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HomeMy WebLinkAboutITEM NO. 1 PART 3 DocuSign Envelope ID:7114515C-4427-483D-8350-432608DF0453 CUP 2022-0019 14851 Yorba St. / 165 Myrtle Ave April 19, 2023 Page 12 Program; there is no difference in the services provided, eligibility criteria, or room location as compared to Recuperative Care; and • "Program of All-inclusive Care for the Elderly (PACE)": A program that enables older adults(55 years or older)to remain living in the community and out of institutions by providing services that include on-site medical care, a day-activity center, transportation, rehabilitation therapies, meals, homecare, medications, medical equipment, and coverage for hospital and long-term care. USE DETERMINATION In light of Staffs analysis of all the material provided by CalOptima, including the most recent submittal on March 28, 2023, the following use determinations for each proposed land use have been made pursuant to TCC Section 9298b. TCC Section 9298b authorizes the Community Development Director to determine, in cases of ambiguity, whether or not the use of any land in any district is similar in character to the particular uses or plans allowed in the district. Recuperative Care and Post-Hospitalization Housing Based on the review of all of CalOptima's submittal documents, including the most recent submittal on March 28, 2023, the Recuperative Care and Post-Hospitalization Housing components of the proposed project are not similar to any of the uses that can be conditionally permitted in the P&I District. Additionally, the P&I District does not explicitly list Recuperative Care or Post-Hospitalization Housing as permitted land uses. The operational characteristics of the proposed Recuperative Care and Post-Hospitalization Housing components are similar in character to residential uses such as extended care facilities or supportive housing, setting the proposed land uses apart from uses that are conditionally permitted in the P&I District. Those operational characteristics include, but are not limited to the following: • Duration of stay (average anticipated stay of one (1) year); • Interim Housing until permanent housing can be identified and secured; • Medical oversight (no direct medical services provided); and • Limited assistance with Instrumental Activities of Daily Living and/or Activities of Daily Living. In accordance with TCC 9298b, the Community Development Director has determined that the proposed Recuperative Care and Post-Hospitalization Housing uses are not similar in character to other uses conditionally permitted in the district; therefore, they are not permitted in the P&I District (nor are they permitted in the Pr or SP9 districts). PACE The P&I District does not explicitly list PACE as a permitted land use, nor is it explicitly prohibited. However, based on the information provided in the application documents, including the most recent Community Development Department 300 Centennial Way,Tustin, CA 92780 • 714-573-3000 • tustinca.org DocuSign Envelope ID:7114515C-4427-483D-8350-432608DF0453 CUP 2022-0019 14851 Yorba St. / 165 Myrtle Ave April 19, 2023 Page 13 submittal on March 28,2023, PACE would offer medical services similar to hospital uses that include, but are not limited to the following: • Routine physicals and preventative health evaluations and care; • Kidney dialysis; • X-ray services; • Laboratory procedures; and • Outpatient surgical and mental health services. In accordance with TCC 9298b, the Community Development Director has determined that the operational characteristics of the proposed PACE use is consistent with a hospital use. Hospital uses are conditionally permitted uses in the P&I District. As such, the PACE use can be allowed with the review and approval of a CUP by the Planning Commission. Per TCC 9294, any decision of the Community Development Director may be appealed to the Planning Commission. Should you wish to appeal my decision, please file an appeal application with the City Clerk during normal business hours within ten (10) calendar days of the date of this letter. The appeal shall be accompanied by the required $1,050 appeal fee. Please contact the City Clerk's office at (714) 573-3001 for more information or additional questions regarding the appeal process or visit wvww.tustinca.org. APPLICATION COMPLETENESS DETERMINATION For the reasons mentioned above and in conformance with Government Code Section 65943, this is notification that your application is considered incomplete. For your application to be considered complete, you must submit an application that omits any use not permitted by the TCC. We welcome the opportunity to discuss the use determinations, application completeness discussed in this letter, and next steps for processing your current application for CUP 2022-0019 or submittal of a subsequent development application. To schedule a meeting, please contact Irma Huitron, Assistant Community Development Director- Planning at ihuitrona-tustinca.org or (714) 573-3035. Sincerely, ----DocuSigned by: I ma, t�l u{V vu On 2ESAE588F82047F... behal f Justina L. Willkom of: Community Development Director cc: Irma Huitron, Assistant Community Development Director— Planning Raymond Barragan, Principal Planner Community Development Department 300 Centennial Way,Tustin, CA 92780 • 714-573-3000 • tustinca.org ATTACHMENT G APPLICANT'S APPEAL OF UD 2023-0002 DATED APRIL 27, 2023 RUTAN Alan B.Fenstermacher Direct Dial:(714)64 1-345 2 RUTAt4 5 TUCKER, LI.P E-mail:afenstermacherra-initan.com April 27, 2023 APR 2 7 2021, TUSTIN CRY CLERKS OFFICE VIA EMAIL AND HAND DELIVERY City of Tustin Attn: Erica Yasuda, City Clerk 300 Centennial Way Tustin, CA 92780 cityclerk@tustinca.org tustinca.org Re: Appeal of April 19, 2023 Use Determinations For Land Uses Proposed in Conditional Use Permit(CUP) 2022-0019 14851 Yorba Street and 165 N. Myrtle Avenue Dear Ms. Yasuda: This letter is sent on behalf of CalOptima Health ("CalOptima"'), for the purpose of appealing the above-referenced use determinations set forth in the April 19, 2023 letter from the Community Development Director ("Director") of the City of Tustin ("City") (the "Use Detern7ination"), pursuant to Tustin City Code("TCC") sections 9298(f) and 9294(a). This appeal concerns CalOptima's proposal to utilize two existing buildings totaling 73,180 square feet, on approximately 2.23 acres at the above-referenced addresses ("Site"), for a 119 bed, temporary post-hospitalization and convalescent recuperative care inpatient facility, as well as to provide outpatient medical services, described in more detail in CalOpnma's CUP application(CUP 2022-0019)and follow up correspondence(the"Project").' The currently vacant Site was previously used as a 119 bed inpatient acute care/medical rehabilitation and skilled nursing facility. The Project does not propose any exterior- modifications (nor would it increase the square footage or bed count), only interior tenant improvements. For the reasons set forth herein, CalOptima hereby appeals the Director's determination that any portion of the Project as proposed is not a conditionally permitted use under the Site's zoning and/or General Plan land use designation, and instead asserts the entirety of the Project (i.e., all the proposed uses identified in the Use Determination, although CalOptima views the Project as one intertwined use) may be permitted on the Site pursuant to a CUP. As referenced. above, very similar uses were previously approved by the City on the Site under CUP 88-01, as amended, attached hereto as Exhibit A. ' The Project's October 2022 application and environmental assessment forrn containing more Project details are collectively attached hereto as Exhibit B. Rutan & Tucker, LLP 118575 Jamboree Road, 91" Floor Irvine, CA 92612 1714-641-5100 1 Fax 714-546-9035 `QV037552-0001 Orange County I Palo Alto I San Francisco I Scottsdale I www.rutan.com wi964,7:.I? m/:Li RUTAN RVYN t TV�RER,LtP City of Tustin April 27, 2023 Page 2 Cal0ptirna also asps the City to respectfully reconsider- its decision — and the Planning Commission to grant its appeal — on the entirely independent grounds that, pursuant to Section 35.130(b)(7)(i) of Title 28 of the Code of Federal Regulations, a disability-related reasonable modification to the City's policies, practices, and/or procedures is necessary to avoid discrimination on the basis of disability, The Project would temporarily house and otherwise service elderly (55 years and older) low income patients with physical and/or behavioral health impairments that substantially limit major life activities, as those terms are defined in the Americans with Disabilities Act("ADA"). (28 C.F.R. § 35.108.) Critically, the Project cannot be treated differently than the previously existing medical facility based on the identity or other protected characteristics of the patients it would serve. 1. Relevant Background The Site was developed with the two existing buildings pursuant to CUP 88.01,as amended by City Planning Commission Resolution No. 2749, which allows an acute care/medical rehabilitation (60 beds) and skilled nursing (59 beds) facility across two buildings. As stated in that CUP, 119 beds were authorized for "neurological or convalescent care," which the City classified as a "hospital," a conditionally permitted use under the Site's General Plan and zoning designation (Public and Institutional or "PI"). The Site was constructed as proposed (with one two-story 56,000 square foot building and a single-story17,180 square foot building), and was operated with the foregoing uses for several decades. The Site is currently vacant. CalOptima is under contract to purchase the Site and make relatively minor interior modifications and updates to operate the existing buildings with the exact same amount of hospital beds as previously approved by the City in the still unexpired CUP 88-01. While CalOptima believed only a minor amendment to CUP 88-01 would be required given the similarities in uses, after receiving feedback from the City,CalOptima filed an application for a new CUP at the City's direction on or about October 17, 2022. (See, Exhibit B.) A more detailed narrative Project description was submitted with the application materials, and is attached hereto as Exhibit C. The City deemed CalOptima's application "pending complete" on November 21, 2022 — indicating the application would be deemed complete when CalOptirna submitted an "operations and security plan"—and indicated that the CUP would be agendized for consideration by the City's Planning Commission at its January 24, 2023 hearing. (See, Exhibit D.) The City also attached draft conditions of approval, which were generally acceptable to CalOptima. CalOptima promptly submitted an operations and security plan as requested on December 6,2022,and provided comments on the draft conditions of approval,which the City indicated were acceptable. However, City staff subsequently reconunended to the Planning.Commission that the January 24,2023 hearing be continued to a date uncertain"to provide the applicant an opportunity to provide additional information regarding the proposed day-to-day operations." (See, Exhibit E, p. 2.) CalOptima did not request this continuance or believe it was necessary to provide additional 3 5 2 31113 7 5 54_{}11Q1 1 N476Hi 2 a04127123 RUTAN xuzarr s r;M4,uu�- City of Tustin April27, 2023 Page 3 information, as CalOptinia had answered every question posed by the City up to that point.'- Importantly, the staff report reco►nmending the continuance nonetheless stated the following: "The project site is 2.27 acres and is located within the Public and Institutional (PI) District. Pursuant to TCC 9245(b), hospital uses, or uses which, in the opinion of the Community Development Director and/or Planning Commission, are similar and are allowed, subject to the approval of a CUP." (Id.) Clearly, even when this hearing was continued, there was no indication that the Project did not qualify as a hospital or was not a conditionally permitted use under the Site's zoning, but the staff report appears to indicate the opposite. Over the next several months, City staff continued to request additional information about the Project, which CalOptima provided, including updated versions of the operations and security plan. Despite providing even more information than it had provided prior to the City determining CalOptima's application was essentially complete in November 2422, the City determined on March 10, 2023 that the application was instead incomplete, with numerous additional questions and requests. (See, Exhibit F.) CalOptima promptly provided detailed responses, as summarized in Exhibit G, along with responses previously provided to the City's earlier cltrestions/requests in the proceeding months. CalOptima also provided City staff with a tour of its PACE facility in Garden Grove and the vacant Site, This process culminated in the April 19, 2023 Use Determination, the first time there was any indication that the City believes the Project is not conditionally permitted under the Site's zoning. The Use Determination was also the First mention of the Professional("Pr")zoning district or Specific Plan 9 ("SP9"), which do not apply to the buildings on the Site and therefore are not relevant to the regulation of the uses proposed herein. II. Basis for Appeal CalOptima hereby appeals the Director's April 19, 2023 determination that the entirety of the proposed Project is not a conditionally permitted use under the Site's General Plan land use designation and zoning district(s), and specifically, the determination that aspects of the Project are not a"hospital"or"similar"use to a hospital or another conditionally permitted use under TCC section 9245(b). CalOptima likewise appeals the Director's determination that its application is incomplete on this same basis. Thus, CalOptima appeals all aspects of the Use Determination, except for the determination that the PACE aspect of the Project is a conditionally permitted use under the Site's General Plan land use designation and zoning. CalOptima was also told that a reason for the continuance was that the City Attorney was evaluated a "conflict of interest" issue, and that analysis would not be completed in time for the January 24, 2023 hearing, 2�231037i12.01JO 1011 , 10.1 __ RUTAN PWTAN;TU6NGR,L P City of Tustin April 27, 2023 Page 4 Ca]Optima respectfully urges the Planning Commiss toil to grant this appeal and,consistent with the City' prior interpretation of the Site's zoning in CUP 88-01, City staffs initial interpretation, and even the Director's current interpretation of the PACE aspect of the Project, affirmatively determine that the entire Project is a conditionally permitted use on the Site_ Denying the appeal would be a significant departure from how this Site has been treated for decades, including with respect to the current Project from October 2022 until this month. Even if the appeal is granted and the entire Project is deten-nined to be a conditionally permitted use, the Planning Commission still has significant discretion when considering approval of the CUP,and therefore is still entitled to impose reasonable conditions of approval on the Project to mitigate any impacts they believe may occur specific to the proposed Project. However, a determination that the Project is not permitted at all is not consistent with past practice, the TCC, or federal law. A. The Proposed Pro'eet is Pro erIv Characterized Hospital, a Conditionally Permitted Use on the Site The Site is subject to the City's PI zoning district, as noted in the Use Determination. As an initial matter, the references to the Pr and SP9 districts should be disregarded, as to the extent they impact the Site at all, they do not apply to any portion of the Site where the existing buildings are located. As a result, the regulations on those districts would not apply to the use(s) being proposed on those existing buildings, the exteriors of which are not being modified. If anything, these districts appear to only apply to parking areas, which would not be modified as park of the Project, but would continue to be used for parking. The Use Deterrination seems to implicitly acknowledge this, as it focuses on the PI zoning district's regulations.. I. The Proposed Project Should be Considered One Integrated Use The Use Determination splits the proposed Project into three distinct land uses, "recuperative care," "post-hospitalization housing," and the "Program of All-Inclusive Care for the Elderly (PACE)." However, all of these "uses" are symbiotic, intertwined, and ultimately all critical facets of one single integrated land use. This is similar to a hospital that provides various services in one facility — including inpatient and outpatient services—the entirely of which would be considered a hospital. First,there is no difference between"recuperative care"and"post-hospitalization housing" uses, which should instead be considered one post-hospitalization recuperative care use, indeed, the Use Determination itself states that "there is no difference in the services provided, eligibility As set forth in Section A(3), the Project will not have any significant or negative impacts, which instead will all be substantially similar— if not identical—to the impacts of the previously approved use that occupied the Site for decades. 2523/037512.0001 19076964,2 a04j27 s3 RUTAN 1111 IN I VCy f..LL• City of Tustin April 27, 2023 Page 5 criteria or room location." (Use Detennination, pp. 1-2.) The only reason these terms were ever used separately was based on Medi-Cal categories created for insurance purposes,where generally, recuperative care is understood to be 90 days or less after discharge from a hospital, and up to six months is referred to as post-hospitalization housing. However, regardless of how long they have been at the Site, all of these patients would be receiving the same type of medical care in the same location. There is truly no distinction in these two categories From a land use perspective. Second, while PACE would provide some outpatient medical services, it would provide those very same services to the post-hospitalization recuperative care patients who are staying at the Site. Thus, the PACE "use'„ is actually a critical part of the inpatient use, and similar to many hospitals or medical facilities,PACE would provide medical services to both those who have the ability to stay outside of the facility,and those that must remain on site. Additionally,the same meals would be provided to outpatient individuals as part of the PACE program that would be provided to overnight patients, utilizing the same kitchen. The statement in the Use Determination that,as part of the overall Project„medical services are not provided to the individuals participating in the inpatient past-hospitalization recuperative care portion of the Project is not accurate. Instead, the post-hospitalization recuperative care patients would receive medical services from the same facilities, personnel, and equipment as the outpatient individuals receiving medical services from PACE. Therefore,because the Director has determined that "the operational characteristics of the proposed PACE use is consistent with a hospital use" and therefore "the PACE use can be allowed with the review and approval of a CUP by the Planning Commission" (Use Determination, p. 3), the same determination should be made for the entire Project because the saine PACE medical services are provided to the entire facility, not just to outpatient customers. 2. The Proposed Project Should be Classified as a. Hospital Under its Commonly Understood Definition The term "hospital" is not defined by the TCC, and thus should be interpreted by its plain meaning, and consistent with the. City's prior interpretations, specifically including CUP 88-01 and Planning Commission. Resolution No. 2749. Acute care, recuperative care, extended care facility, skilled nursing, rehabilitative care and any other medical service uses are all likewise undefined. The World Health Organization ("WHO") considers an establislunent to be a hospital if it is permanently staffed by at least one physician, can offer inpatient accommodation, and can provide active medical and nursing care.` Encyclopedia Britannica defines hospital as "an institLM011 that is built, staffed, and equipped for the diagnosis of disease; for the treatment, bath medical and surgical, of the sick and the injured; and for their housing during this process," and https://www.cdc.kov/nchs/lius_/_s_ourc_es-definition s/hospital.htm 15231037552-OCK)1 19076964.2 304,27?23 RUTAN RW TA"f TOCHER."Lp City of Tustin April 27, 2023 Page 6 further notes that "the modern hospital has often developed outpatient facilities, as well as emergency, psychiatric, and rehabilitation services." Indeed, nearly every hospital has an outpatient emergency room that works in tandem with its inpatient facilities. The entirety of the proposed Project—inpatient and outpatient—clearly qualifies under the foregoing definitions and the generally understood meaning of hospital or similar use. As set forth in materials previously provided to the City, the Project would be staffed 24 hours a day, seven days a week with medical professionals, which includes nurses, medical assistants, therapists, and other professionals. (See, e.g., Exhibit C, p. 3.) As explained above, the wide range of PACE medical services are available to those remaining overnight, and further, if an overnight patient has a need that cannot be met by the fulltime medial staff, Ca]©ptima can bring in the necessary services. The Project as proposed would he functionally equivalent to the skilled nursing and rehabilitation type of inpatient services previously approved at the Site. The biggest difference here is the identity of patients (i.e., specifically qualified, over 55, low income and otherwise unhoused individuals),rather than the use. Finally, while difficult to predict because CalOptima has never operated a facility precisely like the proposed Project, CaU3ptima currently believes that the average duration of stay is likely to be much less than one (1) year as indicated in the Use Determination, and More likely to be closer to 90 days. It bears noting that CUP 88-01 did not impose limits on length of stay at the previous facility on the Site, and instead by implication, patients were permitted to reside there as long as needed. Thus, length of stay — which again, is unpredictable at this time—should simply not be a determining factor here. Indeed, the length of stay in no way changes the nature of the use or services provided, and it ultimately has no bearing on the compatibility of the proposed Project with its zoning and surrounding uses. 3. The Tustin Qy Code Indicates that the Project Should be Interpreted as a Hospital or Similar Use The Director's interpretation that the inpatient portion of the Project is not a permitted use was made under TCC section 9298(b), which applies to ambiguities in the TCC. (Use Determination,p, 2.) As an initial matter, CalDptima believes that here,there is no ambiguity that the Project is permitted under the plain meaning and commonly understood definition of hospital, for the reasons set forth in Section A(2), above. However, assuming section 9298(b) controls here (set forth below in its entirety), the factors that the Director— and now the Planning Commission — must consider also indicate that the Project should be considered a conditionally permitted use: https:llwww.britannica.com/science/hospital 2523103 7 55 2-000 1 1 9076964104127+? RUTAN "i)S.N 6 LLo City of Tustin April 27, 2023 Page 7 "Whenever the Director of Community Development, Planning Con-unission or City Council is called upon to determine, in cases of ambiguity,. whether or not the use of any land or structure in any district is similar in character to the particular uses or plans allowed in the district, the Director of Community Development, Planning Commission or the City Council shall consider the following factors as criteria for their determination, as applicable: (1) Effect upon the public health. safety and general welfare of the neighborhood involved and the City at large. (2) Effect upon traffic conditions. (3) Effect upon the orderly development of the area in question and the City at large, in regard to the general planning of the whole community. (4) All ether pertinent facts." (TCC § 9298(b).) The Project's effects upon "the public health, safety and general welfare of the neighborhood involved and the City at large," "traffic conditions" and "orderly development of the area in question and the City at large., in regard to the general planning of the whole community" would all be identical to the previouslj, approved rises at the Site, particularly considering square footage and even bed count will remain identical. There is no evidence or logical basis supporting a position that any of these factors would change from the previously approved use, and instead would all be substantially similar. To anyone outside of the Site, the Project would appear the same the previously approved facility that operated for decades, and it is unlikely the surrounding community would even be aware operations on the Site had changed (and from a land use perspective there would be no change). Furthermore, the Site is perfectly located in a largely commercial area,directly adjacent to SR-55,without any sensitive uses nearby, and the Project would not result in any new, increased or otherwise negative impacts. Ili sum, the factors that the City must consider when interpretating whether or not the Project is a conditionally permitted use clearly indicate that it should be treated the same as the previous use, as these factors are focused on external impacts, which will remain unchanged. In particular,length of stay or precise type of medical services provided or not provided the express basis for the Use Determination (see, p. 2, bullet points) have no bearing on public health and safety, traffic conditions, or orderly development of the area in question or the City at large.. B. The Appeal Should be Granted as a Reasonable Accommodation Under the ADA The Americans with Disabilities Act ("ADA") prohibits discrimination on the basis of disability,and specifically protects individuals with physical and/or behavioral health impairments that substantially limit major life activities like those the proposed Project would serve. 42 U.S.C. 12131. The federal Fair Housing Act("FHA") and its state counterpart, the Fair Employment and Housing Act("FEHA") likewise protect the Project-s patients fi-orn discrimination on the basis of 25231037552-0 0l 190769(A.2 04127123 RUTAN AVtAM R TUCXER.f.Lr City of Tustin April 27,2.023 Page 8 age and disability. Thus, the Project cannot be treated any differently than a similar use serving a different population. It is legally significant that the City previously approved a nearly identical use(i.e., acute care/medical rehabilitation and skilled nursing)with the exact same bed coat:t(1 19 beds) in the exact same buildings on the exact same Site. The AAA also requires the City "to make `reasonable modifications' in [its] usual ways of doing things when necessary to accommodate people who have disabilities" unless it finds the requested modification would fundamentally alter the nature of the service, program, or activity or result in an undue financial or administrative burden. (DOJ Primer For State and Local Governments; .see also 28 C.F.R. § 35.130(b)(7)(i); 28 C.F.R. § 35.150(a)(3).) The City has the burden of proving the existence of a fundamental alternation and/or undue burden, which here, it must to do deny CalOptima's appeal. (28 C.F.R. § 35.150(a)(3).) Tustin is in the midst of a homelessness crisis.'The Project would provide urgently needed medical services for unliaused elderly members of the community with disabilities, while also keeping them off of fire streets. Without facilities like the Project, the City cannot make meaningful progress towards addressing the homelessness crisis affecting its community, and thus a reasonable accommodation here is clearly warranted. G httRs://www.Rda-gov/resoLirces/titte-ll:priiner/ 7 https://www.tustinca.org/696/Homelessness 1523rt137553-0001 N076%4-22-04127123 RUTAN RVTAN i TUCACR,,. City of Tustin April 27, 2023 Page 9 CalOptima sincerely appreciates City staffs efforts to date, and appreciates the Planning Commission's consideration of this appeal. On the most basic level, the Project is proposing to utilize two existing buildings with the exact same number of beds as previously approved for patients that need medical care (as well as incorporate outpatient medical services), which is functionally no different than the previously approved use under CUP 88-01 as amended, particular with respect to any external impacts. Thus, the City staff s interpretation that the inpatient portion of the Project is not permitted under the Site's zoning—which is also a departure from its initial interpretation of the Project — is not supported by the TCC, particularly when considering how the City has consistently interpreted its provisions in the past. CalOptima is not asking that the Project be permitted under the existing CUP or a minor amendment thereto—which it could —but it has instead been willing to apply for an entirely new CUP and subject itself to associated conditions of approval. CalOptirna respectfully requests that the Planning Commission grant its appeal, and direct staff to process the Project as a conditionally permitted use under the Site's General Plan land use designation and zoning. CalOptirna looks forward to being back in front of the Planning Commission when it considers approval of a CUP for the Project. Sincerely, RUTAN &TUCKER, LLP + Alan B. Fenstermacher ABF 25231037352.01301 19076964.2 a04Q7,23 i II i B i i I i I I Exhibit i 1 RESOLUTION NO. 2749 2 A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF TUSTIN, APPROVING AMENDMENTS TO CONDITIONAL USE 3 PERMIT 88-01 TO ALLOW REVISIONS TO THE PREVIOUSLY- APPROVED PLANS FOR A 56,000-SQUARE FOOT ACUTE CARE 4 (MEDICAL REHAB) HOSPITAL BUILDING WITH A TWO-LEVEL UNDERGROUND PARKING STRUCTURE AT 14851 YORBA STREET, 5 TUSTIN. w 6 The Planning Commission of the City of Tustin does hereby resolve as follows: 7 I. The Planning Commission finds and determines as follows: 8 A. That a proper application amending Use Permit No. 9 88-01 has been filed on behalf of Continental Medical Systems, Inc. requesting authorization to 10 revise previously-approved plans for the construction of a 56,000-square foot acute care 11 (medical rehab) hospital with a two-level underground parking structure. 12 B. A public hearing was duly called, noticed and held 13 on February 12, 1990. 14 C. That establishment, maintenance, and operation of the use applied for will not, under the 15 circumstances of this case, be detrimental to the health, safety, morals, comfort, or general welfare 16 of the persons residing or working in the neighborhood of such proposed use, as evidenced by 17 the following findings: 18 1. The use applied for is in conformance with the requirements of the Tustin General Plan. 19 2. The use applied for is in conformance with the 20 requirements of the Tustin zoning Code. 21 3. The conditions contained in Exhibit A attached to this Resolution are necessary to avoid 22 incompatible elements of the proposed project and compliance with these conditions shall be 23 guaranteed for the life of this Use Permit. 24 D. That the establishment, maintenance, and operation of the use applied for will not be injurious or 25 detrimental to the property and improvements in the neighborhood of the subject property, nor to the 26 general welfare of the City of Tustin, and should 27 be granted. 28 i i i i 1 Resolution No. 2749 February 12, 1990 2 Page 2 i 3 4 5 E. Proposed development shall be in accordance with the development policies adopted by the City Council, 6 Uniform Building Codes as administered by the Building Official and State of California, Fire Code 7 as administered by the Orange County and State Fire Marshal, and street improvement requirements as 8 administered by the City Engineer. I 9 F. The Final Environmental Impact Report No. 88-1 has been recertified with Addendum 90-1 in conformance 10 with the requirements of California Environmental Quality Act for the subject project, as adopted in 11 conjunction with this project by Resolution No. 2748. 12 G. Final development plans shall require the review and 13 approval of the Community Development Department. 14 11. The Planning Commission hereby approves amendments to Conditional Use Permit No. 88-01 to authorize revisions 15 to the previously-approved plans for construction of a new 56,000-square foot Acute Care (Medical Rehab) 16 Hospital facility at 14851 Yorba Street subject to the conditions contained in Exhibit A attached hereto. 17 18 PASSED AND ADOPTED at a regular meeting of the Tustin Planning Commission, held on the 12th day of February, 1990. 19 20 21 DONALD LE JEUNE 22 chairman 23 24 25 NNI FOLEY� 26 Secretary 27 23 i I I EXHIBIT A RESOLUTION NO. 2749 FEBRUARY 12, 1990 CONDITIONS OF APPROVAL FOR AMENDMENTS TO CONDITIONAL USE PERMIT 88-01 I GENERAL i 1.1 The proposed amendments shall substantially conform with (1) the plans for the project date-stamped February 12, 1990 on file with the Community Development Department, as herein modified, or as modified by the Director of Community Development Department in accordance with this exhibit. A final plan check of construction level drawings is required to verify this conformance. The Community Development Director may approve minor changes to the elevations, materials and colors which do not significantly alter the character or appearance of the approved design. 1.2 Unless otherwise specified, all conditions contained in (1) this exhibit shall be complied with prior to the issuance of any State-issued Certificate of Occupancy for the project, subject to review and approval by the Community Development Department. (1) 1.3 The applicant shall sign and return an Agreement to Conditions Imposed form prior to issuance of any permits. 1.4 Approval shall become null and void unless State-issued (1) building permits are issued within eighteen (18) months from the date on this Exhibit. i 1.5 A maximum of 119 beds are authorized in both structures * (60 beds in the acute care (medical rehabilitation) hospital and 59 beds in the existing skilled nursing facility) . Issuance of proper permits and certification from the State of California *is required prior to occupancy of.the new structure. 1.6 Use Permit 88-01 authorizes 119 hospital beds for * neurological or convalescent care only. Should at any time the nature of the hospital use change in any way; an amendment to this Use Permit must be secured prior to installing any change in use. SOURCE CODES (1) STANDARD CONDITION (5) SPECIFIC PLAN (2) CEQA MITIGATION (6) RESPONSIBLE AGENCY REQUIREMENT (3) UNIFORM BUILDING CODE/S (7) LANDSCAPING GUIDELINES (4) DESIGN REVIEW (8) PC/CC POLICY +�** EXCEPTION i I I it i Exhibit A Resolution No. 2749 February 12, 1990 Page 2 i 1.7 Parking for the proposed neurological care facility shall * be maintained as follows: ° 1 parking space per 2 beds; ° 1 parking space per 250 square feet of office use. 1.8 Prior to implementation of the approved changes, a set (4) of State-approved construction plans must be submitted (6) to the Community Development Department for review and approval of zoning code-related issues and Fire Department requirements. 1.9 The Community Development Department shall inspect the * project and approve final construction and conformance with this Use Permit prior to occupancy of the new structure. 1.10 if at any time the City determines that on-street parking (4) problems arise as a result of underuse of the below- (6) grade parking structure, security personnel may be required to be stationed inside the parking garage. j I; (4) 1.11 Revised elevations for the north and south sides of the Acute Care (Medical Rehabilitation) Hospital (new building) shall be submitted for review and approval of the Community Development Department and shall include a decorative cornice or other design/facade embellishments on the north elevation and also additional architectural detailing to improve the architectural transition at the southeasterly portion of the southerly (courtyard) elevation. (4) 1.12 Conditions of Approval No. 1.1 through No. 1.8, and No. 5.1, of Resolution No. 2484, Exhibit A, are hereby deleted. See Exhibit B. (4) 1.13 All other conditions of approval contained in Resolution No. 2484 shall be complied with. See Exhibit B. (4) 1.14 All conditions of approval as contained in Resolution No. 89-96 for the approval of Final Parcel Map 87-412 shall be complied with. See E::nibit C. ! i Exhibit A Resolution No. 2749 February 12, 1990 Page 3 SITE MP BDILDING CONDITIONS (4) 2.1 All improvements and materials shall remain as shown on (6) the approved plans, date-stamped February 12, 1990. Any changes shall be subject to review and approval by the Director of Community Development. All exterior treatments including color, materials and detailing must be noted on submitted construction plans and elevations. LANDSC�IPINC, (4) 3.1 Department of Community Development may request minor (6) substitutions of plant materials or request additional sizing or quantity materials during plan check. Note on landscaping plan that adequacy of coverage of landscaping and irrigation materials is subject to field inspection at project completion by the department of Community Development. (4) 3.2 Revise landscape plan to provide more mature plant stock along the west property line. The plant materials shall be of appropriate size, quantity, spacing and species to visually screen the hospital complex, as determined by the Community Development Department. it i I I i i I Ekhibit B.of Resolution No. 2749 Resolution 2484 EXHIBIT A APRIL 11, 1987 CONDITIONS OF APPROVAL FOR CONDITIONAL USE PERMIT 88-01 GENERAL i 1.1 The proposed project shall substantially conform with the submitted site (1) plan for the project date stamped April 11, on file with the Community Development Department, as herein mod ed, or as modified by the Director of Community Development Department n accordance with this exhibit. A final plan check of construction lev 1 drawings is required to verify this conformance. 1.2 Unless otherwise specified, th ti s ontained in this exhibit (1) shall be complied with r o t -ss a e of any State issued building permit for the pr Iece je t and approval by the Community Developmen D m nt. 1.3 Design r vie shall be become null and void unless building (1) per s issued within eighteen (18) months of the date on this Ex bit. , 1.4 Al conditions of approval as contained in Resolution No.. 2469 for the (I) ado t n of Tentative Parcel Map 87-412 shall be complied with prior to iss ce of any structural building permits. 1.5 A maximum of 99 beds are authorized in both structures (40 b ds in the * new structure and 59 beds in the existing facility). Issuanc of proper permits and certification 'from the State of California 's re ired prior to occupancy of the new structure. 1.6 Use Permit 88-01 authorizes 99Zai a b f eurological or * convalescent care only. S �d ai the ure of the hospital use change in any wi 1 1 spa es and an amendment to this Use Permit must be ecu prioling any changes of use. 1.7 Parking foCing pro ed.neurologicial care facility shall be maintained * as follows 1 parspace per 2 beds; 1 parspace per 250 square feet of office use. 1.8 The CommuDevelopment Department shall inspect the project and * approve final construction and conformance to this Use Permit prior to occupancy of the new structure. SOURCE CODES E..X H I T E� (1) STANDARD CONDITION (5) SPECIFIC PLAN l•/ (2) EIR MITIGATION (6) RESPONSIBLE AGENCY REQUIREMENT (3) UNIFORM BUILDING CODE/S (7) LANDSCAPING GUIDELINES (4) DESIGN REVIEW (8) PC/CC/ POLICY **� EXCEPTION Exhibit A Resolution No. 2484 Page two I I PLAN SUBMITTAL 2.1 At building plan check, submit three sets of construction level plans as follows: A. Construction plans, structural calculations, and title 24 energy (3) calculations shall be submitted for all improvements. Requirements of the Uniform Building Codes, State Handicap and Energy Requirements shall be complied with as approved by the Building Official. Plans should reflect . architectural details and elevations for all structures, walls, enclosures and any other construction level drawings necessary to accurately reflect all proposed construction, B. Provide preliminary technical detail and plans for all utility (3) installations including cable TV, telephone, gas, water and electricity. Additionally, a note on plans shall be included stating that no field changes shall be made without corrections submitted to and approved by the Community Development Department. C. Final grading and specifications consistent with the site plan and (3) landscaping plans and prepared by a registered civil engineer for approval of the Community Development Department. (3) D. A precise soils engineering report provided by a soils engineer within the previous twelve (12) months. E. Information, plans and/or specifications to ensure satisfaction of (1) all Public Works Department requirements including but not limited (6) to conditions contained in Resolution No. 2469 shall be provided including the following: 1. Dedication of. all required street and flood control (6) * right-of-way, vehicular acess rights, sewer easements and water easements defined and approached as to specific location by the City Engineer and other responsible agencies. 2. The Yorba Street entrance minimum curb radius is 20 feet. (6) * Additional right-of-way dedication per City standard 118E must be provided. 3. The construction of new on-site fire hydrants will require a (6) * detector check within an easement per City Standard No. 129. A legal description and sketch of the easement areas along with a copy of the latest vesting for this property shall be submitted to the Engineering Division for review and preparation of an easement deed. Said deed must be executed by the property owner prior to any approvals/permits from the Engineering j Division. i i I Exhibit A Resolution No. 2484 Page three I I F. Note on plans that a qualified paleontologist/archealogist, as j appropriate shall be present during rough grading operations. If resources are found, work shall stop in the affected area and all resources shall be excavated or preserved as deemed appropriate or as recommended by the paleontologist/archealologist subject to review and approval by the Department of Public Works and Community Development. All "finds" shall be reported immediately to the Department of Community Development. I The paleontologist/archealogist shall attend the pregrade construction meeting to ensure that this condition and necessary procedures in the event of a "find" are explained. G. The applicant shall comply with all requirements of the Orange County and (6) State Fire Marshall, including required fire flow, installation where required of fire hydrants subject to approval as to location by the Fire Department, City of Tustin Public Works Department, Tustin Water Works and compliance with all requirements pertaining to construction. H. Prior to issuance of building permits for combustible construction, (6) evidence that adequate water supply and operational fire hydrants are available for fire protection shall be submitted and approved by the Orange County and State Fire Marshall. The applicant shall also submit water improvement plans for approval of the Fire Marshal. I. Note on plans that the interior on-site loop road shall be posted "No (6) Parking- Fire Lane" in accordance with all applicable Orange County Fire * Department requirments. J. All required Orange County Fire Department signs shall be posted and (6) designed in accordance with the Orange County Fire Department * requirements. NOISE 3.1 Should any complaints of noise exceeding the requirements of the Tustin (1) Noise Ordinance be received, the developer shall be required to install (2) muffling equipment which reduces construction related noise to levels in conformance with the Tustin Noise Ordinance. 3.2 Should any noise related complaints be filed with the Community (1) Development Department regarding the construction at the project site, (2) the applicant shall install noise mufflers on construction equipment. I i I Resolution No. 2484 Exhibit A Page four i FEES I 4.1 Prior to issuance of any building permits, payment shall be made of all (1) required fees including: A. Major thoroughfare and bridge fees to Tustin Public Works Department. B. Sanitary sewer connection fee to Orange County Sanitation District. C. Grading planchecks and permit fees to the Community Development Department. 0. All applicable Building plancheck and permit fees to the Community Development Department. E. New development fees to the Community Development Department. F, School facilities fee to the Tustin Unified School District. j I SITE AND BUILDING CONDITIONS 5.1 All improvements, materials and colors shall remain as proposed- the (1) approved plans, date stamped April 11, 1988 any changes shall be u ject (4) to review a a of unity De lopment De par All io trea is st o dins d regard to col r, matey a i an of d an sub i onstructian plans an levations shal ndicate a colors an a als to be used. 5.2 Note on plans that a six foot high chain linked fence shall be installed (1) around the site prior to building construction stages. Gated entrances shall be- permitted along the perimeter of the site for construction vehicles. 5.3 All rooftop mechanical or electrical fixtures and equipment shall be (1) screened from view. All telephone and electrical boxes must be indicated (4) on the building plans and shall be completely screened. Electrical transformers, where provided and wherever possible shall be located toward the interior of the project maintaining a sufficient distance from the frontage of the project. 5.4 Submit detail for all on-site walls to be contructed by developer. Show (1) type of wall cap and type of color, exterior materials and decorative (4) treatment ofall exposed walls. Design of walls/fences shall be subject to final approval of the Community Development Department and should be consistent with main building treatments. 5.5 Provide a final master, sign• plan to be approved by the Community (1) Development Department for project to include: a) project (3) identification; b) on-site address signs. Provide generalized location, (4) sizes, design and colors subject to review and approval of the Tustin Police Department, Orange County Fire Department and Community Development Department. Signs authorized include: i i Resolution No. 2484 Exhibit A Page five i -- two (2) twelve square foot monument signs - two (2) twelve foot wall signs It eiG4AF,5 5.6 Provide details on lighting scheme for project. Note final locations of (1) all exterior lights and types of fixtures. Lighting fixtures shall be of (3) ornamental design and shall be located or designed so to direct rays of (4) light so they do not shine on adjacent properties. (6) 5.7 The 'fire lane' shall be blocked to through traffic by use of gates which are subject to review and approval of the Community Development Director and Orange County Fire Department. 5.8 The trash enclosure and oxygen tank enclosure shall be architecturally (1) treated to match the buildings and shall .have solid metal gates. (4) 5.9 During construction phases of this project the applicant shall provide * either temporary on—site or off—site parking facilities within 300 feet of the project for employees and visitors. The location and design and access to said parking shall be subject to approval of the Department of Community Development. * 5.10 All elevations of the existing hospital facility shall be remodeled. 5.11 All roof drains on new construction shall be internal and not visible on building elevations. All roof drains shall be designed So that run—off (1) is properly drained into concrete swales. No direct run—off over any (4) sidewalk will be permitted or allowed to continue. 5.12 Provide details for labeling compact and handicap parking spaces. (1) (4) LANDSCAPING, GROUNDS AND HARDSCAPE ELEMENTS 6.1 At final plan check a completely detailed landscape and irrigation plan (7) must be submitted for landscaping with whatever scale necessary to depict adequately what is occurring. Provide summary table applying indexing identifiction to plant materials in their actual location. The plan and table must list botantical and common names, sizes, spacing, actual location and quality of the plant materials proposed. Show planting and berming details, soil preparation, staking, etc. The irrigation plan shall show location and control of backflow prevention devices, pipe size, sprinkler type, spacing and coverage. Details for all equipment must be provided. i i Resolution No. 2484 Exhibit A Page six 6.2 The submitted landscaping plans at plan check must reflect the following (7) requirements: a) Turf is unacceptable for grades over 25% a combination of planting j materials must be used, ground cover on large areas alone is not acceptable. I b) Provide a minimum of one 15 gallon size tree for every 30 feet of ! property line on the property perimeter and five-5 gallon shrubs. i c) 8erming shall be provided wherever possible. 6.3 All newly planted trees shall,be staked according to City standards. (7) 6.4 Shrubs shall be a minimum of 5 gallon size and shall be spaced a minimum (7) of 8 feet on center when intended as screen planting. 6.5 Ground cover shall be planted between 8 to 12 inches on center. (7) 6.6 When 1 gallon plant sizes are used the spacing may vary according to (7) materials used. 6,7 Up along fences and or walls and equipment areas provide landscaping (7) screening with shrubs, and or vines and trees on plan check drawings. i 6.8 All plant materials shall be installed in a healthy vigorous condition (7) typical to the species. 6.9 Landscaping must be maintained in a neat and healthy condition, this will (7) include but not be limited to triming, mowing, weeding, removal of litter, fertilizing, regular watering, or replacement of disease or dead plants. 6.10 In irrigation areas controller to be enclosed in lockable housing. (7) Design irrigation systems to provide sufficient coverage as well as avoiding water overspray on buildings and sidewalks. Note of this requirement to be on plan check drawings. 6.11 Interior property lines to the north and south shall have a minimum five (*) (5) foot landscaped planter area. ` I i I STATE OF CALIFORNIA ) COUNTY OF ORANGE ). CITY OF TUSTIN ) I, PENNI FOLEY, the undersigned; hereby certify that I am the Recording Secretary of the P nrying Commission of the City P Tustin. California; a g Resolution No. oZ 5� was duly passed and do ted at a re ular Meeting of the T stin Planning Commission, held on the � dayof a form a; that 198 i � s ENNil FOLE Recording Secretary I i I i i Exhibit C of Resolution No. 2749 1 i 1 RESOLUTION NO. 88-96 j 3 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF 4 TUSTIN APPROVING FINAL.PARCEL MAP N0. 84Z412.: The City Council of the City of Tustin does hereby resolve as follows: G I. The City Council finds and determines as follows: 7 A. That Final Parcel Map No. 87-412 has been submitted by the j K.W. Lawler and Associates. 8 B. That a Public Hearing was held by the Planning Commission on February 22, 1988. At this hearing the Planning Commission recommended approval of Tentative Parcel Map 87-412 to the City 1G Council. Subsequently, the City Council approved Tentative Parcel Map 87-412 on March 21, 1988. The Final Map was reviewed 11 by the Planning Commission and recommended for approval by the City Council on August 22, 1988. 12 C. That the proposed subdivision is in conformance with the Tustin 13 Area General Plan and Subdivision Map Act. 14 D. That the site*is physically suitable for the type of development proposed. 15 E. That the site is physically suitable for the proposed density of 1� development. F. That the design of the subdivision or the proposed improvements are not likely to cause substantial environmental damage or j 15 substantially and avoidably injure fish or wildlife in their habitat. 19l; II G. That the design of the subdivision or the type of improvements 20 proposed will not conflict with easements acquired by the public-at-large, for access through or use of the property 21 within the proposed subdivision. 22 H. That the design of the subdivision or the types of improvements proposed are not likely to cause serious public health problems. 23 I. That the Final Map is in substantial conformance with the 24 Tentative Map. 25 H 1131 261 2;� 28 i i 1 i 2 Resolution No. 88-96 3 .Page two 4 5 It. The City Council hereby approves Final Parcel Map No. 87-412 and al authorizes the City Manager to execute any subdivision bonds agreements for the subject tract. 7 PASSED AND ADOPTED at a/regularn meeting of the Tustin City Council, held the 6th day of Septembers_, 1988. I -1�ona d oesterey 11 Mayor 12 i �� a ry W n 13 city cler I4 •15 • IC 1i 1S IC 20 21 22 23 24 25 26 27 28 i STATE OF CALIFORNIA ) COUNTY OF ORANGE ) CITY OF TUSTIN ) I, PENNI FOLEY, the undersigned, -hereby certify that I am the Recording Secretary of the Planning Commission of the City of Tustin, California; that Resolution No. a y'q was duly passed and adopted at a regular meeting of the Tustin Planning Commission, held on the 21— day of 199L. I I NI FOS�Y Recording Secretary I i I i i i i Exhibit Tv s T 1 N Community Development Department ■300 Centennial Way ■Tustin,CA 92780 Phone a 714.573.3140 ■www,tustinca.org i Environmental Assessment Form To be completed by the applicant. r _ I1C1•dt 141N�,11411t PASI I. General Information 1. Developer or Project Sponsor: Name: CalOptima Health Address: 505 City Parkway West, Orange, CA 92868 2, Project Address: 14851 Yorba St. and 165 N Myrtle Ave. 3. Assessor's Parcel Number: 401-302-14 4. Project Contact: Name: Kelly Bruno-Nelson, Executive Director CaIAIM Address: 505 City Parkway West, Orange, CA 92868 Telephone number: 714-246-8400 E-mail Address: kelly.bruno-nelson@Ca)Optima.org 5. Type of permit applications far the project to which this form pertains: Conditional Use Permit 6. Other related permits not listed above: Sign Permit,Tenant Improvement Building Permits 7. Other approvals required , including those required by city, regional,state,and federal agencies: The Department of Health Care Services will perform a site review for the Program of All Inclusive Care for the Elderly component of the campus. 8. Existing zoning district: Public& Institutional (P&I) 9. Proposed use of site (project for which this form is filed): Convalescent recuperative care and post hospitalization needs for low and extremely-low income individuals until they can gain their autonomy. 11, Project Description 1. Site size: 97,138.8 SF/2.23+1-Acres 2. Square footage: Total SF 73,180; 14851 Yorba St.56,000 SF and 165 N Myrtle Ave. 17,180 SF 3. Number of floors of construction: 14851 Yorba St.2-Story; 165 N Myrtle Ave. Single-story 4. Amount of off-street parking provided: 159 Parking Stalls 5. Impervious surface coverage (Includes all paved areas and building and/or structure footprints.): Existing: Approximately 88,668 SF Proposed: Same i 6. Attach project plans, including conceptual grading plans and a list of structural Best Management Practices (BMPs)that are anticipated to be included in subsequent Water Quality Management Plans (WQMPs). 7. Proposed scheduling: Project duration is anticipated to take 26 months: 3 months for Entitlements,4 months for TI Plan preparation,4 months for Building Permit Check; 3 months bid award/contracts; 12 months for TI Construction 8. Associated project: N/A 9. Anticipated incremental development: N/A i 10, If residential, include the number of units, schedule of unit sizes, range of anticipated sale prices or rents, and type of household size expected: N/A 11. If commercial, indicate the type, whether neighborhood, city, or regionally oriented, square footage of sales area, and loading facilities: N/A 12, If industrial, indicate type, estimated employment per shift, and loading facilities: N/A 13. If institutional, indicate the major function, estimated employment per shift, estimated occupancy, loading facilities, and community benefits to be derived from the project: The primary function will be convalescent recuperative care and post hospitalization needs for low and extremely-low income individuals. The facility will be operational 24 hours per day, every day requiring 3 shifts per day. Detailed operational information and description of community benefits derived from the project are discussed in our Letter of Intent submitted with our development application. 14. If the project involves a variance, conditional use, or rezoning application, state this and indicate clearly why the application is required: City of Tustin Municipal Code(TMC)Article 9, Chapter 2, Part 4, Section 9245 Public and Institutional (P&I) District, subjects all uses within the P&I District as Conditional. I III. Environmental Impacts i Are the following items applicable to the project or its effects? Discuss all items checked yes on additional sheets and attach as necessary. i Yes No 1. Change in existing features of any bays, tidelands, beaches, lakes, or hills or 0 substantial alteration of ground contours. i i 2. Change in scenic views or vistas from existing residential areas, public lands, or 0 O roads. 3. Change in pattern, scale, or character of general area of project. 0 4. Significant amounts of solid waste or litter. 0 5. Change in dust, ash, smoke, fumes,or odors in the vicinity. 0 O 6. Change in ocean, bay, lake, stream, or ground water quality or quantity, or 0 O alteration of existing drainage patterns. 7. Substantial change in existing noise or vibration levels in the vicinity. 0 0 8. Site on filled land or on slope of 10 percent or more. 0 9. Use or disposal of potentially hazardous materials, such as toxic, flammable, or U 0 explosive substances. 10. Substantial change in demand for municipal services (police, fire, water, sewage, 0 O solid waste/recyclables, etc.). 11. Substantial increase in fossil fuel consumption (electricity, oil, natural gas, etc.). 0 12. Relationship to a larger project or series of projects. 0 O 13. Describe the project site as it exists before the project, including information on topography, soil stability, plants, and animals and any cultural, historical, or scenic aspects. Describe any existing structures on the site and the use of the structures.Attach photographs of the site. i The subject property has been improved with two buildings(one single story, and one two-story), surface and subterranean structured on-site parking, solid waste enclosure, paved driveway,walls and fences, and landscape planter areas since circa 1990. The site is approximately 2.23 flat level acres and is primarily accessed from Myrtle Avenue.The single story building at 165 N Myrtle Avenue was previous used as a skilled nursing facility(SNF). The two-story building at 14851 Yorba Street was previously used for a inpatient rehab facility(IRF). The site was previously approved for 119 beds between the two structures. There are 4 fenced enclosures on west side of the i property that house: mechanical equipment, electrical transformers,trash compactor, emergency generator, i cooling tower and bulk oxegen. These facilities will continue to be used in CalOptima's operations on the site. See i attached photo. I 14. Describe the surrounding properties, Including Information on plants and animals and any cultural, historical, or scenic aspects. Indicate the type of land use (residential, commercial, etc.), intensity of land use (single family, apartment houses, shops, department stores, etc.), and scale of development (height, frontage, setbacks, rear yard, etc.). Attach photographs of the vicinity. The surrounding neighborhood is a built environment. The surrounding land uses are: To the West is Interstate 1-55 Freeway. To the North is Professional Office(PO).To the East is Professional Office (PO).To the South are three land uses types: Professional Office (PO), Downtown Commercial Core Specific Plan (DCCSP), and High-Density Residential (HDR). Most adjacent uses are two-story walk up structures consistent with subject site. 15, Describe how storm water will be retained on site and/or treated. I There are no proposed changes to the existing drainage of the improved property. IV. Intended Use of Previously Certified EIR O DCCSP Final EIR O RHASP Final EIR i V. CERTIFICATION I hereby certify that the statements furnished above and in the attached exhibits present the data and information required for this initial evaluation to the best of my ability and that the facts, statements, and information presented are true and correct to the best of my knowledge and belief. AF Applicant f n re i i Kelly Bruno-Nelson, Executive Director of CalAIM Print Name&Title i I October 13, 2022 Date i A � w w T rs to e and 5taiexhaust sg tem air v v , 14851 Yorba 5teet 00 �+1 o- Mechanical Equipment • ,,wtY; 165 N Myrtle Ave. w f nr Mechanical Courtyard with Trash Compactor, Transformer, Generator ti p and Cooling Tower v Bulk Oxygen I T7 f C T T h,7 Community Development Department • 300 Centennial Way •Tustin,CA 92780 J 1 11�4 Phone •714,573,31.40 •www.tustinca.org u Development Application Form 2 HI.. HI S7QKY BUILDING OUR FUTURE HONORING OUR FAST Project Description Request for New or Amended CUP for CalOptima Health's operation of a their Community Living and PACE(Program of All-inclusive Care for the Elderly)Campus.The facility will serve as convalescent recuperative care and post hospitalization needs for low and extremely-low income individuals until they can gain their autonomy. Project Address 14851 Yarba St. and 165 N Myrtle Ave. Assessor's Parcel Number 401-302-14 Zoning District: Existing Public& Institutional (P&I) Proposed Same General Plan Land Use: Existing Public& Institutional (P&I) Proposed Same Present Use of Property Inpatient rehab facility(IRF)and Skilled nursing Facility(SNF) Proposed Use of Property Convalescent recuperative care and post hospitalization needs. Office USe Only Existing Entitlement Affecting the Property CUP 88-01 by Resolution No.2749 Project No. Lot Size 97,138.8 SF 12.23+1-Acres CA 73,180 SF Same CER Building Size: Existing Proposed CP Property Owner Information CUP DA Name David Tang DR Company Yorba Myrtle LLC GPA LFD Address 16027 Brookhurst Street suite 1341 LLA Fountain Valle CA 92708 City,State,ZIP y, LMMA Phone: 714-558-8500 Cell Phone: RAR SCE Fax: E-mail. dtangcpa@yahoo.com SURD TPNI Applicant Information(if different) TTM Name Kelly Bruno-Nelson, Executive Director CalAIM VAR ZC Company CalOptima Health UD Address 505 City Parkway West Other Preliminary Review City,State,ZIP Orange, CA 9286$ Environmental: Phone. 714-246-8400 Cell Phone: ❑Exempt ❑ Initial Study Fax: 714-246-8492 E-mail: kelly.bruno-nelson@CalOptima.org © Neg Dec 0 EIR ❑ Use of previously certified EIR Consultant or Contact Information(if different) ❑ DCCSP CI RHASP Name Douglas D. Dumhart Date Received Company 3-D Advisors,LLC Received by Address 18 Kingfisher Court Fees Paid City,State,ZIP Coto De Caza, CA 92679 Receipt# Itemize Phone: NIA Cell Phone: (949)421-9119 Fax: N/A E-mail: Douglas.Dumhart@gmail.com OCFA SR# Designation of Person(s)to whom notices should be sent pursuant to Cade of Civil Procedures Section 1094.6 Name Kelly Bruno-Nelson Address 505 City Parkway West City,State,ZIP Orange, CA 92868 E-mail: Kelly.Bruno-Nelson@CalOptima.org Name Douglas D. Dumhart Address 18 Kingfisher Court City,State,ZIP Coto De Caza, CA 92679 E-mail: Douglas.Dumhart@gmail.com Legal Description of Property(Attach a separate sheet if necessary) Common address: 14851 Yorba St.and 165 N Myrtle Ave.,Tustin, CA 92780 Assessor's parcel number:401-302-14 Legal Description contained in Preliminary Title Report submitted with application package. Supplemental Application Form Attached(Check if applicable3 0 Variance/Minor Adjustment o Wireless Communications Facilities ❑ Sign Code Exception ❑ Downtown Commercial Core Specific Plan ❑ Alcoholic Beverage Sales Establishment o Red Hill Avenue Specific Plan 11 Shopping Cart Containment Program Signatures and Acknowledgements I hereby certify that I am the owner of the real property described in this application. I hereby acknowledge that this application may not be considered complete until I am notified by the Community development Department consistent with State law. I hereby certify that all of the information contained in this application, including all required plans, supplemental application forms, and other submission materials as specified in the informational handout provided to me by the Community Development Department has been submitted, and the information is, to the best of my knowledge and belief, true and correctly represented. Should any or all of the information submitted be false or incorrect, I hereby agree to defend,indemnify, and hold the City of Tustin harmless from liability and loss by reason of its reliance on any such information. I hereby grant the City the authority to place a public hearing notice an the subject property if a public hearing is required. rd C/11 IJ try lC ' ' - Property Owner's Notarized Signature Print Name Da e r r Applicant's o arize Signature Print Namej Date if the signature is by an agent,notarized, written authorization from the land owner must be atta th "`application. The land owner's and/or agent's signatures on the written authorization also must be notarized. -_ CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of } On Z�/ before me, t,ere ins lalTurW Lit le f the officer) personally appeared �, who proved to me on the basis of satisfactory e ence to be the person(s) whose names is re subscribed to the within instrument and acknowledged to me that h ee/they executed the same i his her/their authorized capacity(ies), and that by erltheir signature(s) on the Instrument the person(s), or the entity upon behalf of the person(s) acted, executed the instrument, certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct, WITNESS my hand and official seal. BRIAN a.NGUYEN CDMm. #2350126 zz ,�•� Notary Public California v x orange es Md. M County Comm.Expires Mar.4,203 Not APublic-Sign (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION FNSTRUCTIONS FOR COWLETING THIS FORM 7Yu,s jurnl contphes limb currertr calffarma staiwes regarding actor),a ur•drriL<a1hi. DESCRIPTION OF THE ATTACHED DOCUMENT if nuedect,should be curr+pleterl and allarhed if)the documenl..Rlckrtau larlgtrre�ir.r fj ao m other stares inay be cowtplered fur docianents being seat 10 thur state so long as 1W hording dues nor require the t:aliforwa notary to violate Califor•rua notcrt7 (T itleofdescription fattacheddocu men 1) • State and County information must be the Stale and.County where the documerit signer(s)personally appeared before the notary public for acknowledgment. I (Till or • Date of notarization must be the date that die signers)personally appeared�%Ilich EI dew scriptfari of attached document continued) must also be the same date the acknowledgment is completed • The notary public most print his or her name as it appears within his �r her Number of Pages Daculnenf Dateld� commission followed by a comma and then your title(notary public) • Print the name(s) of document signer(s) who personally appear at the time or notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect rorms (i.e helshe/4w, . is/we)or circling the correct forms Failure to correctly indicate this Er Individual (s) information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographicalky reproducible.. Impression must not cover text or lines. If seal impression smud.ges, re-seal if a (Title) stiff cient area permits,otherwise complete a dirferent acknowledgsmcnl form. ❑ Partner(s) • Signature of die notary public must match the signature on file with the offiec or nct;county clerk. ❑ Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a ditTerent document. Other Indicate title or type of attached document,number of pages and dale lndicale the capacity claimed by the signer If the claimed capacit} is a corlaorale officer,indicate the title(i.e.C'E0.CFO,Secre(ary). 2015 Verson wovw PlotaryClassas.caln 317fl-Q73 95a Securely attach this document to the signed docurcment with a staple � . . ! lia �II`II. i ". III i" i 4 .!, + � . II' ; •:� ' ! �t -�i�111 ,1 'II [the notary public or other officer completing this certificate verifies only the identity or e individual who signed the document to which this certificate is attached,and not truthrulness,accuracy,or validity of that document. State of California County of Orange On 3/ >Q> -- - before me, Chang-Ming 5u, Notary Public I j`p±?p;5.?r�ra-n-a i d';ue 4t[rr'^ref, personally appeared "� 112 who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s)acted, executed the instrument, I certify under PENALTY OF PERJURY under the laves of the State of California that the foregoing paragraph is true and correct. CHANG•MtNG su COMM, #2263762 z ❑'`• , Notary Public-California a WTNESS my hand and official seal. Orange County M Comm.Ex ires Oct.21,2022 Signature (Seal) Optional information AI,hougn[rl?I, t?r.R ilrlV f:Ei:; _Ct:r:r fi r,r:r req,,+'d C'j 13,v a•,w+kC1 fd?i$r[ri=•,.,1 J'?r[ra i+era"3:L1"3:E3Crrr d�'C°[�u,dCkrGvrF d, T_rrt[-J 3' dar•..+T+'_w and rnl)r Pro,,,Ji,a F._ii:=Teri l,"-:r_1yt^w or C^'e amlc, }+j.•� Description of Attached Document - T�le Method of Signer ld}rltificatior, f� � Y•�•ra� � t;•;7}; rf; �:•-Irr+.J�+? �r ����'•�� __��._f�Cr"1'T`•,(�h �.Qk`�'1 :.- .. _-. _ ., .-. I c , n'I• , f pa• e� and 13tej 7-v a, (714) 603-7776 I i I, i i I i Exhibit CalOptirna Heaitn A Public Agency r 505 City Parkway west 0 (1)CalOpuma Health Orange, CA 92868 `P3 714-246-8400 TTY_ 711 Q caloplirna.org October 7, 2022 Justina Willkom, Community Development Director City of Tustin 300 Centennial Way Tustin, CA 92780 RE: Detailed Project Narrative for CalOptima Health's Conditional Use Permit application at 14851 Yorba Street and 165 N Myrtle Avenue Dear Ms. Willkom: CalOptima Health is a county-organized health system that provides publicly funded health care coverage for low-income children, adults, seniors, and people with disabilities in Orange County, California. CalOptima Health's mission is to serve member health with excellence and dignity, respecting the value and needs of each person. CaIOptima Health serves snore than 911,000 local members with a network of more than 10,600 primary care doctors and specialists and 41 acute and rehab hospitals. This year the California Department of Health Care Services (DHCS) launched CaIAIM (California Advancing and Innovating Medi-Cal) to expand its Medi-Cal program beyond traditional healthcare to cover a variety of community support services that enable more comprehensive care for the whole person.These services include medically tailored meals, personal care, and other services that address individuals' social determinants of health. CaIOptima Health recognizes that health outcomes are greatly influenced by social factors and its member's overall experiences. With that in mind, CaIOptima Health has committed to offering a1114 community supports made reimbursable through CaIAIM and expanding its provider network to reach members across the county. Community supports address some of the challenges faced by the most vulnerable populations in our neighborhoods, including those experiencing homelessness, aging, children with complex care needs, and those involved with the justice system. By providing more comprehensive social support for our members and partnering with more community-based providers, we can meet members where they are and help them on their path to better health. At the beginning of the year, CalOptima Health began offering the first four community supports, including Recuperative Care. Recuperative Care (also known as Medical Respite) is short-term housing for individuals experiencing homelessness who are healing from an injury or illness and could benefit from medical oversight while completing their recovery. i As part of CalOptima Health's strategy for providing this critical community service to its members experiencing homelessness, we are partnering with community providers that operate recuperative care facilities. We are also planning the renovation of the subject property to house a hybrid program for recuperative care and PACE (Program of AII-Inclusive Care for the Elderly.) This Tustin-based facility will focus on service to older adults living in the community and those transitioning from living on the streets to a permanent home. I Bringing Supportive Services to the Community i Recuperative care services will be the foundation of this holistic care site in Tustin. Recuperative care is short-term housing inclusive of comprehensive care management and housing navigation services paired with traditional medical oversight from trained professionals over an up-to-90- day stay. Guests of this program have daily interaction with medical professionals and receive medication education to ensure they continue to heal after their hospitalization. The care management and housing navigation services provided help members to become "housing ready"with the necessary documents that enable access to housing. Guests also receive referrals to job training, substance use disorder services, and any other community supports that prepare them to make a permanent move home. This site will also provide another CaIAIM-funded community support: Short Term Post- Hospitalization Housing. This service functions similarly to the recuperative care program but offers a more extended stay of up to six months. It is anticipated that guests of the recuperative care program will frequently transition into post-hospitalization housing until they can move into their permanent homes. Finally,a portion of the building will be dedicated to CalOptima Health's PACE (Program of all Inclusive Care for the Elderly) program. PACE is a home and community-based service that provides medical services and supports everyday living needs for specific older individuals, most of whom are eligible for benefits under both Medicare and Medicaid. Individuals accessing these services will live both onsite and within the broader Tustin area. PACE offers complete health care and social support within one program, enabling older adults to remain living in the community and out of institutions. PACE provides a wide range of services, including on-site medical care, a day-activity center, transportation, rehabilitation therapies, meals, home care, medications, medical equipment,and hospital and long-term care coverage. At the core of these programs are multidisciplinary teams who treat guests and assess and plan for healthcare and social needs to maintain health. Ali program guests receive individualized care plans and services, and referrals designed to address their health and wellness challenges. i 2 I i CalOptima's History of PACE Services CalOptima Health has provided PACE services to the Orange County community since October 2009,Through its location in Garden Grove, CalOptima Health serves 435 individuals, who have an average age of 72, have multiple chronic conditions, and need help with 4-5 activities of daily living.They receive care in their own homes and on-site at the PACE center. Exceptional outcomes have been demonstrated through CalOptima Health's PACE Program, indicating lower nursing home admissions, shorter hospital stays, lower mortality rates, and better self-reported health and quality of life, Serving our Aging Neighbors CalOptima Health is proposing to provide these services to Orange County residents, with Tustin community members receiving priority at this facility. Overall, the facility will house 119 individuals.The average daily occupancy rate is expected to be 75%. The facility will serve older adults, many of whom were previously experiencing homelessness but are working toward a permanent housing placement, Typically, these individuals have multiple chronic conditions and need help with activities of daily living. To be eligible for PACE, individuals must be at least 55 years of age, reside in Orange County, meet California's skilled nursing facility requirements, and be able to live safely in the community with proper support. Bringing Employment Opportunities &A Spotlight on Innovative Services This facility will be staffed around the clock and will bring various skilled job opportunities to the community. Physicians, registered nurses, and licensed therapists will be retained, in addition to lower-level medical care professionals, administrators, housekeeping, personal care attendants, and guest services associates responsible for ensuring a secure experience for all stakeholders. CalOptima Health employment will likely track closely to recognized industry standards for similar care facilities. We would anticipate a ratio of 1 direct caregiver (including RNs, LPN/LVNs, and NAs)to 5 residents on the day shift, 1 to 10 for evenings, and 1 to 15 for nights in addition to 1 Director of Nursing (DON) and 1 Assistant DON.The proposed 119-bed facility at 100% occupancy would require 24-26 employees on day shift, 12-13 employees on evening shift and 8-9 employees on night shift. Veryfew programs across the state focus on the aging population at the intersection of medical care and homelessness. CalOptima Health is designing a state-of-the-art facility that will provide exceptional services to the residents of Orange County. Beyond that, it will serve as an example of best practices in homeless services, focusing on our aging neighbors,the fastest growing subset of the homeless population, Cordially, V Kelly Bruno-Nelson Executive Director Medi-Cal/CaIAIM 3 i I Exhibit /5:=7 Community Development Department Remembering what connects us. November 21, 2022 Kelly Bruno-Nelson, Executive Director CalAIM CalOptima Health 505 City Parkway West Orange, CA 92868 SUBJECT: CONDITIONAL USE PERMIT(CUP) 2022-0019: A REQUEST TO ESTABLISH A RECUPERATIVE CARE FACILITY AND PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) AT 165 N. MYRTLE AVENUE AND 14851 YORBA STREET Dear Ms. Bruno-Nelson: Thank you for your application submittal received on October 17, 2022. The application proposes to establish a recuperative care facility and PACE within an existing building located at 165 N. Myrtle Avenue and 14851 Yorba Street. This request is identified as CUP 2022-0019. The Community Development Department has reviewed your submittal and in conformance with Government Code Section 65943,this letter serves as a notification that your application is deemed 'Pending Complete" with a tentative public hearing before the Planning Commission on Tuesday, January 24, 2023 at 7:00 p.m. For your application to be deemed complete and scheduled for a public hearing, all materials identified below must be addressed and provided by Thursday, December 8, 2022. ■ Provide an operations and security plan (Refer to Exhibit A — draft Conditional of Approval 2.2) that includes, but not limited to, intake and discharge policies and procedures, policies and procedures related to preference for Tustin residents, on-site security measures, no loitering policies and procedures, and 24-hour contact person. The Draft Conditions of Approval are attached for your reference. Please note that draft conditions of approvals of approval may be amended based upon a review of the submitted operations and security plan. When you are ready, please email the pending information to Imaldonadoa,tustinca.orq. Should you have any questions or concerns regarding this project, please contact me by email or at(714) 573-3174. �Sin(ccerely, 'Ire � . f-4, Jorge Maldonado Associate Planner Attachment: Exhibit A— Draft Conditions of Approval cc: Raymond Barragan,Principal Planner Irma Huitron,Assistant Director Community Development-Planning 300 Centennial Way,Tustin,CA 92780 ■ 714-573-3000 tustinca.org CUP 2022-0019 165 N. Myrtle Ave. and 14851 Yorba St. Exhibit A—Draft Conditions of Approval Page 1 i EXHIBIT A DRAFT CONDITIONS OF APPROVAL CONDITIONAL USE PERMIT(CUP) 2022-0019 165 N. MYRTLE AVE. AND 14851 YORBA ST. GENERAL (1) 1.1 The proposed project shall substantially conform with the plans dated January 24, 2023, on file with the Community Development Department, as herein modified, or as modified by the Community Development Director in accordance with this Exhibit. The Community Development Director may also approve subsequent minor modifications to plans if such modifications are consistent with provisions of the Tustin City Code (TCC) and other applicable codes. (1) 1,2 The conditions contained in this Exhibit shall be complied with as specified, subject to review and approval by the Community Development Department. (1) 1.3 This approval shall become null and void unless the use is established within twelve (12) months of the date of this Exhibit. Time extensions may be granted if a written request is received by the Community Development Department within thirty(30) days prior to expiration. (1) 1.4 Approval of CUP 2022-0019 is contingent upon the applicant and property owner signing and returning to the Community Development Department a notarized "Agreement to Conditions Imposed" form and the property owner signing and recording with the County Clerk-Recorder a notarized "Notice of Discretionary Permit Approval and Conditions of Approval"form. The forms shall be established by the Community Development Director, and evidence of recordation shall be provided to the Community Development Department. (1) 1.5 Any transfer of ownership of the establishment and/or operator shall require the new owner and/or operator to sign and return an "Agreement to Conditions Imposed" form provided by the Community Development. SOURCE CODES (1) STANDARD CONDITION (5) RESPONSIBLE AGENCY REQUIREMENT (2) CEQA MITIGATION (6) LANDSCAPING GUIDELINES (3) UNIFORM BUILDING CODE/S (7) PC/CC POLICY (4) DESIGN REVIEW "`"`* EXCEPTION CUP 2022-0019 165 N.Myrtle Ave. and 14851 Yorba St, Exhibit A—Draft Conditions of Approval Page 2 (1) 1.6 Any violation of any of the conditions imposed is subject to the issuance of an Administrative Citation pursuant to TCC Section 1162(a). i (1) 1.7 CUP 2022-0019 may be reviewed at any time by the Community Development Director. The Community Development Director shall review the use to ascertain compliance with the Conditions of Approval. If the use is not operated in accordance with CUP 2022-0019, or is found to be a nuisance or negative impacts are affecting the surrounding tenants or neighborhood, the Community Development Director shall impose additional conditions to eliminate the nuisance or negative impacts, or may initiate proceedings to revoke the CUP. (1) 1.8 As a Condition of Approval of CUP 2022-0019, the applicant shall agree, at its sole cost and expense, to defend, indemnify, and hold harmless the City, its officers, employees, agents, and consultants, from any claim, action, or proceeding brought by a third party against the City, its officers, agents, and employees, which seeks to attack, set aside, challenge, void, or annul an approval of the City Council, the Planning Commission, Zoning Administrator, or any other decision-making body, including staff, concerning this project, The City agrees to promptly notify the applicant of any such claim or action filed against the City and to fully cooperate in the defense of any such action. The City may, at its sole cost and expense, elect to participate in the defense of any such action under this condition. (1) 1,9 The applicant shall be responsible for costs associated with any necessary code enforcement action, including attorney's fees,subject to the applicable notice, hearing, and appeal process as established by the City Council by ordinance. (1) 1.10 All Conditions of Approval for CUP 2022-0019 shall remain in full force and effect for as long as the facility continues to operate. (1) 1.11 The applicant shall obtain the appropriate permits and approvals from the State Department of Health Care Access and Information (HCAI), and any other applicable regulatory agencies. USE RESTRICTIONS (***) 2.1 A maximum total of 119 beds and occupants is authorized between both structures for the recuperative care component of the facility's operations. A maximum of 100 on-site participants is authorized for the Program of All- Inclusive Care for the Elderly(PACE)component of the facility's operations. i i i CUP 2022-0019 165 N. Myrtle Ave. and 14861 Yorba St. Exhibit A—Draft Conditions of Approval Page 3 i (***} 2.2 The applicant must submit and operate in accordance to the approved operations I security plan. The applicant shall obtain approval from the Community Development Department prior to implementing any changes to a previously approved operations /security plan and prior to the commencement of the operation. The operations 1 security plan must include, but is not limited to addressing the following: a) Intake and discharge policies and procedures b) Policies and procedures related to preference for Tustin residents. c) On-site security measures, including policies and procedures d) No loitering policies and procedures e) 24-hour contact person, including name, telephone number and affiliation. Additional operations procedures may be requested and added based on the review of the Community Development Director and Chief of Police. i (***} 2.3 Prior to operating, the applicant must coordinate with the Public Works Department to remove a segment of red curbing along the west side of Myrtle Avenue. (***} 2.4 Prior to operating, the applicant must equip the vehicle gaffe to the underground parking structure with a knox box and enable it to automatically open and close for vehicles to ensure access by safety personnel. All necessary approvals and permits must be obtained from OCFA and the Building Division. (1) 2.5 Prior to obtaining sign permits, the applicant shall submit a Master Sign Program for review to the Community Development Department. Approval of a Master Sign Program in the "Public and Institutional' (PI) District is subject to obtaining approval of a Conditional Use Permit. PLAN SUBMITTAL (***) 3.1 The applicant shall submit plans approved by HCAI to the Community Development Department for review. If satisfactory, a building permit will be issued and the appropriate inspections must then be requested from the Tustin Building Division as construction occurs. i i CUP 2022-0019 165 N. Myrtle Ave. and 14851 Yorba St. Exhlblt A—Draft Conditlons of Approval Page 4 (1) 3.2 At the time of submittal, plans shall. • Identify the occupancy groups proposed for the building. • Identify the type of construction of the building. • Provide NFPA 13 automatic fire sprinklers. • Provide the appropriate number of van accessible and standard accessible parking spaces, including showing the accessible route to the building entrance. • Comply with the current California Green Building Standards Code Mandatory Measures. FEES (1,5) 4.1 Within forty-eight(48) hours of approval of the subject project, the applicant shall deliver to the Community Development Department, a cashier's check payable to the COUNTY CLERK in the amount of fifty dollars ($50.00) to enable the City to file the appropriate environmental documentation for the project. If within such forty-eight (48) hour period the applicant has not delivered to the Community Development Department the above-noted check, the statute of limitations for any interested party to challenge the environmental determination under the provisions of the California Environmental Quality Act could be significantly lengthened. i I i i I i I I i Exhibit E DocuSlgn Envelope ID: 86A42A51-QOAc-42EA-A6BA-4300CB782887 AGENDA REPORT ITEM #3 MEETING DATE: JANUARY 24, 2023 TO: PLANNING COMMISSION FROM: COMMUNITY DEVELOPMENT DEPARTMENT SUBJECT: CONDITIONAL USE PERMIT (CUP) 2022-0019 SUMMARY: CUP 2022-0019 Is a request to establish a hospital use providing recuperative care and short- term post-hospitalization housing needs for individuals experiencing homelessness and low and extremely-low income individuals with an ancillary Program of All-Inclusive Care for the Elderly (PACE) and support services for the elderly within the existing buildings located at 14851 Yorba Street and 165 N. Myrtle Avenue. The proposed uses are described as follows: Recuperative care is short-term housing for individuals experiencing homelessness who are healing from an injury or illness and could benefit from medical oversight while completing their recovery, The program is inclusive of comprehensive care management and housing navigation services paired with traditional medical oversight from trained professionals for up- to-90-day stay. Guests of this program have daily interaction with medical professionals and receive medication education to ensure they continue to heal after their hospitalization. The care management and housing navigation services provided help members to become "housing ready" with the necessary documents that enable access to housing. Guests also receive referrals to job training, substance use disorder services, and any other community supports that prepare them to make a permanent move home. Short-term post-hospitalization housing functions similarly to recuperative care; however, offers an extended stay of up to six (6) months. Most individuals utilizing this service transition from recuperative care at the end of 90 days. PACE is a home and community-based service that provide medical services and supports everyday living needs for specific older individuals. Individuals accessing these services would live both on-site and within the boarder Tustin area. PACE offers complete health care and social support within one (1) program, enabling older adults to remain living in the community and outside of institutions. The program provides complete health care and support social support within one (1) program, including on- site medical care, a day-activity center, transportation, rehabilitation therapies, meals, home care, medications, medical equipment, and hospital and long-range care coverage, DocuSign Envelope ID:86A42A51-00AC-42EA-A6BA-4300CB782887 CUP 2022-0019 January 24, 2023 Page 2 I The project site is 2.27 acres and is located within the Public and Institutional (PI) District. Pursuant to TCC 9245(b), hospital uses, or uses which, in the opinion of the Community Development Director and/or Planning Commission, are similar and are allowed, subject to the approval of a CUP. Staff is requesting a continuance of this item to provide the applicant an opportunity to provide additional information regarding the proposed day-to-day operations. Staff is requesting that the item be continued to a date uncertain. RECOMMENDATION: That the Planning Commission continue the public hearing on CUP 2022-0019 to a date uncertain. DocuSlBned by: EDocuSlgned by: �V1M �1u�Vbw ►Mbin,� 1jc�Va�aln' 2E5aAE588F82047F... E4 A57E1057540F,,. Irma Huitron Raymond Barragan Assistant Director- Planning Principal Planner DocuSinned by: �uo�iha, �. ln�iQQkaw� ED45DA2823954A5.- Justina L. Willkom Community Development Director I I i i i Exhibit F "ri~- Community Development Department Remembering what connects us. March 10, 2023 Kelly Bruno-Nelson, Executive Director CalAIM CalOptima Health SOS City Parkway West Orange, CA 92868 SUBJECT: INCOMPLETENESS OF CONDITIONAL USE PERMIT (CUP) 2022-0019: A REQUEST TO ESTABLISH RECUPERATIVE CARE/SHORT-TERM POST HOSPITALIZATION HOUSING SERVING THE HOMELESS AND PROGRAM OF ALL-INCLUSIVE CARE (PACE) AT 165 NORTH MYRTLE AVENUE AND 14851 YORBA STREET Dear Ms. Bruno-Nelson: Thank you for your supplemental application materials, received on February 61 and 10", 2023.The CUP application proposes to establish a recuperative care/short-term post hospitalization housing serving the homeless and PACE within an existing building located at 165 North Myrtle Avenue and 14851 Yorba Street.This request is identified as CUP 2022-0019. The Community Development Department has reviewed your submitted supplemental materials, and in conformance with Government Code Section 65943,this is notification that your application is considered incomplete. For your application to be considered complete, all information, exhibits, and materials identified in Exhibit A must be provided, and all comments addressed. Please address each comment, and submit two (2) sets of plans, and an electronic copy for review. If changes are incorporated into plans, identify plan sheet and note number within the written response to staff comments. When you are ready to resubmit your project, please contact me so that arrangements can be made to accept the resubmittat. Should you have any questions or concerns regarding this project, please contact me at (714) 573-3016 or rbarragan(cPtust.inca.arg. Respectfully, Raymond Barragan, Principal Planner Attachment Exhibit A-Comments and Corrections cc' Justina L.WiRom,Community Devetopment Director Irma Huitron,Assistant Director—Planning Douglas D.❑umhart,Consultant 300 Centennial Way,Tustin,CA 92780 • 714-573-3000 tustinca.org EXHIBIT A COMMENTS AND CORRECTIONS CUP 2022-0019 CALOPTIMA RECUPERATIVE CARE/SHORT-TERM POST HOSPITALIZATION HOUSING SERVING THE HOMELESS AND PACE FACILITY LOCATED AT 165 MYRTLE AVENUE AND 14851 YORBA STREET On January 26, 2023, the Community Development Department transmitted via email a list of questions and comments seeking clarification regarding the operations plan and security measures associated with the application request for Conditional Use Permit (CUP) application 2022-0019 (Project). Responses to those questions/comments were submitted by the applicant on February 6th and 10th, 2023. The documents submitted consisted of an "annotated plan floor plan" and a document entitled "Community Living Center of Tustin -Operations and Security Plan" (Plan). In addition, on February 23, 2023, staff toured a PACE facility in Garden Grove operated by the applicant and the proposed location at 165 Myrtle Avenue and 14851 Yorba Street. 1. It has been determined that the information contained in the responses to comments and the Plan are insufficient for staff to complete a thorough analysis of the proposed project. The Plan provided contains high-level descriptions of policies and procedures associated with the operations and security measures; however, the Plan lacks details to describe the implementation of procedures and security measures. The following is an example of how the Plan does not provide the level of detail needed for Staff's analysis to determine that proper Findings can be made for the CUP request pursuant to TCC 9291 c. EXAMPLE #1 In the Plan Section, Page 31, subheading "Alcohol and Drug Protocol", the following is stated: Guests will be made aware that drugs and alcohol are not permitted at the Community Living Center and educated on this policy during the Guest Orientation process that occurs upon admission. Guest belongings will be scanned upon admission. All staff will be trained to identify behaviors commensurate with drug use to ensure the safety of all Guests. The consistent Rounding Program (detailed above) will provide consistent monitoring of the facility to ensure illegal drug use does not occur. Finally, should a Guest be observed using drugs or alcohol, they will be reminded of the policy they agreed to upon admission. Should a guest need to be reminded a second time, they will be disenrolled from the program. The above narrative does not address how the Alcohol and Drug Protocol will be implemented, and as such, the following questions remain unanswered: CalOptima Incompleteness letter 2nd Submittal March 10, 2023 Exhibit A; Comments and Corrections Page 2 of 7 I • How will guests be made aware of the drug and alcohol policy? Will guests sign and agree to a code of conduct prior to admittance that clearly advises them of their responsibilities and expressly consents to searches of their belongings? Is there a draft Guest Code of Conduct that can be provided as an attachment? • Confirm guests will not be required to sign lease or occupancy agreements. • In addition to when a guest is admitted to the facility, will guests' belongings be subject to search in the event that facility staff observes, or has reason to believe, that a guest is in violation of the protocol? • What constitutes "observed using drugs or alcohol?" Does that include a guest who returns to the facility intoxicated after consuming drugs and/or alcohol at an offsite location? If so, how will staff/security engage with the guest? Are the consequences the same? • What training will staff receive to identify signs of an intoxicated guest? Is training required on a recurring basis? The example above is provided to demonstrate the need for the Plan to include details regarding implementation. Upon resubmittal, the Plan should be tailored to the proposed project and clearly define obligations related to implementation, monitoring and reporting. The comments and questions provided on the Plan are not exhaustive and are only provided to illustrate the need for additional information. I 2. Please clarify how the recuperative care/short-term post hospitalization program differs from each of the following: emergency shelter. navigation center, transitional housing, and homeless shelter. MONITORING OF CLIENTS 3. Coordinated Entry System (page 36). The Plan states: "Kelly Bruno-Nelson, CalOptima Health's Executive Director of Medi-Cal and CalAIM currently serves on the Board of the County of Orange Continuum of Care. CalOptima Health has access [emphasis added] to the Coordinated Entry System and plans to utilize this system at the Community Living Center." Please specify if the proposed operation would incorporate the use of the CES into its day-to-day operations, and if so: �I i i CalOptima Incompleteness letter 2nd Submittal March 10, 2023 i Exhibit A; Comments and Corrections Page 3 of 7 I a. How will CES be utilized? b. What are the qualifications/requirements the applicant must meet to utilize CES? i c. If applicant's leadership changes, will the applicant continue to have access to CES? If not, what will be used instead of CES? 4. Specify if applicant will enter clients into the Homeless Management Information System (HMIS). Explain why or why not? i 5. Elaborate on the "Interdisciplinary team/guest services" mentioned on pages 8, 21, and 30. Specifically, elaborate on how the applicant will ensure that the post- hospitalization clients will be supported to ensure that they transition to transitional or permanent housing. a. Identify the services the applicant will provide to assist guests to identify and j apply for housing, obtain benefits and connect with available resources. 6. Provide a list of partners (i.e., service providers such as non-profit organizations) that will potentially provide housing to clients post-hospitalization. Clarify if such partnerships are currently in place by existing contracts/agreements, or other means. Specify in detail that applicant's method for identifying permanent housing. 7. Provide a list of partners (i.e., service providers such as non-profit organizations) that will potentially provide services to guests. Clarify if such partnerships are currently in place by existing contracts/agreements, or other means. 8. Provide data and statistics related to the success rate for placement of individuals into permanent housing after completion of stay. If none available for CalOptima, please specify in writing why, and provide alternative data for other recuperative care facilities (i.e. Illumination Foundation facility in Fullerton). 9. Identify applicant's procedures and processes for handling "missing adult reports" and state whether such individuals would be classified as "at-risk". OPERATIONS 10. Remove references to the "Village of Hope" operation and revise to specify how the proposed operation will be implemented for the proposed use. 11. Define "local preference" and description of how the policy will be implemented, monitored and reported to the City of Tustin. i CalOptima Incompleteness letter 2nd Submittal March 10, 2023 Exhibit A; Comments and Corrections Page 4 of 7 I a. Identify all funding sources utilized by the applicant for the Project and confirm that the `local preference' is consistent with the requirements for all Project funding. b. If Tustin Police and Tustin Shelters are allowed to refer guests, will CalOptima also be required to accept guests from other police departments and/or shelters? 12. Provide a comparison chart that describes the differences between recuperative care program and short-term post hospitalization care program. 13. Confirm whether any funding source for the Project requires acceptance of hospital referrals to the recuperative care/short-term post hospitalization program. If so, please identify each such funding source and identify the specific requirement(s). 14. Confirm whether any funding source for the Project requires hospital referrals for each guest to qualify for the recuperative care/short-term post hospitalization program. If so, please identify each such funding source and identify the specific requirement(s). 15. Provide a typical daily itinerary for (1) PACE only client and (2) a Recuperative Care/Short-Term Post Hospitalization client that is also a PACE client. 16. Provide a list of medical care services that are provided to guests in the recuperative care/short-term post hospitalization program. 17. Provide a list of other recuperative care/short-term post hospitalization program facilities associated with and/or operated by CalOptima and explain CalOptima's role at each such facility. FLOOR PLAN I 18. Confirm the proposed quantity and location(s) of all primary points of access to the j facility from Yorba Street. During the tour of the project site, CalOptima verbally indicated that there will a single point of entry to the facility facing Yorba Street (covered entry); however, the floor plan shows two (2) independent entrances, one that is the covered entry and the other identified as the "PACE Entrance" shown on Sheet A2.1 b. 19. The applicant verbally stated the interior floor plan would not change; however, the submitted plans indicate demolition of walls which implies that tenant improvements are planned. Please provide a scope of work that is consistent with the plans submitted. Revise and resubmit plans as needed. I CalOptima Incompleteness letter 2nd Submittal March 10, 2023 Exhibit A; Comments and Corrections Page 5 of 7 20. During the site visit, CalOptima indicated there would be rooms with single beds but none are shown on the floor plan. Please clarify which is correct and revise and resubmit floor plans as needed. SUBMITTED NARRATIVE OPERATOR INFORMATION 21. Recuperative/Post-hospitalization: a) Provide a list of other locations operated by CalOptima for Recuperative and/or Post-hospitalization. b) Provide a list of other recuperative and/or post-hospitalization facilities in Orange County and, if none, other locations. 22. It is our understanding that CalOptima has a project that combines a medical clinic with affordable housing. Please clarify how the recuperative care/short-term post hospitalization program functions either similarly or differently from such facility. 23. Provide the name of the entity that will be responsible for the day-to-day operation of the facility and the name of a person that will be the City contact once the facility is operational. If CalOptima, then please confirm that information in writing. If services will be outsourced to other providers, please identify the providers. Please provide a chart that describes which, if any, operational responsibilities that will not be contracted to another entity or party. 24. Please provide a summary of staffing, including quantity by position title and number, listed separately for (1) Recuperative/Short-Term Housing and (2) PACE separately. Supplement this information with an organizational chart to demonstrate the responsible parties for the various areas that comprise the proposed operations. 25. Provide a justification for the number of beds proposed. 26. Provide a separate narrative that explains the association between CalOptima and CalAIM. 27. Provide clarification regarding the statement that guests will not be counted towards the Point in Time Count in light of the requirement that guests must be homeless to participate in the recuperative care/short-term post hospitalization program and, upon such participation, would be "sheltered". i CalOptima Incompleteness letter 2nd Submittal March 10, 2023 Exhibit A; Comments and Corrections Page 6of7 Site Tour Follow-up Questions 28. City staff was informed that no pets would be allowed at site for recuperative care/short-term post hospitalization program clients; however, Page 37 of the Plan states pets would be allowed in up to ten (10) rooms. Please clarify. If pets are allowed, please be specific as to the size of pets, number of pets, and identify any j boarding or keeping areas for pets in the site and floor plans. 29. City staff was informed that clients in recuperative housing can leave and are not on "lock down." Please provide procedures that the applicant will implement to ensure clients are accounted for overnight. In addition, please clarify how staff identifies registered clients from visitors. Please also identify how loitering at or near the exterior of the Project will be monitored and prevented or discouraged. Be specific on the responsible party for monitoring and specify consequences for violating the curfew and who will be responsible for implementing those consequences. ON-SITE CIRCULATION � 30. Provide a gp g queuing Ian with shuttle turning radius to demonstrate that the shuttles q can load and unload on-site without causing conflicts to building entries/exits, no queuing off-site onto street, not impeding on drive-aisles, and not impeding on-site circulation. 31. Label and indicate any loading areas for laundry and/or cafeteria food service deliveries, and any other vendors that may deliver to the site as part of the day-to- day operations. PROJECT DATA 32. Provide a parking summary for all employees and anticipated guests and demonstrate that required parking can be provided on-site. i i 33. Project Data — Sheet A0.1 (i.e., units vs. beds) a) Revise "Total number of units"to "Total number of rooms". Project does not include an independent kitchen for each room; therefore, these are not considered "units". 34. Specify the Building Occupancy Type proposed for the recuperative care and PACE sections of the buildings. Indicate whether any State or other regulatory agency would be required to review and approve floor plan modifications, building/site improvements? I i CalOptima Incompleteness letter 2nd Submittal March 10, 2023 Exhibit A; Comments and Corrections Page 7 of 7 GUEST SCREENING/REQUIREMENTS 35. How will guests' medical qualification to participate in the recuperative care/short- term post hospitalization program be determined and by whom? What are the criteria? 36. Once guests' medical needs have been met (i.e. they have healed from their injury or illness and/or are medically stable), what funding sources will be used to finance their continued occupancy at the recuperative care/short-term post hospitalization program? 37. Will guests be permitted to utilize the Project more than once in their lifetime? If so, what are the policies regarding returning guests? 38. Page 8 of the Plan states that Cal-Optima is the only Medi-Cal Health Plan in Orange County and, therefore all guests admitted to the recuperative care /short- term post hospitalization program will be CalOptima Health members. What happens if another Medi-Cal Health Plan starts operating in Orange County? COMMUNITY ENGAGEMENT 39. Please describe the applicant's proposed community engagement program during the entitlement process. 40. Please provide additional detail regarding the applicant's good neighbor policy and procedures after entitlement. ZONING 41. The proposed site has a combined zoning designation of Public Institution, Professional and Specific Plan 9. The City reserves the right to revisit the zoning of the Project based on the information received from the applicant as it affects the j proper land use determination and categorization of the Project. If determined to be necessary, approval of a Zone Change (ZC) and General Plan Amendment (GPA) by the Planning Commission and the City Council may be required. i i it I Exhibit G i CalOptima's Responses to the City's Incomplete Letter dated March 10, 2023 EXHIBIT A COMMENTS AND CORRECTIONS CUP 2022-0019 CALOPTIMA RECUPERATIVE CARE/SHORT-TERM POST HOSPITALIZATION HOUSING SERVING THE HOMELESS AND PACE FACILITY LOCATED AT 165 MYRTLE AVENUE AND 14851 YORBA STREET On January 26, 2023, the Community Development Department transmitted via email a list of questions and comments seeking clarification regarding the operations plan and security measures associated with the application request for Conditional Use Permit (CUP) application 2022-0019 (Project). Responses to those questions/comments were submitted by the applicant on February 6th and 10th, 2023. The documents submitted consisted of an "annotated plan floor plan" and a document entitled "Community Living CenterofTustin-Operations and Security Plan" (Plan). In addition,on February 23,2023, staff toured a PACE facility in Garden Grove operated by the applicant and the proposed location at 165 Myrtle Avenue and 14851 Yorba Street. City's Questions_ 3-10-23 1. The above narrative does not address how the Alcohol and Drug Protocol will be implemented, and as such, the following questions remain unanswered: • Haw will guests be made aware of the drug and alcohol policy? Please see original answer in Security Policies section, subsection Security Plan, second subsection Alcohol and Drug Protocol. • Will guests sign and agree to a code of conduct prior to admittance that clearly advises them of their responsibilities and expressly consents to searches of their belongings? Original answer in Operations Plan section, subsection Code of Conduct • Is there a draft Guest Code of Conduct that can be provided as an attachment? Original answer in Operations Plan section, subsection Code of Conduct. • Confirm guests will not be required to sign lease or occupancy agreements. Guests are not requested to sign a lease or occupancy agreement. Please see new FAQ #25 • In addition to when a guest is admitted to the facility, will guests' belongings be subject to search in the event that facility staff observes, or has reason to believe, that a guest is in violation of the protocol? Original answer in Operations Plan section, subsection Code of Conduct, second subsection Recuperative Care/Post Hospitalization and updated answer in Page 1 of 19 Security Policies section, subsection Security Plan, second subsections Alcohol and Drug Protocol and Weapons Protocol. • What constitutes "observed using drugs or alcohol?" Updated answer in Security Policies section, subsection Security Plan, second subsections Alcohol and Drug Protocol. • Does that include a guest who returns to the facility intoxicated after consuming drugs and/or alcohol at an offsite location? Updated answer in Security Policies section, subsection Security Plan, second subsections Alcohol and Drug Protocol. ■ If so, how will staff/security engage with the guest? Updated answer in Security Policies section, subsection Security Plan, second subsections Alcohol and Drug Protocol. + Are the consequences the same? Updated answer in Security Policies section, subsection Security Plan, second subsections Alcohol and Drug Protocol. + What training will staff receive to identify signs of an intoxicated guest? Original answer in Security Policies section, subsection Security Plan. + Is training required on a recurring basis? Original answer on in Security Policies section, subsection Security Plan. 2. Please clarify how the recuperative care/short-term post hospitalization program differs from each of the following: emergency shelter. navigation center transitional housing, and homeless shelter. Answered in new FAQ #23 and new Appendix F MONITORING OF CLIENTS 3. Coordinated Entry System (page 35). The Plan states: "Kelly Bruno-Nelson, CalOptima Health's Executive Director of Medi-Cal and CalAIM currently serves on the Board of the County of Orange Continuum of Care. CalOptima Health has access [emphasis added] to the Coordinated Entry System and plans to utilize this system at the Community living Center." Please specify if the proposed operation would incorporate the use of the CES into its day-to-day operations, and if so: a. How will CES be utilized? Updated answer in FAQ #12 b. What are the qualifications/requirements the applicant must meet to utilize CES? Updated answer in FAQ 912 Page 2 of 19 c. If applicant's leadership changes, will the applicant continue to have access to CES? If not, what will be used instead of CES? Updated answer in FAQ #1 2 4. Specify if applicant will enter clients into the Homeless Management Information System (HMIS). Explain why or why not? Updated answer in FAQ #12 5. Elaborate on the "Interdisciplinary team/guest services" mentioned on pages 8, 21, and 36. Specifically, elaborate on how the applicant will ensure that the posthospitalization clients will be supported to ensure that they transition to transitional or permanent housing. Answer in Operations Plan section, subsection Intake/ Admission Process, second subsection Recuperative Care/Post Hospitalization Program, third subsection Development of a Housing and Care Plan a. Identify the services the applicant will provide to assist guests to identify and apply for housing, obtain benefits and connect with available resources. Answer in Operations Plan section, subsection Intake/ Admission Process, second subsection Recuperative Care/Post Hospitalization Program, third subsection Development of a Housing and Care Plan 6. Provide a list of partners (i.e., service providers such as non-profit organizations) that will potentially provide housing to clients post-hospitalization. Clarify if such partnerships are currently in place by existing contracts/agreements, or other means. Specify in detail that applicant's method for identifying permanent housing. Answered in FAQ # 34, Appendix H and Operations Plan section, subsection Intake/ Admission Process, second subsection Recuperative Care/Post Hospitalization Program, third subsection Development of a Housing and Care Plan 7. Provide a list of partners (i.e., service providers such as non-profit organizations) that will potentially provide services to guests. Clarify if such partnerships are currently in place by existing contracts/agreements, or other means. Answered in FAQ # 35 and Appendix I 8. Provide data and statistics related to the success rate for placement of individuals into permanent housing after completion of stay. if none available for CalOptima, please specify in writing why, and provide alternative data for other recuperative care facilities (i.e. Illumination Foundation facility in Fullerton). Answered in FAQ #26 9. Identify applicant's procedures and processes for handling "missing adult reports" and state whether such individuals would be classified as "at-risk". Answered in Security Policies section, subsection Security Plan, second subsection C u rfew. Page 3 of 19 OPERATIONS 10.Remove references to the "Village of Hope" operation and revise to specify how the proposed operation will be implemented for the proposed use. Completed 11.Define "local preference" and description of how the policy will be implemented, monitored and reported to the City of Tustin. Answered in Operations Plan section, subsection Local Priority Policy a. Identify all funding sources utilized by the applicant for the Project and confirm that the `local preference' is consistent with the requirements for all Project funding. Please see updated answered in FAQ #13 b. If Tustin Police and Tustin Shelters are allowed to refer guests, will CalOptima also be required to accept guests from other police departments and/or shelters? Answered in Operations Plan section, subsection Intake/Admission Process, second subsection Recuperative Care/Post Hospitalization Program. 12.Provide a comparison chart that describes the differences between recuperative care program and short-term post hospitalization care program. Answered in new FAQ # 24 and new Appendix F 13.Confirm whether any funding source for the Project requires acceptance of hospital referrals to the recuperative care/short-term post hospitalization program. If so, please identify each such funding source and identify the specific requirements). Answered in updated FAQ #13 14.Confirm whether any funding source for the Project requires hospital referrals for each guest to qualify for the recuperative care/short-term post hospitalization program. If so, please identify each such funding source and identify the specific requirements). Answered in Appendix F 15.Provide a typical daily itinerary for (1) PACE only client and (2) a Recuperative Care/Short-Term Post Hospitalization client that is also a PACE client. Answered in Appendix B updated to include both itineraries. 16.Provide a list of medical care services that are provided to guests in the recuperative care/short-term post hospitalization program. Answered in Operations Plan section, subsection Program Scope of Services, second subsection Recuperative Care/Post Hospitalization Program. Page 4 of 19 17.Provide a list of ether recuperative care/short-term post hospitalization program facilities associated with and/or operated by CalOptima and explain CalOptima's role at each such facility. Originally answer in FAQ #10 FLOOR PLAN 18.Confirm the proposed quantity and location(s) of all primary points of access to the facility from Yorba Street. During the tour of the project site, CalOptima verbally indicated that there will a single point of entry to the facility facing Yorba Street (covered entry); however, the floor plan shows two (2) independent entrances, one that is the covered entry and the other identified as the "PACE Entrance" shown on Sheet A2.1 b. There is one single point of entry for each program as shown on Sheet A2.1 b 19.The applicant verbally stated the interior floor plan would not change; however, the submitted plans indicate demolition of walls which implies that tenant improvements are planned. Please provide a scope of work that is consistent with the plans submitted. Revise and resubmit plans as needed. Answered in new FAQ #27 20.During the site visit, CalOptima indicated there would be rooms with single beds but none are shown on the floor plan. Please clarify which is correct and revise and resubmit floor plans as needed. Answered in new FAQ #28 SUBMITTED NARRATIVE OPERATOR INFORMATION 21.Recuperative/Post-hospitalization: a. Provide a list of other locations operated by CalOptima for Recuperative and/or Post-hospitalization. See original answer in FAQ #10 b. Provide a list of other recuperative and/or post-hospitalization facilities in Orange County and, if none, other locations. Answered in new FAQ #26 22.It is our understanding that CalOptima has a project that combines a medical clinic with affordable housing. Please clarify how the recuperative care/short-term post hospitalization program functions either similarly or differently from such facility. This is not accurate. CalOptima does not have a project as described above. 23.Provide the name of the entity that will be responsible for the day-to-day operation of the facility and the name of a person that will be the City contact once the facility is operational. If CalOptima, then please confirm that information in writing. If Page 5 of 19 services will be outsourced to other providers, please identify the providers. Please provide a chart that describes which, if any, operational responsibilities that will not be contracted to another entity or party. Answered in Appendix 1 24.Please provide a summary of staffing, including quantity by position title and number, listed separately for (1) Recuperative/Short-Term Housing and (2) PACE separately. Supplement this information with an organizational chart to demonstrate the responsible parties for the various areas that comprise the proposed operations. Originally FAQ #21 and additional FAQ #22 and Appendix 1 25.Provide a justification for the number of beds proposed. Answered in Executive Summary 26.Provide a separate narrative that explains the association between CalOptima and CaIAIM? Answered in new FAQ # 33 and new Appendix G 27.Provide clarification regarding the statement that guests will not be counted towards the Point in Time Count in light of the requirement that guests must be homeless to participate in the recuperative care/short-term post hospitalization program and, upon such participation, would be "sheltered". Answered in updated answer in FAQ #4 Site Tour Follow-up Questions 28.City staff was informed that no pets would be allowed at site for recuperative care/short-term post hospitalization program clients; however, Page 37 of the Plan states pets would be allowed in up to ten (10) rooms. Please clarify. If pets are allowed, please be specific as to the size of pets, number of pets, and identify any boarding or keeping areas for pets in the site and floor plans. Answered in updated answer in FAQ #19 29.City staff was informed that clients in recuperative housing can leave and are not on "lock down." • Please provide procedures that the applicant will implement to ensure clients are accounted for overnight. Answered in Security Policies section, subsection Security Plan, second subsection Rounding Program. • In addition, please clarify how staff identifies registered clients from visitors. Answered in Security Policies section, subsection Security Plan, second subsection Sign in and Out Protocol. Page 6 of 19 • Please also identify how loitering at or near the exterior of the Project will be monitored and prevented or discouraged, Answered in Security Policies section, subsection Loitering. • Be specific on the responsible party for monitoring and specify consequences for violating the curfew and who will be responsible for implementing those consequences. Answered in Security Policies section, subsection Security Plan, second subsection Curfew. ON-SITE CIRCULATION 30.Provide a queuing plan with shuttle turning radius to demonstrate that the shuttles can load and unload on-site without causing conflicts to building entries/exits, no queuing off-site onto street, not impeding on drive-aisles, and not impeding on-site circulation, Addressed in revised Sheet A1.1 of the plan set. 31.Label and indicate any loading areas for laundry and/or cafeteria food service deliveries, and any other vendors that may deliver to the site as part of the day-today operations. Answered in Appendix DA PROJECT DATA 32.Provide a parking summary for all employees and anticipated guests and demonstrate that required parking can be provided on-site. Addressed in the Project Data section of Sheet A0.1 of the plan set. 33.Project Data — Sheet A0.1 (i.e., units vs. beds) a) Revise "Total number of units" to "Total number of rooms". Project does not include an independent kitchen for each room; therefore, these are not considered "units". No answer required. 34.Specify the Building Occupancy Type proposed for the recuperative care and PACE sections of the buildings. Indicate whether any State or other regulatory agency would be required to review and approve floor plan modifications, building/site improvements? Answered in new FAQ #37 and on revised Sheet A0.1 of the plan set. GUEST SCREENINGIREQUIREMENTS 35.How will guests' medical qualification to participate in the recuperative care/short term post hospitalization program be determined and by whom' Page 7 of 19 Answered in Operations Plan section, subsection Eligibility Criteria, second subsection Recuperative Care/Post Hospitalization • What are the criteria? Answered in Operations Plan section, subsection Eligibility Criteria. Second subsection Recuperative Care/Post Hospitalization. 36.Once guests' medical needs have been met (i.e. they have healed from their injury or illness and/or are medically stable), what funding sources will be used to finance their continued occupancy at the recuperative care/short-term post hospitalization program? Answered in new FAQ #30 37.Will guests be permitted to utilize the Project more than once in their lifetime? If so, what are the policies regarding returning guests? Answered in new FAQ # 31 38.Page 8 of the Plan states that Cal-Optima is the only Medi-Cal Health Plan in Orange County and, therefore all guests admitted to the recuperative care /short term post hospitalization program will be CalOptima Health members. What happens if another Medi-Cal Health Plan starts operating in Orange County? Answered in new FAQ #Question #36 COMMUNITY ENGAGEMENT 39.Please describe the applicant's proposed community engagement program during the entitlement process. Answered in new FAQ #32 40.Please provide additional detail regarding the applicant's good neighbor policy and procedures after entitlement. Answered in Security Policies Section, subsection Good Neighbor Policy ZONING 41.The proposed site has a combined zoning designation of Public Institution, Professional and Specific Plan 9. The City reserves the right to revisit the zoning of the Project based on the information received from the applicant as it affects the proper land use determination and categorization of the Project. If determined to be necessary, approval of a Zone Change (ZC) and General Plan Amendment (GPA) by the Planning Commission and the City Council may be required. No answer required. Page 8 of 19 CalOptima's February 10, 2023 Responses to City's Request for Additional Information dated January 26, 2023. Request for Additional Information January 26, 2023 Conditional Use Permit 2022-0019 The Community Development Department is requesting clarification on information provided regarding Conditional Use Permit (CUP) application 2022-0019. Please see the questions and comments below which are organized by the document they reference. Please consolidate the responses to these questions with the responses and operation plan previously provided such that all information is submitted in one document. Also, to expedite our review, please provide separate documents under a different cover for (1) Operations Plan and Manual and (2) Security Plan. Operations and Security Plan dated 12-15-2022 I. FLOOR PLAN AND SITE PLAN: a. Identify on the floor plans the areas used for PACE vs. recuperative care vs. post- hospitalization housing. Consider shading or ❑utlining these areas in different colors. Identify what entrances will be used for specific programs. Answered in Appendix D b. Clarify if any new fencing is proposed around the perimeter of the property or building, and how access to and from the buildings, common outdoor areas, and underground parking is otherwise secured and controlled. The perimeters of the building are already enclosed which provides privacy as well as security. No additional fencing is being proposed. Security will be provided 24 hours a day, 365 days per year with 2417 monitoring of approximately 40 cameras (both inside and outside the building) by the Safety and Security team. This team consists of the Safety and Security Manager and 24 Guest Safety Associates. More detail can be found in FAQ #16 II. REGARDING PROJECT DESCRIPTION AND USE: a. Define "Community Living Center." Answered in Operations Plan section and FAQ # 11 b. Define eligibility criteria for the recuperative care program and short-term post- hospitalization housing. Answered in Eligibility Criteria section C. There has been conflicting information provided in the submittal. Page 9 of 19 i. Some narrative identifies clients are low and extremely low-income individuals with no defined age; other narrative identifies clients as unhoused older adults. Clarify if patients are limited to unhoused older adults or any individuals that are low or extremely low income. Define older adults. Answered in Eligibility Criteria section Older adult is defined in Operations Plan section d. Clarify if the facility is going to function as a Navigation Center for all homeless individuals or limited to registered patients only. Clarify the differences, if any, between the proposed use and a "navigation center." Answered in FAQ #1 and a new Table clarifying the differences between programs has been provided in Appendix E. e. Clarify if the site will provide housing to homeless individuals who do not need medical assistance or rehabilitation services. Answered in FAQ #Z L Confirm if services (recuperative or PACE) would be provided to families that are experiencing homelessness and/or meet income eligibility requirements, but who are not otherwise elderly or in need of medical care. Answered in FAQ #3 f. Clarify any differences between the recuperative care vs, short-term post- hospitalization program. Answered in the Operations Plan section, subsection Program Scope of Services, second subsection Recuperative Care/Post Hospitalization Program and a Table depicting program comparisons can be found in Appendix F. L Is there a difference in services provided, eligibility criteria, room locations within the center, etc.? Answered on Page 5 and the Table in Appendix F. ii. Is there a fixed number of beds available for the recuperative care program vs. the short-term post-hospitalization housing program? Answered in the Operations Plan section, subsection Program Scope of Services, second subsection Recuperative Care/Post Hospitalization iii. Are the 6 months of post-hospitalization housing in addition to the initial 96-day term of the recuperative program (so 9 months total)? Is there a time limit after the 6 months? How much longer can they stay? Answered in the Operations Plan section, subsection Program Scope of Services, second subsection Recuperative Care/Post Hospitalization and the Table in Appendix F Page 10 of 19 iv. Explain how insurance companies handle situations where guests exceed the 6- month term for post-hospitalization housing. Are guests automatically approved? How often is this anticipated to happen? Answered in the Operations Plan section, subsection Eligibility Criteria, second subsection Recuperative Care/Post Hospitalization g. What is expected of recuperative care/short-term housing participants in their role as care recipients? Answered in Operations Plan section, subsection Code of Conduct, second subsection Recuperative Care/Post Hospitalization Program. i. Will there be a curfew? If so, how will this be implemented or monitored? Our Code of Conduct Policy will request Guests observe a 1 a:ggpm curfew. Our Security Policies addresses how Guests will be monitored for compliance with policies and rules, ii. Will there be a no drug or alcohol use policy? If so, how will it be enforced? Answered in Security Policy Section, subsection Security Plan, second subsection Alcohol and Drug Protocol.. h. Is there a visitor policy for recuperative care/short-term housing recipients? Yes, this was preciously addressed, The visitor policy can be found in the Security Policy Section, subsection Security Plan, second subsection Visitors. i. What is CalOptima's or CaIAIM's affiliation with the County of Orange Continuum Care, Coordinated Entry System, etc.? The relationship has been clarified in FAQ # 12 j. Clarify the funding mechanism behind the program — on what basis are funds allocated from CalAIM to the center? Are there any other funding sources outside of CaIAIM? Additional information has been added to FAQ #13 k. Are Tustin community organizations, such as Families Together of Orange County, partnered with the center? This was previously addressed. We anticipate to partner with local qualified service providers but these organizations will need to respond to a formal Request for Proposals (RFP). Please refer to FAQ # 17 III. GENERAL a. Will guests in the recuperative care or short-term post-hospitalization housing programs be counted towards the Point in Time Count? Please clarify how guests are counted as sheltered or unsheltered. If they are counted as homeless individuals, to what cities are they to be assigned? Page 11 of 19 This was previously addressed in FAQ # 4. Guests are not counted in the Point in Time Count. IV, INTAKE AND DISCHARGE a. PACE: i. Clarify if other homeless individuals (not recuperative patients) can access the PACE center and its services. Answered in Operations Plan section, subsection Eligibility Criteria, second subsection PACE program. ii.Clarify and provide a map for the CalOptima PACE Service Area. Answered in Operations Plan section, subsection Eligibility Criteria, second subsection PACE program. iii. Define the "financial criteria" for PACE participants. Answered in Operations Plan section, subsection Eligibility Criteria, second subsection PACE program. iv. Provide a Code of Conduct with expectations for PACE participants. Answered in Operations Plan section, subsection Code ❑f Conduct, second subsection PACE program b. Recuperative Care: i. Define and clarify Recuperative Care and Post Hospitalization service areas. Can any person throughout the county receive services if they meet eligibility criteria? Answered in Operations Plan section, subsection Eligibility Criteria, second subsection Recuperative Care/Post Hospitalization Program ii. The Operation Plan states guests are patients discharged from hospitals. Clarify what hospitals guests will be received from. Provide a list of participating hospitals, if any. Answered in Operations Plan section„ subsection Eligibility Criteria„ second subsection Recuperative Care/Post Hospitalization Program iii. Define or provide information related to behavior expectations and Code of Conduct for recuperative care/post-hospitalization housing recipients. Answered in Operations Plan section, subsection Code of Conduct, second subsection Recuperative Care/Post Hospitalization Program iv. Clarify if homeless individuals can register themselves into the recuperative care and post-hospitalization housing programs. Page 12 of 19 Homeless registration was previously addressed in FAQ # 5. No homeless individuals are able to register themselves for recuperative care/post hospitalization. v. Clarify eligibility requirements for the recuperative care and post-hospitalization housing programs, such as individuals needing to have injuries, be referred by hospitals, etc. Answered in the Operations Plan Section, subsection Eligibility Criteria, second subsection Recuperative CarelPost Hospitalization. vi. For involuntary discharge, please identify potential discharge locations. Will guests be discharged to locations based upon their last known residences? If guests are from other cities (not Tustin) where will they be discharged? Does CalOptima have any cooperative agreement(s) with other shelters, affordable housing providers, non-profit organizations, etc. that will accept discharged individuals? Please describe the mechanism to allow guests to be discharged to the specific locations. Answered in Operations Plan section, subsection Discharge, second subsection Recuperative Care/Post Hospitalization, third subsection Involuntary discharge, vii. Can other shelters refer individuals to the program? If yes, how do you determine if guests are eligible? Do they need to be referred by a medical professionals or hospitals? Answered In Operations Plan section, subsection IntakelAdmission Process, second subsection Recuperative Care/Post Hospitalization viii. The program will provide preference for individuals that have ties to Tustin. How will this be provided? Is there a minimum number of beds set aside for Tustin individuals? Answered in Operations Plan section, subsection Local Priority Policy. C. Post Hospitalization: i. Clarify eligibility for the Post Hospitalization Housing Program. The narrative includes "quality care to older adult neighbors experiencing homelessness." Clarify if this program is limited to guests "terming out" of the recuperative care program only. If not, please clarify where guests originate from and how they are admitted to the program. Answered in Operations Plan section, subsection Eligibility Criteria, second subsection Recuperative Care/Post Hospitalization Program V. SECURITY b. Loitering Page 13 of 19 i. How many Managers on Duty will be present on-site? What are their weekday and weekends hours of availability? Are they available after regular business hours? If not, who is the point of contact at the center after hours? Answered in Security Policies Section, subsection Contact Information. J. What personnel are on the Neighborhood Engagement Team? How often do they meet, and what happens after they identify an issue? Answered in Securities Policies section, subsection Good Neighborhood Policy, second subsection Neighborhood Engagement Team c. Security Plan i. How many security personnel will be on-site during regular business hours (daytime) and after hours (nighttime)? What certifications, if any, would they have as security personnel? Answered in Security Policies section, subsection Security Plan. ii. Provide a detailed Security Management Plan for review and approval. The Security Management Plan shall include security measures to minimize impact to adjacent residential and non-residential uses from potential noise, pedestrian and vehicular activities (i.e. noise from ambulance, Fire trucks, loitering, etc.). The Security Management Plan shall also include measures to address loitering, illegal drugs/narcotic activities, illegal activities, security cameras, security alarms, procedures for calling Tustin Police Department regarding observed or reported crime, security measures during non-operating hours, training protocols for all employees and security personnel, and an after-hours single point of contact for the Police Department prior to the commencement of the proposed use. Answered in Security Policies Section, subsection Security Plan, iii. Define the protocol for ensuring guests do not use illegal drugs. Answered on page 37 iv. Define the protocol for ensuring guests are unable to bring weapons into the center. Ex. will there be bag checks, metal detectors, etc.? Answered in Security Policies Section, subsection Security Plan, second subsection Weapons Protocol. v. Elaborate on the rounding program that will monitor guests throughout the day. What does this entail? Answered in Security Policies Section, subsection Security Plan, second subsection Rounding Program. vi. What staff will have portable communication devices? Will this be implemented from the beginning of the center's opening? Answered in Security Policies Section, subsection Security Plan. Page 14 of 19 vli. What personnel will staff the front entrances? Answered in Security Policies Section, subsection Security Plan City follow-up Questions to Responses to Questions dated January 3, 2023 1. Clarify who are the hospital partners that would accept guests needing additional medical care. Answered in FAQ #8 2. Clarify where the BeWell Regional Campus is located, and how the terms of the partnership between them and Cai©ptima. Answered in FAQ #9 3. Clarify who are partnering county and city shelters - what organizations operate these shelters and what cities are they located in? Answered in Appendix A 4. Expand on how Tustin PD would be a partner. What type of services are anticipated to be needed based on other recuperative care and short-term post-hospitalization housing facilities? 5. Answered in Security Policies Section, subsection Security Plan, second subsection Partnerships with Tustin Police Department City follow-up Questions to Responses to Questions dated January 10, 2023 1. Regarding the use of shuttles for PACE participants, please elaborate on future plans assuming maximum capacity at the center. Are shuttles anticipated to be parked on- site at any point in the future? Answered in Appendix C 2. Specify the dimensions and seating capacity of the shuttle vans, and provide a site plan showing the loading and parking/idling areas for the shuttles. Answered in Appendix C 3. Specify which third-party company provides shuttle services, and what city/location the vans are stored when not in use. This has been previously addressed in Appendix C 4. Elaborate on van arrival schedules. Now many shuttles arrive/depart per hour? Where would they loadlunload on-site? Anticipated shuttle operation can be found in Appendix C. 5. Provide a floor plan showing what parts of the building will be open for PACE activities during PACE hours of operation (7:30 a.m. to 5:00 p.m., Monday through Friday). What will these areas be used for outside of regular PACE operating hours? Page 15 of 19 Provided in Appendix D 6. Indicate where the PACE receptionist will be sitting and provide a written walkthrough description of a typical PACE participant experience at the center, starting from when they check in. Indicated on floor plans in Appendixes 8 and D 7. Specify how recuperative care recipients arriving by their own vehicle would know where to park underground. How would they gain access to the parking structure? Will stalls be dedicated for this purpose? If so, how many? Answered in Security Policies Section, subsection Security Plan, second subsection Guest with Vehicles 8. Specify approximate shift times. What constitutes morning, evening, and night shift? For PACE: specify the number of employees by expertise (i.e. therapists, social workers, recreation, etc.). The hours have been previously addressed in FAQ #20, Staffing levels by expertise has been updated and is found in FAQ 421 9. Please specify the full breadth of services provided to PACE participants and participants of the recuperative care/short-term housing programs. Answered in Operations Plan section, subsection Program Scope of Services, second subsection PACE Program. City follow-up Questions to Responses to Questions dated January 12, 2023 1. Specify which local hospitals would be referring patients to the recuperative care program. Define local hospitals. Answered in Operations Plan section, subsection Eligibility Criteria, second subsection Recuperative Care/Post Hospitalization. 2. Elaborate on how you would work with Tustin PD and the OC Fire Authority to identify individuals that may be eligible for the recuperative care program. If possible, provide examples of how you accomplish this with other cities. Answered in Operations Plan section, subsection Intake/Admission Process, second subsection Recuperative Care/Post Hospitalization, 3. Please explain how the center would process potential recuperative care recipients who are living on the street and not referred by a hospital (i.e. referred by Tustin PD, OCFA, etc.). How are these individuals evaluated for eligibility for the recuperative care program? What if they are not injured or do not require rehabilitation? What defines injured individuals or individuals that need recuperative care? Answered in Operations Plan section, subsection Intake/Admission Process, second subsection Recuperative Care/Post Hospitalization. Page 16 of 19 Will beds be designated for emergency shelter while the intake/screening/insurance process occurs? No. Previously answered in FAQ # 18 4. Specify where the intake department will be located. Specified on the floor plan in Appendix D 5. Please elaborate on the "housing tenancy services" that will be offered to successful program participants. is this part of PACE, or one of the recuperative care programs? Both? Answered in Operations Plan section, subsection Discharge, second subsection Recuperative Care/Post Hospitalization, third subsection Housing tenancy Services. 6. Please incorporate into the operations plan, with a high level of specificity, the year/version of the NIMRC standards for medical respite care programs to be used, and explain how they apply to the recuperative care and short-term post- hospitalization housing programs being proposed. Answered in Operations Plan section, subsection National Institute for Medical Respite Care Standards. 7. On the floor plan, specify the size of guest storage areas and their locations. Identify storage within the semi-private bedrooms in addition to storage locations for "guests with additional items." Answered in Appendix D. 8. How many rooms are anticipated to be made available for guests with pets? How large of pets and what kind would be permitted? Answered in amended FAQ # 19. Previously identified limited accommodations for pets. This policy has been revised that no pets will be allowed. 9. Please specify who will make arrangements with local shelters for recuperative care recipients that choose to leave the program prior to securing permanent housing. What shelters does this include, and how long does this process take? Answered in Operations Plan section, subsection ❑ischarge, second subsection Recuperative Care/Post Hospitalization, third subsection Voluntary Discharge. City follow-up Questions to Responses to Questions dated 1-18-23 1. Does CalOptima have experience providing recuperative care or short-term post- hospitalization housing in another County or state? Please elaborate on the experience of facility administrators, medical care providers, and the staff that will be operating the day-to-day operations. Answered in FAQ# 19 City Questions dated 12-22-22 Page 17 of 19 1. Where are guests are taken when involuntarily discharged from the PACE and Recuperative Care programs? Answered in Operations Plan section, subsection Discharge, second subsection Recuperative Care/Post Hospitalization, third subsection Involuntary Discharge. 2. Security camera locations and willingness to share surveillance footage with the Tustin Police Department? Answered in Security Polices section, subsection Security Plan and second subsection partnership with Tustin Police Department City Question 1-1 Q-23 1. How many shuttles will you have for the facility, what are their sizes, and will they be stored overnight on-site? Answered in Appendix C 2. What are the shuttle arrival schedules? Are they staggered? Answered in Appendix C 3. What are the hours of PACE hours of operation? Answered in Operations Plan section, subsection Program Scope of Services, second subsection PACE Program. 4. Operations and Safety Plan for the Recuperative Care states "All guests will arrive to the program by uber, taxi, ambulance, or non-medical transportation." Will any Recuperative Care guests arrive by their own vehicle? Answered in Security Policies section, subsection Security Plan, second subsection Guest with Vehicles. 5. The Detailed Project Narrative identifies the anticipated number of employees for the Recuperative Care component by shifts. How many employees will there be for the PACE component of the campus? This was previously addressed in FAQ # 21 City's Questions 1-12-23 1. How do prospective guests apply for the program? Are they only to be referred by hospitals? Certain partner organizations? Answered in Operations Plan section, subsection Eligibility Criteria, second subsection Recuperative Care/Post Hospitalization. 2. Does the program involve a follow-up meeting with guests after they have been placed in permanent housing and successfully recovered? If so, please describe. Answered in Operations Plan section, subsection Discharge, second subsection Recuperative Care/Post Hospitalization, third subsection Housing Tenancy Services. Page 18 of 19 3. Does the proposed recuperative care program follow the NIMRC Standards for Medical Respite Care Programs? Answered in Operations Plan Section, subsection National Institute for Medical Respite Care Standards. 4. What is the policy regarding storage of guest belongings? Where do they store belongings when part of the program? Answered in Operations Plan Section, subsection National Institute for Medical Respite Care Standards, subsection Standard 1:Medical Respite Program Provides Sage and Quality Accommodations. 5. What is the pet policy? Can guests bring pets with them? Answered in FAQ # 19 6. Can guests voluntarily disenroll from the recuperative care program prior to being placed in permanent housing? What is the protocol in this scenario? Answered in Operations section, subsection Discharge, second subsection Recuperative Care/Post Hospitalization, third subsection Voluntary Discharge. 7. What is the protocol once guests exceed the 6-month term for post-hospitalization housing? Answered in Operations Plan section, subsection Program Scope of Services, second subsection Recuperative Care/Post Hospitalization Program. Cites Question 1-17-23 1. Can you confirm if CalOptima provides recuperative care services elsewhere in the county? I know CalOptima partners with other agencies who provide similar services, like the Illumination Foundation, but is CalOptima an operator? Answered in FAQ # 10 Page 19 of 19 Veronica Y. Carpenter ,Chief of Staff veronica,carpL-nter@calc)ptima.org 657-900-1161 916-761-7722 cafoptima.org Michael Hunn Chief Executive Officer i michael,fiunii@cafoptima.org 714-246-8570 c,110ptima.arg ATTACHMENT H CITY EMAIL TO APPLICANT REGARDING PATHWAY TO PROCESS THE PROPOSED USES DATED JUNE 1, 2023 From: Huitron.Irma To: Doualas Dumhart Cc: Barraaan. Raymond; Kelly Bruno-Nelson;Veronica Carpenter MPA Subject: RE:CUP 2022-0019; 165 N.Myrtle Ave.&14851 Yorba St.-Application Status Date: Thursday,June 1,2023 1:46:03 PM Good afternoon Douglas, Please email me a couple of days and time that work for you early next week so we can discuss the following. Let me know who you would like to include in the meeting. Thank you for your interest in the City of Tustin for your prospective business. Most recently, on March 28, 2023, CalOptima representatives submitted plans and documents for review regarding the proposal to establish a Recuperative Care/Post-Hospitalization Housing use to serve the unhoused and a Program of All-Inclusive Care for the Elderly(PACE) use at the site located at 14851 Yorba Street and 165 N. Myrtle Avenue. All uses are intended to serve those individuals who are fifty(55)years and older. As the City has indicated in the Use Determination letter dated April 19, 2023, the subject property has a combined zoning designation of Public and Institutional (P&I) District, Professional (Pr) District and Specific Plan 9 (Yorba Street Specific Plan). Based on the review of all of CalOptima's submittal documents, the Recuperative Care and Post-Hospitalization Housing components of the proposed project are not similar to any of the uses that can be conditionally permitted in the P&I District. Additionally, the P&I District does not explicitly list Recuperative Care or Post-Hospitalization Housing or"Program of All-Inclusive Care for the Elderly(PACE)" as permitted land uses. The operational characteristics of the proposed Recuperative Care and Post-Hospitalization Housing components are similar in character to residential uses such as extended care facilities or supportive housing, setting the proposed land uses apart from uses that are conditionally permitted in the P&I District. In addition, based on the information provided, the PACE component is most similar to a hospital use. Next Steps: In accordance with Tustin City Code (TCC) 9295, the applicant may submit a Specific Plan Amendment of Specific Plan No. 9 (SP 9)to request that the entire project site (referenced as 14851 Yorba Street and 165 N. Myrtle Avenue) be incorporated and added to SP 9, request that the SP 9 be amended to authorize the proposed use, combination of Recuperative Care and Post-Hospitalization Housing, and "Program of All-Inclusive Care for the Elderly(PACE)"), be listed as a conditionally permitted uses in the SP 9 district, and a zone change removing the P&I and Pr zoning designations from the project site.The applicant may request that a CUP application for the proposed use be processed concurrently with the Specific Plan amendment and Zone Change request. Please be advised that the requests for the Specific Plan amendment, zone change, and CUP will require a public hearing before the Planning Commission and City Council. Further, a Specific Plan Amendment and zone change, adopted by Ordinance, requires two (2) City Council public hearings, an "introduction" or first reading of the associated Ordinance, and a second reading for adoption. If approved, the Ordinance would then be in effect thirty(30) days after. Any CUP application would be processed in accordance with TCC 9291 and 9296, and would be contingent on a Specific Plan Amendment approval as described above. The CUP would not be effective until the Ordinance process concludes. Also, the City will be required to comply with CEC1A and may require SB 18 (Tribal Consultation) as part of the Specific Plan Amendment process. In order to proceed, please follow these instructions: Submit your Application: 1. Please refer to page 2 of the Instructions for Filing a Development Application for required items to submit in conjunction with the required Development Application. The instructions also contain detailed descriptions for each application item. (Follow the submittal requirements for "Zone Change" (for both the Specific Plan Amendment and Zone Change requests) and "Conditional Use Permit". 2. Development Application Form—Complete the Application form in its entirety. a. Requires notarized signature(s) of Property Owner and applicant 3. Application Fee* a. Major Specific Plan Amendment$5,250 Deposit b. Zone Chane $10,500 Deposit c. Conditional Use Permit$5,250 Deposit *For your reference: Fee Schedule City of Tustin's Comprehensive Fee Schedule (Pgs.3-6). 4. Letter of Request (i.e. Request to amend Specific Plan No. 9 (SP No. 9) to incorporate the project site into SP 9 and allow "recuperative care, post-hospitalization housing, and PACE" as a Conditionally Permitted Use at the project site (specific APNs), and amend the City's Zoning Map with corresponding edits. Please include Findings, that support how the Conditionally permitted uses would be consistent with the project site's General Plan land use classification of Public & Institutional (P & 1) and include appropriate Finding for the CUP request. The letter must also request a new CUP consistent with the revised project description for the CUP request (i.e. allow "recuperative care, post-hospitalization housing, and PACE" as Conditional Permitted Use in the SP9"). Please note that a new CUP application and application materials must be submitted, as this will be considered a new application. 5. Set of Plans—Refer to "Information to be Included in Plans"* 6. Color and Materials Samples—Confirm in the Letter of Request that no exterior modifications are being requested for the building and site. Otherwise provide applicable Color and Materials Samples that correspond with the Set of Plans provided. 7. Supplemental Application Forms—Not applicable. 8. Environmental Assessment Form -Complete the Application form in its entirety. 9. Radius Map & Mailing Labels a. Map. 300-foot Radius Map showing all the ownership lines. The map must also contain a key to an ownership list. Provide one (1) ownership list from the latest Assessor's records, of properties within a 300-foot radius from the subject property. On the map, each property within the 300-foot radius must be referenced to the ownership list by number. b. Labels. Two (2) sets of labels for all properties within 300 feet of the subject project site. Reference Development Application Instructions for label format. 1. Provide Affidavit Signed by Preparer with date of preparation, within thirty (30) days of Development Application submittal. 10. Preliminary Title Report (2 copies) a. Prepared within three (3) months of revised application submittal. 10. Parking Summary/Justification. A summary of the proposed land use, calculations showing applicable TCC parking requirements and site/project's conformity with TCC parking requirements. 11. Preliminary Noise Report—Not applicable at this time. 12. Preliminary Water Quality Management Plan (WQMP) - Not applicable at this time. *Information to be Included in Plans—Please refer to Development Application Instructions Section C. *Notice to Applicants - Please refer to Development Application Instructions Section D. I would encourage you to provide all materials in electronic format via email first to Raymond Barragan at RBarraganl@tustinca.org and then coordinate a time to drop off the hard copies of the application materials along with your applicable deposit amount payable to "City of Tustin". This will help to expedite application intake process. Sincerely, Irma Irma Hut Director Assistant Director—Planning Community Development Department 300 Centennial Way, Tustin, CA 92780 Mobile:657-226-5760 ou S ihuitron(a).tustinca.org I tustinca.ora ATTACHMENT I CITY'S DENIAL OF REQUEST FOR REASONABLE ACCOMMODATION DATED JUNE 12, 2023 Community Development Department US Remembering what connects us. io June 12, 2023 VIA E-MAIL Kelly Bruno-Nelson, Executive Director CalAIM CalOptima 505 City Parkway West Orange, CA 92868 Re: Denial of Request for Disability-Related Reasonable Accommodation— 14851 Yorba Street and 165 N. Myrtle Avenue Dear Ms. Bruno-Nelson: By letter dated April 27, 2023, pursuantto Section 35.130(b)(7)(i) of Title 28 of the Code of Federal Regulations, the federal Fair Housing Act ("FHA") and the California Fair Employment and Housing Act ("FEHA"), you submitted a formal request for a disability- related reasonable modification to the City of Tustin's policies, practices, and/or procedures ("Request") pertaining to the Community Development Director's Use Determination letter dated April 17, 2023 for the proposed Project located at 14851 Yorba Street and 165 N Myrtle Avenue ("Property"). The Project site has a combined zoning designation of Public and Institutional (P&I) District, Professional (Pr) District and Specific Plan 9 (SP9 - Yorba Street Specific Plan) and is generally comprised of a two-building campus with 73,180 square feet of programmable space. As described in the materials submitted by CalOptima, the "Project" would provide the following to individuals who are 55 years or older: • Recuperative Care: A "short-term housing [program] inclusive of comprehensive care management and housing navigation services paired with traditional medical oversight from trained professionals over an up-to-90-day stay" (CalOptima 10/7/22 letter);this program is only available to unhoused individuals (Cafttima Operations and Security Plan submitted 3/27/23 ("Ops. Plan") p. 35.) 300 Centennial Way,Tustin, CA 92780 . 714-573-3000 • tustinca.org 14851 Yorba street and 165 N. Myrtle Avenue June 12,2023 Page 12 • Post-Hospitatization Housing: A program that "provides Guests additional time to receive medical support and permanent housing assistance immediately after the Recuperative Care Program ... [t]here is no difference in the services provided, eligibility criteria, or room location" as compared to Recuperative Care (Ops. Plan pp. 3, 8); this program is only available to unhoused individuals (Ops. Plan p. 35);and • Program of ALL-Inclusive Care for the ELderLy (PACE): A program that 11enable[es] older adults to remain living in the community and out of institutions" by providing services that include "on-site medical care, a day-activity center, transportation, rehabilitation therapies, meals, homecare, medications, medical equipment, and coverage for hospital and Long-term care." (Ops. Plan p. 2.) First and foremost, we acknowledge that persons with physical and/or mental impairments that substantially limit major life activities, are qualified individuals afforded full protection against discrimination under the Americans with Disabilities Act (28 C.F.R. 5 35.108),1 Furthermore, the City is obligated to make reasonable modifications to its policies, practices, or procedures - incLuding land use planning and zoning regulations - when the modifications are necessary to avoid discrimination on the basis of disability (28 C.F.R. § 35.130(b)(7)). Nevertheless, afterthorough review of your Request, we have determined that a modification of the City's polices, practices, and/or procedures is not warranted in this instance. With regard to the PACE portion of the proposed Project, the City has determined that "the operational characteristics of the proposed PACE use is consistent with a hospital use. Hospital uses are conditionally permitted uses in the P&I District. As such,the PACE use can be allowed with the review and approval of a CUP by the Planning Commission." The City has treated the PACE portion of the proposed Project identically to the previously existing medical rehabilitation facility at the Property. With regard to the Recuperative Care and Post Hospitalization Housing portions of the Project, CalOptima has failed to establish that its intended guests will or must suffer 1 Notably, the FHA prohibits housing discrimination because of race, color, national origin, religion, sex, disability or familial status. FEHA prohibits housing discrimination because of race, color, religion, sex,gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, familial status, source of income, disability, veteran or military status, or genetic information. Community Development Department 300 Centennial,Way,Tustin, CA 92780 • 714-573-3000 • tustinca.org 14851 Yorba Street and 165 N. Myrtle Avenue June 12, 2023 Page 13 from any disability. To the contrary, the documentation submitted to the City by CalOptima establishes that Recuperative Care and Post Hospitalization Housing guests must be "[a]ble to complete all Activities of Daily Living (ADLs) independently or with minimal assistance" in order to participate in the program. Accordingly, not only does CalOptima's documentation fail to establish that the intended guests of the Project will or must suffer from any disability, the program parameters outlined by CalOptima expressly exclude those individuals who are "[u]nable to complete ADLs, personal care, or medication administration," thereby apparently excluding disabled individuals from participation. (Ops. Plan p.7.) Moreover, the Tustin City Code does not explicitly list Recuperative Care, Post- Hospitalization Housing, or Program of All-Inclusive Care for the Elderly (PACE) as a permitted use, nor is it expressly prohibited. As you know, a formal Use Determination for the proposed Project was issued to CalOptima on April 17, 2023. In accordance with Tustin City Code ("TCC") § 9298b, the Community Development Director issued a Use Determination as follows: • That the proposed Recuperative Care and Post-Hospitalization Housing uses are not similar in character to other uses conditionally permitted in the district; therefore, they are not permitted in the P&I District, nor are they permitted in the Pr or SP9 districts. The operational characteristics of the proposed Recuperative Care and Post-Hospitalization Housing components are similar in character to residential uses such as extended care facilities or supportive housing, setting the proposed land uses apart from uses that are conditionally permitted in the P&I District. Additionally, the P&1 District does not explicitly list Recuperative Care or Post-Hospitalization Housing as permitted land uses; and • That the operational characteristics of the proposed PACE use is consistent with a hospital use. Hospital uses are conditionally permitted uses in the P&I District. As such, the PACE use can be allowed with the review and approval of a CUP by the Planning Commission. The Use Determination was based solely on the operational characteristics of the Project's two programs, and without regard to the intended guests' alleged disability. Your Request asks the City to reconsider its Use Determination and consider the entire proposed Project as a single "Hospital Use" subject to a CUP, in order to avoid Community Development Department 300 Centennial Way,Tustin, CA 92780 • 714-573-3000 • tustinca.org 14851 Yorba Street and 165 N. Myrtle Avenue June 12, 2023 Page 14 discrimination on the basis of alleged disability of CaLOptima's intended guests. To do so would be improper based upon the documentation provided by CalOptima regarding the operational characteristics of the Recuperative Care and Post-Hospitalization Housing component of the Project and CaLOptima's own characterization of the Project as a "two-pronged program: a Recuperative Care and Post-Hospitalization program and a PACE program" and as "two programs ... designed to provide services consecutively." (Ops. Plan pp. 3, 8.) . TCC § 9290 (Conditional Use Permits) provides a pathway for a fair hearing, for the conditionally permitted PACE use, and it would be improper to assume that the City's process will ultimately yield an outcome that violates the requirements of the Americans with Disabilities Act. Furthermore, the City cannot process an entitlement request that includes a use that is not permitted in the zone or TCC (i.e. Recuperative Care/Post- Hospitalization Housing). City staff has further provided a pathway for a fair hearing with regard to the Recuperative Care and Post-Hospitalization program as set forth in the email dated June 1, 2023 from Irma Huitron to Douglas Dumhart (with copy to you and Veronica Carpenter of CaLOptima), describing the process and `next steps' by which CaLOptima may apply for a concurrent Specific Plan Amendment, zone change and Conditional Use Permit. Based on the foregoing, your Request is respectfully denied. Per TCC 9294, any decision of the Community Development Director may be appealed to the Planning Commission. Should you wish to appeal my decision, please file a written appeal by submitting a Letter explaining your request, to the City Clerk during normal business hours within ten (10) days of the date of this Letter. The appeal shall be accompanied by the required $1,050 appeal deposit. Please contact the City Clerk's office at (714) 573-3001 should you have any questions. Please contact Raymond Barragan, Principal Planner, at (714) 573-3016 or via email at rbarraqan0)tustinca.o_rcL should you have any questions regarding this letter. Si erely, r stina L. Willkom Community Development Director Community Development Department 300 Centennial Way,Tustin, CA 92780 . 714-573-3000 . tustinca.org 14851 Yorba Street and 165 N. Myrtle Avenue June 12, 2023 Page 15 CC: Irma Huitron, Assistant Community Development Director M- Nanning Raymond Barragan, Principal Planner Alan B. Fernstermacher, Rutan & Tucker, LLP David Tang, Yorba Myrtle LLC. Douglas Dumhart, 3-D Advisors, LLC Community Development Department 300 Centennial Way,Tustin, CA 92780 . 714-573-3000 tustinca.org ATTACHMENT J PUBLIC COMMENT Barragan, Raymond From: Barragan, Raymond Sent: Wednesday, June 21, 2023 10:25 AM To: marnot@childrenscauseoc.org Subject: FW: Planning Commission -CalOptima Importance: High Hello Mr. Arnot: The agendas and agenda items for both meetings will be available for public review no less than 72 hours prior to either meeting. You can find the agendas for the June 261"Special Meeting of the Planning Commission and the June 271n Regular Meeting of the Planning Commission on the City's website here: httl)s://www.tustinca.org/282/Meetings- Agendas . For further information relative to the subject matter, please see the City's Planning Department's Current Project Page that can be accessed by clicking on the following link: https://www.tustinca.org/1080/Current-Projects . Please let me know if you have any further questions. Sincerely, Raymond Barragan Principal Planner Planning Division Community Development Department /0001 300 Centennial Way,Tustin, CA 92780 P: rU IS"IN P: 714-573-3016 I F: 714-573-3113 TustinPlanning(o-)tustinca.orq I tustinca.orq STAY CONNECTED WITH US: • Download our app—Apple Store• Google Play • Follow us-Facebook•Twitter •Join our newsletter From: Michael Arnot<marnotC@childrenscauseoc.org> Sent: Monday,June 19, 2023 11:08 AM To: City Clerk<CityClerk@tustinca.org> Subject: Planning Commission -CalOptima Hello, Are there agenda's for the Planning Commission meetings on 6/26 and 6/27?Will the CalOptima proposal be considered at those times or on another date? Thanks, i Michael Michael Arnot Executive Director Children's Cause Orange County 13217 Jamboree Road,#235 Tustin,CA 92782 (949)690-5274 www.childrenscauseoc.org 2 ATTACHMENT K RESOLUTION NO. 4476 DENY/NGTHE REQUEST FOR DISABILITY-RELATED MODIFICATION OF POLICIES, PRACTICES AND PROCEDURES RESOLUTION NO. 4476 A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF TUSTIN, DENYING A REQUEST FOR DISABILTY- RELATED ACCOMMODATION OF CITY POLICIES, PRACTICES AND/OR PROCEDURES RELATED TO A PROPOSED RECUPERATIVE CARE, POST-HOSPITALIZATION HOUSING, AND "PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY" AT 14851 YORBA STREET AND 165 NORTH MYRTLE AVENUE The Planning Commission does hereby resolve as follows: I. The Planning Commission finds and determines as follows: A. That on October 17, 2023, CalOptima ("Applicant"), filed a request for a Conditional Use Permit (CUP)to allow the operation of the proposed land uses listed below to provide services to individuals who are 55 years or older ("Project")at 14851 Yorba Street and 165 North Myrtle Avenue, Tustin, California (the "Property"): • Recuperative Care: A "short-term housing [program] inclusive of comprehensive care management and housing navigation services paired with traditional medical oversight from trained professionals over an up-to- 90-day stay"; this program is only available to unhoused individuals; • Post-Hospitalization Housing: A program that "provides Guests additional time to receive medical support and permanent housing assistance immediately after the Recuperative Care Program ... [t]here is no difference in the services provided, eligibility criteria, or room location" as compared to Recuperative Care; this program is only available to unhoused individuals; and • Program of All-inclusive Care for the Elderly (PACE): A program that "enable[es] older adults to remain living in the community and out of institutions" by providing services that include "on-site medical care, a day- activity center, transportation, rehabilitation therapies, meals, homecare, medications, medical equipment, and coverage for hospital and long-term care." B. That the existing buildings located at 14851 Yorba Street and 165 North Myrtle Avenue are located within the Public and Institutional zoning district (P&I); the front parking lot at 14851 Yorba Street is located within the Professional Office zoning district (Pr) and Specific Plan No. 9 (SP-9 — Yorba Street Specific Plan) and the entire Property has a Public and Institutional (P/1) General Plan land use designation. C. The purpose of Pr District is to identify properties that are authorized for professional offices. D. That the purpose of the SP9 is to encourage orderly development and lot consolidation, and to preserve and protect the public health, safety, and welfare of the area. Resolution No. 4476 Appeal of Denial of Request for Disability-Related Reasonable Modification June 26, 2023 Page 2 E. That the purpose of the P&I District is to identify properties within the City that are used or authorized for public, quasi-public, and institutional uses distinct from the standard classifications of residential, commercial, and industrial. F. That the P&I District, as described in Tustin City Code (TCC) 9245(b), does not permit any land uses by right, and instead, conditionally permits uses such as libraries, places of worship, schools, and hospitals—or other uses determined to be similar— subject to obtaining a CUP. G. That on April 19, 2023 the Community Development Director issued UD 2023- 0002 (Attachment 1), pursuant to TCC Section 9298b, determining the following relative to the proposed uses: 1. That based on the review of all of CalOptima's submittal documents, the Recuperative Care and Post-Hospitalization Housing components of the proposed project are not similar in character to other uses conditionally permitted in the district; therefore, they are not permitted in the P&I District, nor are they permitted in the Pr or SP9 districts. Additionally, the P&I District does not explicitly list Recuperative Care or Post-Hospitalization Housing as permitted land uses. 2. That the operational characteristics of the proposed Recuperative Care and Post-Hospitalization Housing components are similar in character to residential uses such as extended care facilities or supportive housing, setting the proposed land uses apart from uses that are conditionally permitted in the P&I District. Those operational characteristics include, but are not limited to the following: • Duration of stay (average anticipated stay of one (1) year); • Interim Housing until permanent housing can be identified and secured; • Medical oversight (no direct medical services provided); and • Limited assistance with Instrumental Activities of Daily Living and/or Activities of Daily Living. 3. That the P&I District does not explicitly list PACE as a permitted land use, nor is it explicitly prohibited. However, based on the information provided in the application documents, including the most recent submittal on March 28, 2023, PACE would offer medical services similar to hospital uses that include, but are not limited to the following: • Routine physicals and preventative health evaluations and care; • Kidney dialysis; • X-ray services; • Laboratory procedures; and • Outpatient surgical and mental health services. Resolution No. 4476 Appeal of Denial of Request for Disability-Related Reasonable Modification June 26, 2023 Page 3 4. That in accordance with TCC 9298b, the Community Development Director has determined that the operational characteristics of the proposed PACE use is consistent with a hospital use. Hospital uses are conditionally permitted uses in the P&I District. As such, the PACE use can be allowed with the review and approval of a CUP by the Planning Commission. The City has treated the PACE portion of the proposed Project identically to the previously existing medical rehabilitation facility at the Property. H. That in accordance with TCC Section 9294, UD 2023-0002 may be appealed to the Planning Commission within ten (10) calendar days of the issuance letter dated and sent on April 19, 2023. 1. That on April 27, 2023, Rutan and Tucker, LLP, on behalf of the applicant, submitted a written appeal of UD 2023-0002 (Attachment 2). The applicant's appeal requests that the proposed Project should be considered one (1) integrated use and characterized as "a `hospital' or `similar' use to a hospital" and therefore a conditionally permitted use on the project site. The applicant's appeal included a statement that all aspects of the UD are appealed, except for the determination that the PACE aspect of the project is a conditionally permitted use under the site's zoning district and general plan land use designation. J. That the April 27, 2023 letter (Attachment 2) also included a request for a disability-related reasonable accommodation in the form of a modification to the City of Tustin's policies, practices, and/or procedures to avoid discrimination on the basis of disability with regard to the UD 2023-0002 determination pursuant to Section 35.130(b)(7)(i) of Title 28 of the Code of Federal Regulations. The applicant requested that the Planning Commission reconsider the UD decision and grant its appeal pursuant to Section 35.130(b)(7)(i) of Title 28 of the Code of Federal Regulations. The applicant states that the Project would temporarily house and otherwise serve elderly (55 years and older) low-income patients with physical and/or behavioral health impairments that substantially limit major life activities as those terms are defined in the Americans with Disabilities Act ("ADA") (28 C.F.R. 35.108). K. That on June 12, 2023, the Community Development Director denied the request for Disability-Related Reasonable Accommodation (RA) (Attachment 3) for the proposed Project and determined that a modification of the City's policies, practices, and/or procedures is not warranted to accommodate the proposed Project and on June 12, 2023, the applicant notified the City of its appeal of the City's denial of the Request for Disability-related RA. L. That the appeal has been determined to be Categorically Exempt pursuant to Section 15301 (Class 1) of the California Environmental Quality Act (CEQA). M. That the Planning Commission considered said appeal of the denial of the request for a Disability-related RA at a duly noticed public meeting on June 26, 2023. Resolution No. 4476 Appeal of Denial of Request for Disability-Related Reasonable Modification June 26, 2023 Page 4 N. That at this public meeting, applicant, applicant's representatives, and members of the public were provided the opportunity to present written and oral testimony. O. That the Planning Commission has carefully reviewed and considered all of the evidence presented in connection with the appeal, including, but not limited to, the agenda report, and all written and oral testimony presented. P. That the Planning Commission recognizes that persons with physical and/or mental impairments that substantially limit major life activities are qualified individuals afforded full protection against discrimination under the ADA, and the City is obligated to make reasonable modifications to its policies, practices, or procedures — including land use planning and zoning regulations — when the modifications are necessary to avoid discrimination on the basis of disability (28 C.F.R 35.130(b)(7)). After thorough review of the subject request, the Planning Commission agrees with the Director's determination that a modification of the City's policies, practices, and/or procedures is not warranted in this instance. Q. That the Planning Commission also recognizes that with regard to the PACE portion of the proposed Project, the City has determined that "the operational characteristics of the proposed PACE use is consistent with a hospital use. Hospital uses are conditionally permitted uses in the P&I District and can be allowed with the review and approval of a CUP by the Planning Commission." The City has treated the PACE portion of the proposed Project identically to the previously existing medical rehabilitation facility at the property. R. That with regard to the Recuperative Care and Post Hospitalization Housing portions of the proposed Project, CalOptima has failed to establish that its intended guests will or must suffer from any disability. To the contrary, the documentation submitted to the City by the applicant establishes that the Recuperative Care and Post Hospitalization Housing guests must be "[a]ble to complete all Activities of Daily (ADLs) independently or with minimal assistance" in order to participate in the program. Accordingly, not only does the applicant's documentation fail to establish that the intended guests of the project will or must suffer from any disability, the program parameters outlined by the applicant expressly exclude those individuals who are "[u]nable to complete ADLs, personal care, or medication administration," thereby apparently excluding disabled individuals from participation. S. That the UD was based solely on the operational characteristics of the Project's two (2) programs, and without regard to the intended guests' alleged disability. The applicant's request asks the City to consider its UD and consider the entire proposed project as a single "Hospital Use" subject to a CUP, in order to avoid discrimination on the basis of alleged disability or the applicant's intended guests. To do so, would be improper based upon the documentation provided by the applicant regarding the operational characteristics of the Recuperative Care and Post Hospitalization Housing Resolution No. 4476 Appeal of Denial of Request for Disability-Related Reasonable Modification June 26, 2023 Page 5 component of the project and the applicant's own characterization of the project as a "two-pronged program: a Recuperative Care and Post- Hospitalization program and a PACE program" and as "two programs...designed to provide services consecutively." T. That TCC Section 9290 provides a pathway for a fair hearing, for the conditionally permitted PACE use, and it would be improper to assume that the City's process will ultimately yield an outcome that violates the requirements of the ADA. In addition, the City cannot process an entitlement request that includes a use that is not permitted in the zone or TCC (i.e. Recuperative Care/Post Hospitalization Housing). City staff has provided a pathway for a fair hearing with regard to Recuperative Care and Post Hospitalization Housing program by which the applicant may apply for a concurrent specific plan amendment, zone change and CUP. II. That, based on the foregoing, the Planning Commission hereby denies the appeal requesting Disability-Related Reasonable Accommodation, finding that a modification of the City's policies, practices, and/or procedures is not necessary to avoid the potential for discrimination on the basis of disability. PASSED AND ADOPTED by the Planning Commission of the City of Tustin, at a special meeting on the 26t" day of June, 2023. STEVE KOZAK Chairperson JUSTINA L. WILLKOM Planning Commission Secretary Attachments: 1. Community Development Director's April 19, 2023 Use Determination letter 2. Applicant's Appeal of UD 2023-0002 and a Request for a Disability-related Reasonable Accommodation dated April 27, 2023 3. Community Development Director's Denial of the Request for a Reasonable Accommodation dated June 12, 2023 Resolution No. 4476 Appeal of Denial of Request for Disability-Related Reasonable Modification June 26, 2023 Page 6 STATE OF CALIFORNIA ) COUNTY OF ORANGE ) CITY OF TUSTIN ) I, JUSTINA L. WILLKOM, the undersigned, hereby certify that I am the Planning Commission Secretary of the Planning Commission of the City of Tustin, California; that Resolution No. 4476 was duly passed and adopted at a special meeting of the Tustin Planning Commission, held on the 26t" day of June 2023. PLANNING COMMISSIONER AYES: PLANNING COMMISSIONER NOES: PLANNING COMMISSIONER ABSTAINED: PLANNING COMMISSIONER ABSENT: JUSTINA L. WILLKOM Planning Commission Secretary