est. ,Avg, Monthly Consumpt Li on� Water Discharge Charge to System in Excess of 10 Ccf REMARKS, [:J' i, SEWER SERVICE IS AVAILABLE This property and its proposed use Can be served by the existing sanitary serer collection system., 2. E IER SERVICE IS_:NOT, AVAILABLE Thio property and/or ita proposed use cannot be served at this gime because of the i~ollowing= The proposed use of this property is not Incompliancewith the Chico General Plan. The Chico General Plan designation i this property is ❑ This property is located outside of the Chico Sphere of Influence and is not currently eligible for sewer service. Sewer service to this property would require changes in City Council policy, the Chico Sphere of Influence, And the Chico General Plan. This property is located outside of the City Sewor Service Area. 'Thera is insufficient capacity in the existing Sewer Callection System to saxve this property'. 3. If an approved privata sewage disposal system is installed'in lieu of connection to City Sanitary sewer system, all connection fees quoted herein, pLus 6 main =' extension fee of $ 1�_ f.f: X $22) shall be s�cGUldi..tuion,A,of�.,t.l�e,*1>�+�4►�7.61�wbin'i/rr�dJ��m.t�cl!��i�ll 4. AMC- �� rte. � •_� �,�,� � y G.B.S. PROPERTILS 375 Cohas;set Road Chico, CA 95926 Ph: (916) 343-5595 Juno 27, 1985 Laura M. Tuttle -Associate Planner. ., Planning Commission 7 County Center Drive t- U Oroville, CA 95965-3397 Re: Use Permit 0 AP 42=45-38' Log No. 85-05-23-01 Dear Laura: Thank -you for taking the time to see me and explain certair, matters to me. If there are an questions the below mentioned items y que„ a.ons or concerns: about please let me know. Thanks again. 38Changes in absorption rates drainage patterns or the amount of surface runoff will coo into -the storm drainage system and conveyed to SUDAD facilities. 6 Noise level: A 8/4 inch foam barrierwill be installed A&B on the two soi�h side wings of -the building. Also a six foot brick wa-1 will be installed on the building,to south side of the prevent glare and noise from the traffic. The project will also act as buffer to East Ave., to -that Of future development and existing housing. The will project, also create a lot less traffic than would two acres o6 apartments, and would not place as many demands oil police services or noise to the area. 10 No. A Radiation Disposal is handled by Portable X -Ray service. Facility does not and will �+l riot accept that of disposing hazardous radiation materials. Infectious wastes are disposed at N.T. Enloe Hospital, see regulations 72643, 72645 & 72647. Oxygen is stored at the facility, chained and looked in an appropriate area approved by State Architectural. Board of California & Departmen•t of Health Services. No inciner-- ations mechanisms will be used at or near facility. I y Cid , TffXAg1 22 ' HEAUM 1; ACMITI&S AND REFir;tRAL AGENCIES ¢ 72fi45t�► �, tr.. _ jR�latar a� Nc. is.-x�a+2f (p. 2081) 72641. Enae emo ►�, „y Lighting and Power System, (a) Aux liary li�ghting and power facilities shall be provided as .required by tine Code. Flastili gghtsshall b $ or Title V, Wifornfa A.dininistra Sections EY 0,02-t�, V02 and .E702-210 e in reiadiness for use at ai, tunes, Opeiamflitnte type of light shall not !�e used (l; The license. shall provide and mrtintain an emergency electrical system M sate operatingcondMon and in compliance with subsections d ( ), (e), and (t7 , The system shaserve all lighting, signals, alarms and equipment required to permit a ritiinued operation of ail necessary functions of the fneility for a mini- mum of six hours. (c) If the Department determines that an evaluation of the emergency electrical system of a facility or portion thereof, is necessary the Department may r, juire the licensee to submit a report by a registered electrical engineer which shall establish a basis for alteration of the system to provide reasonable compliance with Subarticle E700.,-k�, Part 3, Title 24, California Administrative Codi. (Einer ency Electrical Systems for Kdsting Nursing Homes), Essential engineering ata, including load cxlculatioeis, assu3 tptions and tests, and where necessary, pians and specifications, acceptable to the Department, shall be submitted in substantiation of the ,report, "'hen corrective action is determined to be necessary, the work shall be initiated and completed within an acceptable time limit. (d)The emergency ligghting and power system shall be maintained in oper- aline condition to provk a automatic restoration of power for emergency cir- cuits within ten seconds after normal power failure, (p) Emergency generators shall be tested at least every 14 days under full load condition for a minimum of 30 minutes. (f) A written record of inspection, performance, exercising period and re- pair of the emergency eieci; ic, l system shall be regularly maintained on the premises and available~ forinspectionby the Department, NOTE: Autivulty cited: Sections W8(LN) and 1275, Health and Safety Code. Reference; Section 1276, Nealth and Safety Code, 72643. Storage and Disposal of Solid Wastes. (a) Solid Wastes shall be stored and eliminated in a manner to preclude the „ e wastes shall not be a nuisance or transmission. of communicable disease. Thos minimize (b) Solid wastef containers shall e stored be a food source for either, breeding odors in patient or dietary areas, and located in a manner that will (c) S sin �,+es and needles; before being discarded into waste containers, shall be ref dereei unusable. NOTE: Authority cited; Sections M(a) and 1276, Health and Safety Code. References Sectioni 1276, health and Safety Code, 72645, Solid Waste Containers, (a) All containers, except movable bins used for storage of solid wastes, shall have tightfitting covers in good repair, external handles and be leakproof and rodent proof; (b) Movable bins when used for storingor transporting solid wastes from the remises $hall have approval of the local health department and shall meet the .. • M. p •. following requirements: (1) Have tightfitting covers, closed when not being loaded, (2) Be in good repair, «..ur rt Nt J"Xt1� ,.� 1(M.1' `.�7•fiil�rr %ta,}apw . II�r>r , , jp47 HEALTH FACILITIES AND REFERRAL AGENCIES TITLE 22 (p. 2W) (110016tor az. No. tti--2•xA�9 1 3j Be leakproof, 4 Be. rodent proof unless stored in,a room or screened enclosure. c} All containers receiving putrescible wastes shall be emptied at least evefour days or more if necessary. ra (Solid waste containers, including movable bins, shallbe thoroughly washed. and cleaned each time they are emptied unless soil contact sur aatgs have been completely protected from contamination by disposable liners, bnrits and shat heave a removed ra na tee deith the waste. Each movable ce to allow corn lete cleaningn shall at the storage area, o gg arGit, (e) Infectious wastes as defined in Section 72647 shall be stored separatoly From other solid wastes unless combit;ed storage is approved by the local health department. NOTE: Authority cited; Sections 206(a) and 1276, health and Safety Code, 'Referci tee: Section 1276, Health and Safety Code. 72641. Infectious Wastes. �a Infectious wastes shall be defined as: 13 Siggnnifiicant laboratory wastes including pathologic specimens, (which shall include all tissues, specimens or blood elements, excreta and secretions obtained from patients). (2) E uipment, instruments, utensils and fomites that are disposable acrd that are from the rooms of patients with suspected or diagnosed communicable disease requiring isolation. )ht section construed limit authority of the localhealth officer to require in this a waste to as (b) The facility shall select and conform to one of the following approved methods for disposal of infectious wastes: (1) Incineration in an incinerator providing complete combustion on the facility premises if ,allowed by local air control regulations, or (2) Incineration in an incinerator providing complete combustion at another health facility, if allowed by local air.control regulations and `if the transports- cion method is approved by the1ocal health department, or (3) Autoclaving an the facility premises, according o posted procedures and following proper precautions for handling, wrapped or bagged and placed in noninfectious waste containers and disposed of according to county regulation for waste disposal,' or (4) Autoclaving at another health facility and disposed of by such facility if a transpportation method is approved by the local health department, or . (5} Other methods that are approved in writing by the Department and the loco health departments, (c Where `there is disposal of infectious wastes by other than incineration, sterilizationor sanitary sewer, an approved area shall be provided for the cleaning of containers and storage of infectious wastes. Such areas shall include the following; „ p , ' o a sewer approved (1) A curbed concrete floor slo ed'to a drain connected t by the local health department,, (2) 'Steam, hot water and cold water with acceptable backflow prevention, (d) When immediate disposal of infectious wastes is not possible or feasible, Infectious wastes shall be stored in containers which shall be lined with disposa- ble plastic bags of an odequate thickness to contain infectious waste$, The container shill have tight- ittino, leakproof covers and shall be lalaeled with letters at least four ceritimeters ligh', '1Nl?CCl'lOUS WAS'I'la5 tO-M.; Authority cited; Sections 208(a) and 1275, Health' and Safety Code. Reference. qoo ii>n 1276, Health and Safety Code. G N r ' �. Orth-.Yar ro, N Y ~ R tOject A.I` No, After 'Recording , Return To; County of Butte _ Dept.. of Public Works 7 County Center Drive Oroville CA 95965 6a rCam ROAD r4ATv7rPr rh?.rcE ACREtam' o � ' e' W REAS each of the parties hereto owns a portion Of' a parcel of land described in L. hibit that will be benefitted by the roadways and drainage facilities_ on ease- ments described on Lxhibit "All attached hereto and lncozpor. atea herein: NCW THf;RL- p0RF , it is mutually agreed by the .-rties hereto as follows:; I. m For so long as the above mentioned works shall exist in private ownership, the Parties hereto, their suc. c�:ssors and assigns, shall bear the expenses of maintaining thein n good repair, It is agreed that the cost of .maintain. ins said works shall be paid by the Parties hereto, their successors and assigns, in proportion to the number of land ,parcels owned by each owner'and/or their successors and assisgns, :end each owner w lit upon written demand, contri d pay his proportionate share or any monies paid ot;t �ur o tlac: several owners Or of any Obligation incurred . ur tie reasonable maintenance or repair of said works e 2 "Reasonable maintenance or repairos- shall not include the enlargement Of said W -,r w and this "agree.rijent shall not be construed to require an . y owrier to ,contribute tc' the cost of any enlargement of said works.. 3.. Any owner may bring actions in any court of comoe- Lent Jurisdiction in the County of Butte to enforce collection A Of any monies due from any owner as their proportionate share # Of the; cost Of the: reasonable maintenance or repair of said worlcs and in any such action or actions the p g pa� reVailin r t_y or parties shall be entitled to recover a reasonable attorneys fee to be fixedby tjae court in such actions d r purposes of this agreement, the. decision a ar t% of the owners of a majority of the parcels to the effect that specified repair or maintenance work is necessary shall be � owners and the decision of said conclt;.sive on the remaining - as to to ;the reasonableness of: the cost of any such. rra o`r repair' or inainten ince wort: shall be conclusive on the remain ing owner.- provided that said cost does not exceed the average OV three independent cost estimates secured not more than 60 r' or to c encement of the work. ' days _p_i 5� +Uhe owners of a majority of the parcels may author o the creation, of a� mai:„penance and repair account in a savjmgs and loan association or banIC monies deposited there-in shall.be expended only for maintenance, and repair of the above ,referenced works and the number of signatures required to with - draw monies authorized.shall be spe�:fied at the time: said. account.' 2 s 6. Receipts for all monies received and of all expenditures made shall, be preserved and rude available for inspection and copying by arr- Mmer, 3.n person or by agent, for a period of one year. 7. The taord st owner” , as used herein, shall mean one person in whom sole title is vested. It shall also mean two y j tenants, or more ..persons t�ho hold a unity ar interest as joint M1artners or as husband and wate with as, tenants in corvz=., as p tithe. ,v'est'ed "as their con-mnity property.1°For the purpose or determining if the omers of a arajoraty of the parcels are in favor of a proposal- the af�`i native vote of any pour, joint , tenant, or tenant in common shall constitute approval by that, parcel* irrespective of the number of co-owners of that parcel. may be terminated at any time by the $, his agreement vote of the owners of two thirds of the parcels. Upon termina monies remaining une ended shall tion of this agreement, any _ . . Y 2 be distributed to the then owners of a4l parcels in the same: proportions as received. 9, This agreement is to be construed as a covenant jfi�#.g,,�iath the 'lane and it is further understood and- agreed .that this agreement shall inure to and bind the suc-- cssors in interest of the parcels owned by all the parties Me=ets, whether by tray of sale, assignment, inheritance or otherwise, and it shall be applicable_ to such smaller par cels as may be created by subsequent divisions of said parcels, 10. This agreement is executed '.a2 counterparts, the signature pages: of which shall be attached hereto and made: a pari: hereof prior to recording.. l j a —3..; i _! ................ ......................... SrXTE, OF C'ALi%vPINl as, Caanty' of ...............:.........�. . ,... 19 ....... before me. Oa ......................................... ... ............... a ..,.......... , T kl,e undersign. �► t+!otary 1�ublic in and for th- Strte nd C`Iilifnrnid, residing therein, duly commissioned sworn,u rsonally appeared ........... ,......i................................................................. •. ......................... Y•..........,. .............................................. ••..IIIc} - •.......... '.............. i ... . ' ' - .w....• ... •. known to me to be the person .• whose name................. subscribed to the wicuted the same. thin instrument and acknowledged khat • ..,....... ............... exe WIT-LgESs my hand ar-d of tial seal. ....,.., ... Signature .....,....... ........................ ...............o ...... ...,.a.. Name iTyPed or i'ri�ce�) �u BUTTE_:COUNTY PLANNING COMMISSION NOTICE OF PUBLIC HEARING " Native is hereby given by the Butte County Planning, Commission aha will be held on Thursday, July 25, 1985 in the Butts Count Board t �?ublic hearings Room, County Administration Center, 25 County Center Drive, OrovilOr' Ua g regarding the following item at the fallgwing time,; o0 Supe visoiaj lforna, ITEM ON WHICH A NEGATIVE DECLARATION REGARDING ENVIRONMENTAL IMPACT HAVE_ nn— EN`RECOMME 8:00 p.m. G. NI�En Properties G B. S. P erties - Use Permit to allow a 99 iced Conv'�.t�t�soent Hospital and 1R- 4 (Ma.simum De ilityj on property zoned R-3 (140d jum (Skilled Nursing Density Residential , Re 17dnsity Re,sidential) on the north side of East Avenue app Restricted Se'�vice.) located identified as AP 42-45-38, Chico. feet east of CussiaR Avenue, The above mentioned application, ma impact are on file and available for�publ,icand eviewingdat the off'eclaration regarding County Planning Department, 7 County Center Drive, Oxoville, California,g environmental ice of the Butte BUTTE COUNTY PLANNING COMMISSION B. A. KIRCHER, DIRECTOR OF PLANNING TO BE PUBL18HED IN THE CHICO ENTERPRISE RECORD ON THURSDAY, JULY 11, 1985 IT�WII�w�irn �r_wmm�osaimirwinvin nn•�mr�wo�wiw`��`--'-- .'• AMk film ...~'-`' "fib ^� .+W—•fwY�+,1!^+ Sark Count i, l A ra " PLANNING COMMISSION 7 COUNTY CW11R.. DRIVE OROVILLE, CALIFORNIA 959654397 PHONE: 534.4601 June 21, 1985 G.M. Properties 375 Cohasset Road Chico, CA 95926 Re: Use Permit AP 42-45-38 Log No 85-05-23-01 Gentlemen: An initial study of your proposed project, a Use Permit to allow a 99 -bed convalescent hospital (Skilled Nursing Facility) on property zoned R-4 and R'-3 located on the north side of East Avenue, 600 feet east of Cussick Avenue, Chico, indicates potentially adverse impacts to the environment (refer to Appendix F, Items b and 10). To reduce or eliminate these impacts, suitable mitigation measures ark; required as part of the project. Other wise, an environmental impact report (EIR) is required pursuant to the California Environmental Quality Act. An early response to this notification, sent to the Planning Department, will expedite tha scheduling of your project. P F -uses farvard your written resp-m8e within ;.3 days from the date of this Letter`. if you have any questions or comments, please contact; this office. Sincerely, B.A. KIRCHER Director of Planning c. wr, vis Laura M. ` Tuttle Associate Planner W ss Enclosures r ENE= L A N D O F N ATURAL WEAITII AID BEAUTY u PLANNING COMMISSION 7 COUNTY CENTER DRIVE .. QROVILLE CALIFORNIA 459653397 PHONE:,534-4601' May 23,'1985 C.B.S. Properties 375 Cohasse't Road Chico, CA 95926 Re Use Permit APIA 42-45-38 Log f 85-05-23-01 Dear Gentlemen. This is to roti£ a Ise Pexl;.�it on y you that we have received Your Restricted Service) andyR-3nNedium `Dens um Densztpp�"kation for located on the north side of East Avenue y ial) - zty Residential) Avenue, Chico. 600 ft East of Cussick An initial stud of y potential environmental consequences anticipated in connection with this by the Butte County Planning Depar mentJect is being ngbe completed to you, and, forwarded Shbu;3d you have any questions regarding thi free to contact this office. s matter, plea$e feel Sincerely A. irc ler Director of Planning BAK:ell O I._ 1.�Z,18 TLI` 1 _�...., L I S T z 0 R R E V RE UESTS `County Public Works ;,-'County Env. Health IRRIGATION WATER � City of Biggs T city cit` Chid gOs r I dl e v � �� Water Dist. ���� Gutte Water Dist. "` Ci tv of Gridley City of Oroville Durham Irr � Dist. Oroville-Wyand. Irr. Dist, _.. Town O Paradise r;-�--'.` Paradise Irr, Dist. %,-"` Richvale Irr, I.�.,. _,� ,��� County Mt.TrQnsportation Dept. p dist. M Table Mtn, Irr. Dist;. ,. :: Thermalito Irr. 1C IAT R . ---�-- -_ Dist. RETI A TI 0 N FA C 11. 1! I E 5 o B e w ry Creek Water C o. Bloomer Mtn. l Water Co. __._.,.�..�._..... ,�.._..,..., Chico Arra Rec. &Perk gist. ...fir,._.,.. Brush Greek Estates state Butte Water District Durham Area Rcc. & Park Dist. .. Feather River &enc. & Park Dist.. ......_, ,;�, - CA Water Service 00. (Ci,,ico _ Parad se t �c . A Park Dist. -�"` "ch"le Ret, urban area & part of Orozoille) Del. Oro Water Co. & ;park Dist State Paras & Rec. Dept. „ (Paradise Pines) � .-.-_,�..� Mate Fish &Game Dzpt Feather Falls (Louisiana SCHOOL DISTRICTS Forest Ranch Mutual Gran Mutual (Skansen Sub. / Biclgs Ur f ecf �' Butte Community College ` "Green Acres (Blerttovod DrChico ) . - Gridley Farm Labor Camp' Butte County Sup, of Schools �-?—CA State University, Chico —7 --Chico Lake Madrone Water Dist,ti �?_. Magalia Co. Water Dist. Unified_%.,... � Durham Unified MerrY Mtn. Mutual (Clipper Mills) ^7 Feather Falls Union Golden Feather Union Mulberry Water (SE Chico) _, Gridley High Gridley Union NorthWeeds Mutual (Forest; Ranch) Ramit�ex Water � Oroville Elementary �_ "" of Living Haters (Richardson O�ovilie Union High a Palermo Unified Springs) / Stirling Cityy%.`" Palermo Union (Diamond International)" Vista Mutual (Durham) Pidneer Union Thermalito Union COMMUNITY SERVICES _.._.�._._.�. SEWERS Lime Saddle Comm. Serv, Dist. DRA- - / R i c h a v l e Sanitary Di s t ' / _ Butte Creek Drainage ,Dist. ELECTRICAL r N. Burbank Pub. Utility Dist. (S. Oroville & Kelly fudge) POWER Gas & Electric - � Skansen Sub. (CSA 21) —L -L EIRE PROTECTION /_ Sterling City Suer Maint. Dist.'.. I E1 Medio Fire Protect.... Dist. / Thermalito Irr, Dist. (CSA 26) R�URCE PiANAGEMEN7' `County, Fire Department- State Division of Forestry /State Water Resources Kept. ;7�" U,S MOSQUITO ABATEME(VT DISTRICTS Forest Service U.S Bureau of Land Management Dunham_, Oroville, or Butte County PRICE PROTECTION OTHER tate Highway Patrol =S `"County Sheriff ,t .BUTTE, COUNTY JN I NG COMM I SS I OPJ % COUNTY CENTER DRIVE - OROVILLE CALIFORNIA 95965 PHONE: 534-460 TO County of Public titrorks DATE May , 1985 I�f : PJ3OJECT R ,0 1W AND ENV1:I�ONMI'NTAj' iCVALUA'1'ION Enclosed is preliminary data our office hay; received or gen(ff't)d concerning the following project: G.B.S. Pro erties - AP 42.45 Use Permit to allow a 99 Bed' Convalescent leas ital (Skilled Nursing Facility) on ropertY zoned R-4 6 R-3 located - ed on the north side of East Avenue 600 ft Bast of C11SSick Avenue, Chico. We are making an assessment of' pos.�ible �rtvironmental impacts and will be preparing an environmental document, either a Negativt; Declaration, I-litigated Negative M!(-Ia2�atiolt or an Erlvironmontsl I(rllp':r0t Report. Please provide any factual st,atementr.), ideas; £or invo,tigation., or opinions you can Off" n your arca of cunctivn or expertise that relate to eo her Physical, „ocittt, 01. 0=10111ic ilnpactt, tlinL thin pr'o,jtrcl, may gerial,ate. Please .respond witllir, 14 days of the above-notal (Iota. If no response is generated by this inquiry, there it shall be assumedthat there a1"e r10 significant envie"o►tiiie.%cttal impact,-, wftioh s)ns~ loot en ti1►1, from the project. We appreciate .any assistance you can provide. Sincerely Rick Rodriquez Planning Technician Comments: C,eNs�/u %9 ,�,� ��®/NiPci/l 'x�1i! !/7`r "s;r rl c:�/2�yt� p t,� •" D� rt r1i� C�Yr c! L.......J--ALN .(Wri`eor typo in J =LF provided re turn this shoet.)' r f` BUTTE, COUNTY PLWI ING COMMISSION COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 9,5965 a4 PHONE Ii- i6Q� N`eCp. �Ih�11NOC JUS �;,}_� i �J 1985 DATE: May omyllq, 0htlforala TO: Environmental. Health DATE: 2�, x98.5 RE: PR0 ECT 'I E'yTEW AND ENVUONME IAL EVALUATION Enclosed is preliminary data our office has received or generated concerning the following project: G.B.S. Properties AP 42-45-38 Use Permit to allow a 99 Bed Convalescent 110,8 V.tlal (Skilled Nursing_ Facility) on property zo ed R-4 & R-3 located on the north side of Past Avenue 600 it East of Cusick Avenue, Chico. We are making an assessment cit` possible environmental impacts and will be preparing an environmental document, either a Negative Declaration, Mitigated Negative Doclaration ar all Environmental Impact Report. Please provide any factual statements, ideas for investigation, or opinions you can of'fcr in your area of concern or flxpertise that relate to either physical, oociul, or economic imljncl. y that, thii project may generate. Please respond within 14 days or the above-noted date. If no response is generated by this inquiry, thea it rhall he assumod that there are no significant environmental impact which are potential from the project. We appreciate any assistance you can provide. Sincerely, Rick Rodriquez Planning Technician Comments: L"lCa- a' „i�nfirte %��t.cGt^� CoaUK C NA -Aet�- V 4 {,�, � 4 � � �'r i�CS"'NI U,;it.. � -.. ��✓�►Jkp Y'� �y� lk:.?°`iY'� t` ` r 1 (Write or type in space provided & 'return this shout. ' BUTTE, COUNTY P M I NC COMMISSION % COUNTY CENTER DRIVE - OROVIL'LE, CALIFORNIA 95965 E3utfe Co. Planning Damm, PHONE: 534-4601 JUN 14 1085 Oroville, California TO: P G & Chico DATE htay 23, 1985 550 Salem Chico; 'CA 95926 RE PRO JE('T REM -;W AND ENV IFQPtMi,�i'rA , LVALUATION Enclosed is preliminary data our office hao received OV POnerated concerning the following project: G.B.S. Propel -ties -,A P rig�.�j5_L8 Use Permit to allow a 99 Bed Convalescent Ilos : tax (Skilled Nursing Fac.ility) on property zoned R-4 & R- 3 located on the north side of East Avenue 600 ft hast Of Cussi.ck Avenue, Chico. We are making an assessment of possiue onvironmer.tal impacts and will he preparing an environmental document, eitiler a Negative Declaration, Mitigated Negative rOe UWZItiun or an Environmonial Impact Report. Please ,*Ovide arty factual st•atemen(;s, ideas for invdatigation, or opinion you can offer in your area of cojlecern or• o.:prrt se that relate to either physical, social., 01'ccot1omic inpncl.r, LhmL thio projact may generate. Please respond witilirt 14 d,lys of the above --noted date. If no response, is generated by this inquiry, then it shall be assumed that there are no significant envi.vonviontal impaote, which arc, poicntial from tale project. We appreciate any assistance ,you can ,yrovidp Sincerely, Rick Rodriguez Planning Technician CammetitN: 44%4411 /-/e 't,�t`7I°j/ e2AS '%'..� ; vv - (Write or typo in Pact! Provided & retur,n thi.tr, nhoet. )' , BUTTE. COUNTY P INING COMtjISSIOSJ 7 COUNTY CENTER DRIVE_ - cIROVILLE CALIC~ORN ,A 9,�r1r� PHONE: 4 " �Q Buf a Co, Planning cd,,f` I T0:'J UPI 198b City of Chico QI Ofi Cly C y F.U. Box 3420 CA WY, Q,�ei r�,� z�, � < Chico, Ca 9594",7 I2f;: PROJEC,'L' �#c�iVIEW AND N�NrtCCnl, �;�nr.�UATIOt4 Enclosed is preliminary data our officr, 116 c; recti . 8 . S , Pra enti es iveci as 6'Ura ted conctl,11ialg the followrrig project: G'AP 42-45 �-'8 Use P erm to "ll" a 9 Bed Co escentF'i #tal (Skill( • �Nurain�; 1~acil.it h�`W-.:..-- Yr°'ertY zoned R.4 6 �2•� iodated on the north side of bast Avenue GU'D ft St Eao£ C� y ------- - ,ttssicic Avene C n We are malting an ass essmentTrossab.le iatrvar anmentaa: imPgcts and Preparing art nwironmental document, either a Negative Declr�rat onwill be Negative %•�'c"I"I,tic!" car an Environmonta1 IMP"ct Roijort, a Mitigated Please provi,je, any t?actual s1;,te1hcrttn, ideas For invest atidn p10,y`,Cic`,n10,f,f001- in your• area of cisnc�rr.'n of ea � g , or opitcions cial, ar L-Conomic i►iii,acic ihn hi pro,jcjrt m`elate to eithter Pleaue res ori Y generate. p 3 is inti r days of the c'bove- 10t0d date. generated by this inciUiry, then it ,;ha11 be assumed that there are no If no responso is significant envit+ortn,L4ntu1 impac:t:, whicFt sere• assn ed f't t the h We a p..o�ect,, ppreciate ,3try assistance you curt lu'ovido, Sincerely, Rick Rodriquez Planning Technician .3une 13, :985 Comment,, • The City of Chico requests full urban im -- prove:ments to �- 11ed on the East Ave. f ontage. xt is i:ecominend6d that se aired throe haat the parking lot as part Of landsoaj�ing re uirements to shade as much of the area as ,Possible.. Zanne M hewson Miers Planning eehnician (Write or typo irr` sirac�provir9e�i �: reti.trn this 44 _ i a r . c BUTTE COUNTY N�J��Ic� coMn?I�S � lieJ�u&ieCq.planningGar,C©UTY CENTER d)RI'V� - IO.J JUN 31985 PHONE: OROVdLI.E CALIF QRNdA 95965 534--4E�01 il�+avel6am �,ilt4sata CA Water Service P.0. Box 3480 I)ATia May 23 "If Chico, CA 95927 RP-,: nt�ot�z�/�r 8.5 nr An I;iq'I'lCIA`'llr0N Enclosedis prelimna the fnllowatr y data our office has r Proete' G jer, t: r .__B_.._. S • PertYo ro zved or gezlerat od c s - AP X12- oncerning 11�.Z Pest_ o„ llol Va g gtend Ca--- n -=a= Nursing Fa 11, ro ertY zoned R- I the north side of }"3 loc:�tc�d oto East Avenue 600'ft Last of C """""-,-------... u s s i e,f Avertu e_ , Chico. We are making an ass,ssmenk cit' prepaFIX an a I►os.silile c• rtvironment�7; FIX-, nvironinen tal document, c i tt►er impacts Negative !?erla ►•,� t irsr� a � s ` � p' and will. be r t►ty E►tvionipr.ttt..al Inipac.tLivar�.�eclaratan hlitigat.:d Please provid(-! any I -actual t You can of f ct� in s ate►ret► ts, ideas Yo uc nl you,,r area of ccncerri or ,,�; ,for investigation .,ocirt , 0" c"conomic im ►,:rt•I t1li tiss 'iiat relate �tor other nc J th;►I, this; pr'•� jr:c t ni,z : ait}ter Please resportt3 within 14 da y FrtrierateF generated by this inquiry,ys al' the hove.,1toEc(I (jute. Significant environn►ntaimpacthe►tltwhif filar�e potent' If no response ja asuunterl that there ay`e no We $ I iaX .from the I�rojedt appreciate any, assistance ,You can p�ovidr;. Sincerely, Rick Rodriguez Planning Tec3incian comments: dr ,(Write Ort type in praviriod return this sheet. ����� nil IF Hy f -IRE KF"A utto Co. Planning Cortittl,Adftk . ..,1 f:£ JUN 4 1985, DEVU0P.M.tFUT NAME.,L u ..,...., _, _ .._...a . u. AP";.....x 5- oroville, Cal'sta tate LOCAII QN`7? 1J, _ eve Gyres"rdfJc DATE / This project must meet the requirements in the uniform Building Code amended to Butte County standards. :xr, 'Catlf, Departmont of Forestry Butte County Pira Depariment ' r In accordance with Section 13,00 (Fire Standards) of the - Cooperetiv© Fire Protection Improvement Standards, the water requirements for this f parwel/project are, (Applicable standards are checked). RICHARD D. TILLER ' 13.01-1, re ection Requirement_ Cl I. A water supply for 9attalton Chief fiprotwiil not be required. r 1 tl1 2 ROauirerent Class L, A pressurized water system with adequate numbl5rs of hydrants is pre- ferred, but if this is not feasible, the followtng OFFICE(916) 891.2789 Option will satisfy the fire department, require- 9, men" for water. a. Water storage tanks with a capacity Of 10,000 gallons or more, equipped tl access and fire department connection (S- ), q Peed with direct all weather^ ( ) b. In ground swimming pools equipped with a drafting connection or drafting access; or, ( ) c, A dry standpipe system plumbed to a reliable water source. Such standpipe system will not exceed 1,000 feet in length. There must be least 10,000 gallons of water available and strategically located' for each 10 dwellin3s or portions thereof. (Example: 11 dwellings would require two separatedsources Provisions must be made to insure that the water stored is always available and accessible for use under allweatherconditions, ( ) 13 01-s Requirement Class 3. A pressurized community water- system is requirod. Tentative hydrant locations are indicated ani the attached preliminary map, Finailocations must be exactly indicated and recorded an the final map J Number of hydrants required ,maximum hydrant to hydrant spacing afeet, hydrant SizeG '1e(04U.ff ?I -;D 04' 0" 136r�X8nd installed according to Butte County_rubi` c41Orks specification lid nraae ar mo S-27 and requiremes,ts of local water agency. Required fire flows are 2Q� aliens Mitigation flows listed under other conditions. _g per minute. { ) 13.01-4 Requirement Class 4. Water for fire protection is required. The preferable system is ;a hydrant system capable of meeting the fire flow requirements. If this is not feasible, a system involving inde- pendent pumps, static water storage and dry standpipes may be substituted. Such a system is subject to the approval of the fire department. The available water flow from such a system must flow belons made to insurethes stem rovided is maintained tO it'ge must be gallons. Prnvi,ions mint per minute. The minimum volume Of water in storage Y P s design capacity. ( ) 13,.01-5 Reouirement Class 5. Pressurized water for ,ire protection is available ,rithin 1,000 feet of the created parcels. In lieu of bearing the cost of installing a fire hydrant(s) the develo eP r may pay into the fire department hydrant fund. Pay in -lieu fee into hydrant fund based wattcn agency on $1.25 per frontage foot. Frontage is indicated by the red line an the attached reap. Approximate fee is i . Final frOntage calcination to be made by surveyor and recorded an final map, Frontage calculation will include both sides a; the street on included streets. Required water systean for fire protection must be installed and ; operating prior to building construction.7 her Condtitions: J�D�✓�= ( ) Response times for the first 3 fire engines is as follows CDF/BCFO 1.- Station minutes 2, Station ;r _ ` _.min 3. Station f minutes ( ) 1n the Safety Clement of the Butte County General Plan, this project area is classified a5 a fire hazard area. ._. WILLIAM. TIE count re and By: , 9E.tallon Chief l/ Local water a,geno.y reauirr^iehts for h;/d-ar.Ms may be more res;rictt`ve. X14 i�d \, e � a T(9q [ 1a �, ,( �,•. S 14 f/ a, eta. `' " •@. tib. 1 j Y 's 1.� ,.1 r ,� r•7 1 it i �' i 1 _..Lp...�.,.-„i �,L....':_..._„_t.�.,..o..b.,.��,,,.J.,..�,•,�.e..a.-...��.....���.®..aa....,_..s� 'r ..ae.,m,v..�. � ,..®.���._� �..,�6 .._s.�.�.mal_��.....:�eL..'���_._s_�.�+�,:.��a...�,.tX...,'.:�....'i.Qa._w.. COUNTY OF BUTTE OFFICE OF PLANNING COMMISSION COUNTY CEN'T'ER DRIVE �a � �iU�a� C"� V-5, At OROVILLE. CALIFORNIA 95965 JY �i m Lk )IS Ahptd� URHro TO 00 SENDER woo 8-07-23 Rath A. lvettheim S64.2 Chaney sane paradise, CA 95969 COUNTY OF BUTTE OFFICE OF PLANNING COI4IMISSIOrN � „ !TV,,yC 7'COUNTY CENTER DRIVE TO OROVILLE, CALIFQA1414 95965 ' tlot ,a� y �s LAW +t /x,� y( Y.dd ii ir.Atl �. I:.,3 W r� C✓Y - � pA,v"F Pi,1�'�' W. � � '�J J' •• kr. �ij ti; .i..I. �c.J� U N J.: 07/,i..,i. Ir A !/J * L, .,, L•y A� Ntl 5 f" "�lh?;Nt,` 4 UNAIt rhYY1. 'Y'Q I TIRWARD ,. AN 8-06-03 Charles F. bawler 31 Pebbl.ewood Pznes C Chico, CA 95925 w