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HomeMy WebLinkAboutRes 03-51 CUP 03-01 Carl Voce CITY OF PALM DESERT DEPARTMENT OF COMMUNITY DEVELOPMENT STAFF REPORT REQUEST: Consideration of an appeal to a decision of the Planning Commission denying a conditional use permit to allow a 10,294 square foot cancer/ chemotherapy / internal medicine / research facility medical office in the office complex on the north side of Alessandro between San Pascual and San Juan, 73-712 and 73-726 Alessandro Drive. SUBMITTED BY: Steve Smith, Planning Manager APPELLANT: Carl Voce 545 Via Media Palos Verdes Estates, CA 90274 CASE NO: CUP 03-01 DATE: April 24, 2003 CONTENTS: Draft Resolution No. 03-51 Planning Commission Minutes involving Case No. CUP 03-01 Planning Commission Resolution No. 2199 Planning Commission Staff Reports dated February 18, March 4 and March 18, 2003 Related maps and exhibits Staff Recommendation: That the City Council grant the appeal reversing the Planning Commission denial and adopt Resolution No. 03-51 approving CUP 03-01 , subject to conditions. Discussion: BACKGROUND: In July 2001 the City approved a three (3) building office complex having a total of 33,196 square feet. Construction of the buildings was completed in July of 2002. Staff Report Case No. CUP 03-01 Page 2 April 24, 2003 The project as constructed had an eight-space parking surplus (128 spaces provided, 120 spaces required) based on its use for general office purposes. Based on this eight-space surplus, staff in July 2002 approved a 4,400 square foot plastic surgery center in the north building adjacent to San Pascual. Any additional medical use requires approval of a conditional use permit. ADJACENT ZONING AND LAND USE: North: R-1 / single family residential South: C-1 / professional offices, general retail East: R-3, R-1 / Verizon parking, single family residential West: R-3, R-1 / Buccino building parking lot, single family residential SITE ZONING: The property is zoned O.P. (office professional). PROPOSAL: Mr. Voce proposes a 10,294 square foot cancer / chemotherapy / internal medicine / research facility medical office which will bring the total medical office space in the complex to 14,694 square feet of the total 33,196 square feet in the complex (44%). PLANNING COMMISSION ACTION: The Planning Commission considered this request at three (3) public hearing in February and March 2003. April 1, 2003 Commission on a 5-0 vote adopted its Resolution No. 2199 denying the conditional use permit request citing the following reasons for denial: 1. The proposed medical office use would amount to 31% of the complex and when coupled with the previously approved plastic surgery office would total 44.6% of the complex. Staff Report Case No. CUP 03-01 Page 3 April 24, 2003 2. The proposed medical office would have a parking shortage of 21 spaces when compared with the amount required by code for a medical office use. 3. The conditions necessary to assure compliance with the number of patients to be served as described by the applicant would be burdensome, difficult to enforce, and could result in an invasion of privacy beyond which the City should be engaged. 4. The number of patients is related to the number of doctors working from the complex. Monitoring the number of doctors working from the facility would be difficult. ANALYSIS OF PROPOSED MEDICAL USE: The floor plan provides a total area of 10,294 square feet in two buildings. The applicant indicates the facility will have a maximum of 20 employees. Staff reviewed the floor plan and concluded there will be a minimum of 17 employees. A maximum of 20 employees seems reasonable. The applicant explained in detail the operation of the three (3) facilities (chemo facility, internal medicine - colonoscopy/sigmoidoscopy) and research center. The infusion area will have a maximum of six chairs. These patients take from two to four hours each. The applicant advised that Desert Medical Group operates six existing facilities across the valley. The goal here is to consolidate its infusion facility. This facility will not be a full service facility. It will be specialized and limited to infusion only. People will not come to this location for daily checkups. These will be handled at the Palm Springs and Bermuda Dunes locations. At anyone time this area will have a maximum of six patients. Conditions limiting the number of chairs to six and prohibiting performing daily checkups are included in the draft resolution. The internal medicine area will perform colonoscopies and sigmoidoscopies. The quantity of these services which may be performed is limited to two per hour (based on one doctor at the facility). At anyone time this area will have a maximum of six occupied gurneys (two in recovery, two in procedure and two in prep). Staff Report Case No. CUP 03-01 Page 4 April 24, 2003 The research area operator anticipates four contracted oncology studies with seven patients in each study group for a total of 28 patients. These 28 patients would have 10 visits per year each for 280 total visits or about one visit per day. The applicant indicates they would be expected to group appointments by day so we could expect one per hour. Based on this explanation of the operation, a maximum of 12 patients could be expected at the facility at any one time. This count is confirmed by the flow chart the applicant provided (copy attached). Staff has been given to understand that this flow chart has been reviewed and concurred with by Kay Estell-Gillette of Desert Medical Group. The flow chart of operations shows that the peak number of patients and employees at this facility will be at 10:00 a.m. and 11 :00 a.m. when 32 people will be onsite (12 patients and 20 employees). Based on a parking requirement of four spaces per 1 ,000 square feet, this area has 41 assigned parking spaces less 8% unusable area = 38 available spaces. The flow chart and the applicant's explanation of the operation shows a maximum parking demand for 32 spaces. This office complex is, for the most part, currently unoccupied by tenants so a parking survey would not yield meaningful information. The CUP process allows City Council to evaluate specific use requests and approve acceptable requests subject to conditions. In this instance, staff feels there are extenuating circumstances which should be considered. The existing 4,400 square foot medical office is a plastic surgeon's office (Dr. Ball). This office has six employees and sees six to eight patients per day. The doctor spends mornings in surgery and consults with patients in the afternoon. The eight patients would be spread out between 1:00 p.m. and 5:00 p.m. This area of the complex then would have an actual parking demand of 8-9 spaces on any given afternoon. This space has 16 parking spaces allocated in the complex parking lot. Staff Report Case No. CUP 03-01 Page 5 April 24, 2003 The proposed cancer/ chemotherapy/ internal medicine / research facility medical office, according to the applicant, will have twenty employees and see a maximum of 12 patients at any one time for a total parking demand of 32 spaces. This space (10,294 square feet - 9,470 square foot net) has 38 spaces allocated in the parking lot. According to the applicant's figures both medical uses will have parking demands below that of a general office use. CONCLUSION: The recently completed office complex is an attractive addition to the neighborhood. The complex currently remains basically vacant except for Dr. Ball's office, which recently completed its interior improvements. The CUP process for medical offices was created to address the problem generated by high traffic general medical uses (i.e., dental clinics, urgent care facilities, pediatrician offices, and the like) which attract walk-in patients without appointments. The proposed new medical use and Dr. Ball's plastic surgery center are specialty medical uses which for parking purposes are at the low end of the parking generation spectrum. These uses only accept patients with an appointment. The CUP process allows the City to impose conditions which will limit the medical uses to those described in the application (i.e., cancer/chemotherapy/ internal medicine/ medical research medical office use). The approval will be tenant specific. Additionally, staff is recommending a condition which requires that all employees be required to park onsite. Based on staffs review of the expected tenant mix, number of employees and number of visitors/customers/patients as provided by the applicant, staff concludes that the office complex parking lot can support this medical office proposal. Staff recommends that the appeal be granted and the CUP be approved, subject to conditions which will limit medical use in the complex to that described in the application. Any future change in the medical office use in the center will require an amendment to the CUP and public hearing before the Planning Commission. Any future medical use Staff Report Case No. CUP 03-01 Page 6 April 24, 2003 including replacing Dr. Ball's space will be comparable low parking demand specialty type medical uses. The draft resolution contains a condition which will allow the City, should parking become a problem, to review appointment books to confirm that patients are being scheduled consistent with the flow chart provided. We recognize that patient names will need to be redacted. CEQA: The project is a Class 5 Categorical Exemption for purposes of CEQA. No further environmental documentation is necessary. Submitted by: Department Head: Steve Smith Phil Drell - Planning Manager Director of Community Development Approval. Approval: ilee !'p, omer Croy Carlos L. Orteg ACM for Devel ent Services City Manager * By Minute Motion, denied the appeal Xf and affirmed the decision of the CITY COUNCIL ACTION: Planning Commisison. APPROVED DENIED 3-1 (Kelly NO, Spiegel ABSENT) RECEIVED OTHER MEETI - - �y- r AYES: , rf;tlSan. 'LI'16Y\ NOES* ��- 4.1= ABSENT:, ' (Wpdocs\tm\sr\cup03-01.cc) ABSTAIN VERIFIED BY: I Original on File th 1tY Clerk's Office CITY CLER-ICS OFFICE PALM DESERT, CA '''..... • 2003 R -2 e. i 10: 011i4 \I CITY OF PALM DESERT, CALIFORNIA s svi yi APPLICATION TO APPEAL ZS' .% / ••.. ..• ......... DECISION OF THE /(9/11/tilii6 aVolla - (Name of Committee/Commission) Case No. c p 03 —of Meeting Date: L igoo5 •(,7,--i/ez_ /A) Name of Appellant Address 5-ys; Phone: (=No).3-7Sav‘eS Description of Application: /•91)/Peez--- 72) 720/6 I:)e; '/;94, Pie ...7,-4‘e" "6,4e/e--7 6 2- /0/41 Reason for Appeal- ZEP iff,40/164e_ erzmiic eis-4cs 22099A.1 , 1AAx/4/6- frXe-4100,54, r,ws. me. 7- :74/ srelicc tec--‘9,4/4,AP bP ?ea/Mae/iv 7794- le6qa-6-sr. 14/AS , A) a4AibisIticiew 224-c/stox). • Signature of Appellant arnti‘e.---- Date063 FOR OFFICIAL USE ONLY 02 - 63 Appeal Filed: Fee Received: 5 - 0 Date 3(0g/ >gyi Treasurer's Receipt #: Received by: Public Hearing Set For. 1734 Action taken by the City Council: DATE 1-4 RESOLUTION NO. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PALM DESERT, CALIFORNIA, GRANTING AN APPEAL AND APPROVING A REQUEST FOR A CONDITIONAL USE PERMIT TO ALLOW A 10,294 SQUARE FOOT CANCER / CHEMOTHERAPY / INTERNAL MEDICINE / RESEARCH FACILITY MEDICAL OFFICE IN THE OFFICE COMPLEX LOCATED AT 73-712 AND 73-726 ALESSANDRO DRIVE. CASE NO. CUP 03-01 WHEREAS, the City council of the City of Palm Desert, California, did on the 24th day of April, 2003, hold a duly noticed public hearing to consider an appeal by CARL VOCE, to a decision of the Planning Commission denying the above noted; and WHEREAS, the Planning Commission did by its Resolution No. 2199 deny the request for a 10,294 square foot medical office building; and WHEREAS, Carl Voce did file a timely appeal to the Planning Commission denial of the request; and WHEREAS, said application has complied with the requirements of the "City of Palm Desert Procedure for Implementation of the California Environmental Quality Act, Resolution No. 02-60," in that the Director of Community Development has determined that the project is a Class 5 Categorical Exemption and no further documentation is necessary; and WHEREAS, at said public hearing, upon hearing and considering all testimony and arguments, if any, of all interested persons desiring to be heard, said City Council did find the following facts and reasons to exist to justify its granting approval of said appeal and conditional use permit: 1. The medical uses at the subject property are specialty medical uses which for parking purposes are at the low end of the traffic spectrum. 2. With the conditions contained in the draft resolution, the proposed use will be compatible with the neighborhood. 3. The location of the conditional use permit is in accord with the objectives of the municipal code and the purpose of the district in which the site is located. 4. The proposed location of the conditional use and the conditions under which it would be operated or maintained will not be detrimental to the public health, safety, or welfare, or be materially injurious to properties or improvements in the vicinity. RESOLUTION NO. 5. The proposed conditional use and conditions under which it will operate will comply with each of the applicable provisions of the zoning ordinance. 6. The proposed conditional use complies with the goals, objectives, and policies of the City's general plan. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Palm Desert, California, as follows: 1. That the above recitations are true and correct and constitute the findings of the City Council in this case. 2. That the appeal by Carl Voce is hereby granted and that CUP 03-01 is hereby approved, subject to the attached conditions. PASSED, APPROVED and ADOPTED at a regular meeting of the Palm Desert City Council, held on this day of , 2003, by the following vote, to wit: AYES: NOES: ABSENT: ABSTAIN: JEAN M. BENSON, Mayor ATTEST: RACHELLE D. KLASSEN, City Clerk City of Palm Desert, California 2 RESOLUTION NO. CONDITIONS OF APPROVAL CASE NO. CUP 03-01 Department of Community Development: 1. The development of the property shall conform substantially with exhibits on file with the Department of Community Development as modified by the following conditions. 2. Construction of tenant improvements of said project shall commence within one year from the date of final approval unless an extension of time is granted; otherwise, said approval shall become null, void and of no effect whatsoever. 3. The development of the property described herein shall be subject to the restrictions and limitations set forth herein which are in addition to all municipal ordinances and state and federal statues now in force, or which hereafter may be in force. 4. That the conditions of approval imposed on Case No. PP 01-13 shall be conditions on this application. 5. That the complex owner shall require that all employees of the complex shall park on site. 6. That the approved medical use under this approval shall be limited to a cancer/ chemotherapy/internal medicine/oncology research practice only. Any change or addition of other medical uses within this 10,294 square foot approved space shall first obtain approval of an amendment to this conditional use permit. 7. That the infusion center shall be limited to a maximum of six (6) chairs. 8. That the infusion center shall not provide daily check-ups. 9. That should parking in the complex become a problem in the future, the operator(s) of the medical facilities approved under this permit agrees to provide the City, upon 15 days notice, copies of current appointment books (names may be redacted) to confirm that patients are being scheduled consisted with the flow chart (copy attached) provided by the applicant. 3 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 Action: It was moved by Commissioner Lopez, seconded by Commissioner Campbell, approving the findings as presented by staff. Motion carried 5- 0. It was moved by Commissioner Lopez, seconded by Commissioner Campbell, adopting Planning Commission Resolution No. 2187, approving CUP 02-34, subject to conditions. Motion carried 5-0. NJr I. Case No. CUP 03-01 - CARL VOCE, Applicant Request for approval of a conditional use permit to allow a 9,500 square foot cancer/chemotherapy/internal medicine medical office in the office complex located at 73-712 and 73-726 Alessandro Drive. Mr. Smith explained that in July of 2001 the Planning Commission approved the three-building office complex with a total of 33,196 square feet. It was basically concluded in July of 2002. Later in July of 2002, based on an eight-space parking surplus a plastic surgeon's office, Dr. Ball, was approved by staff in the subject buildings. That occupied some 4,400 square feet. So at this time they were looking at a 128 space parking lot with 128 spaces accounted for. At this time the applicant proposed a 9,500 square foot cancer/chemo/internal medicine medical office which would bring the total medical use in the center to some 13,900 square feet or approximately 42% of the complex. The typical issue with medical offices was parking. The parking code for medical offices was six spaces per 1 ,000 square feet versus four per 1 ,000 for general office. Staff did not do a parking survey for this location because the complex was basically still empty. He counted spaces there one day and there were approximately nine cars occupying 128. He stated that basically what they were looking at was a center that would have two medical office uses in it which were both very low traffic generating medical office uses in that they were not a clinic and didn't take patients without appointments. They only took people with 48 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 appointments and as seen with the plastic surgeon's office, they had been advised that they see six to eight patients a day. The proposed cancer/chemo/internal medicine office, while it would have 20 employees, the applicant indicated they would be looking at a maximum of seven patients at any one time for a parking total of 27 spaces. In the parking lot it was allocated 34 spaces and at this time they were saying a total parking demand of 27. The CUP process for medical offices was created to address the problem generated by high traffic general medical uses like dental clinics, urgent care facilities and pediatricians offices. As noted, both of these uses fall at the opposite end of the parking generation spectrum. They were at the low end. They only see patients by appointment. So if they could be assured that the tenants in these medical office spaces would stay at the low end of the parking generation spectrum, then staff felt that they could comfortably address the parking. Staff felt there were adequate conditions to limit it to those uses and was recommending approval of the request. He noted that a letter of support was received today from the Baltzars of 44-750 San Pascual. He asked for any questions. Commissioner Jonathan noted that Mr. Smith said there were 34 parking spaces allocated to the 9,500 square feet. So under the normal ordinance at six per 1 ,000, the requirement would be 57. Mr. Smith said there would be a 17-space difference. Commissioner Jonathan said he was calculating six times 95. Mr. Smith said it was two spaces per 1 ,000 more. Commissioner Jonathan noted that 34 was actually less than the four per 1 ,000. He was coming up with a 23-space shortage and 57 would be required. Mr. Smith said that in the draft report before commission got it had the explanation on the reduction in building size. They took a look at the non useable space in the building and hence the parking was based on that net amount, which was where he got the 8,579 as the net size of building area for parking purposes. So it was 8,579 times the six per 1 ,000 and 17 spaces short. Commissioner Jonathan noted that would be a 35% variance. Mr. Smith said it was 33%. Commissioner Jonathan said if they were 17 short and there were 34 allocated, the normal requirement would be 51 . He asked if that was correct. Mr. Smith said yes. 49 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 Commissioner Jonathan asked if Mr. Smith was familiar with the Sunlife building. Mr. Smith said yes. Commissioner Jonathan asked what he knew the size of that building. Mr. Smith said no. Commissioner Jonathan noted that the experience over there was very negative. He wanted to get an idea of what there parking space deficit was compared to this one and assuming that this entire building was accessible down the line, if they would be creating the same situation with this application as they already had there and at several other medical locations. Mr. Smith said that building went in prior to the requirement for six per 1 ,000 and it probably pushed the requirement in that direction. At that point the standard was five per 1 ,000 after the first 2,200 square feet for medical. They also had a situation in that building where they have an urgent or stat care, a pediatrician's office and a series of high traffic generating medical uses. Commissioner Jonathan asked if staff thought that building was parked at five per 1 ,000. Mr. Smith said he would guess 4.5. Mr. Drell concurred. Commissioner Jonathan noted that building was parked at 4.5 per 1 ,000 and was experiencing severe problems. The application before the commission tonight was being proposed at four per 1 ,000. Mr. Smith said that with this building, they were talking about a maximum of 42% medical use. Commissioner Jonathan clarified that he was talking about the 9,500 square feet. It had 34 spaces allocated to it which was four per 1 ,000 based on the reduction. So this use, the application before them, was being allocated less than the Sunlife building currently provides. Mr. Smith said that was right, but they were dealing with a complex where the remaining 58% was at a general office standard versus the Sunlife medical building which was 90% medical. Commissioner Jonathan asked if Mr. Smith was relying on the rest of the parking lot in the event there was an overflow to meet that excess demand. Mr. Smith said yes. They had provided staff with a break down of their anticipated tenant mix with the number of employees. It supported staff's belief. Chairperson Finerty noted that the staff report said that these uses only accept patients with an appointment. She asked if this was staff's interpretation or if it was what the applicant was telling him. Mr. Smith said it was staff's interpretation of people going for plastic surgery and chemotherapy. Chairperson Finerty stated that while she would concur that would be accurate for plastic surgery, having just gone through chemotherapy with her husband in early 2002 and following up at the 50 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 end of last year, at the Cancer and Blood Institute they didn't go there with an appointment. There was a lot of follow-up where they monitor blood on a daily basis and they were there seven days a week and they just pop in and get in line with everyone else in the waiting room to have a CBC and then determine what treatment is needed. She understood that while they were setting up the type of treatment they might come in with an appointment, but when the chemotherapy actually got under way, that was not what she has experienced. She was also perplexed with 20 employees only seeing seven patients at any one time. She didn't know what the building looked like so she didn't know if that was because they were going to have only seven rooms for patients or how many people could be in the waiting room. She wasn't sure of the setup, so it would be helpful if they had an idea of how they were going to run the facility and perhaps the applicant could answer that. But she would be very concerned about the parking. Mr. Drell suggested opening the public hearing and directing some of the questions to the applicant. Chairperson Finerty asked if anyone else had any questions for Mr. Smith. Commissioner Tschopp noted that there was a comment that staff was recommending a condition that all employees park onsite. He asked why they didn't do that with all commercial buildings of this size or like size. Mr. Smith said in this instance he included that condition because it was a problem at the Sunlife building. He didn't care to repeat it. Commissioner Tschopp thought it was a great idea and maybe something that they should look at in the future when they were reviewing commercial buildings. Chairperson Finerty opened the public hearing and asked the applicant to address the commission. MR. BOB YOUNG, with Lyle Commercial, stated that he was representing the owner of the building. As well, Margie Taft was representing the tenant. He said they have had a space plan of the 51 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 use for the tenant to show the different functions. He said that Ms. Taft could go through and talk about the actual uses within it. MS. MARGIE TAFT, 72-787 Fleetwood Circle in Palm Desert, stated that it was her understanding that the cancer and chemotherapy, some people come to the clinic and only stay one hour or up to four hours. The tenant told her that a maximum of seven patients per hour was their expectation. It was the tenant who filled out the form for them to bring to the City. That was the only knowledge she had of it. Chairperson Finerty asked Ms. Taft to walk the commission through the plan. Ms. Taft said she wasn't sure she could walk them through the whole thing because it had changed with the contractor. There were two clinics. One was the cancer infusion clinic and the other was sigmoidoscopy. She pointed out the treatment area. Chairperson Finerty asked how many chairs would be in there. Ms. Taft said she didn't. Chairperson Finerty asked what all the cubicles they were seeing. Ms. Taft said they were the procedure rooms for the sigmoidoscopy. There was one area where the patients would check in. There was one receptionist that would check people into both clinics. She pointed out the waiting room. Chairperson Finerty asked what all the other cubicles were other than the infusion center and the rooms for the sigmoidostopy. Ms. Taft wasn't sure. She didn't know a lot about this type of procedure of if they changed clothes there, but pointed out the area where they would do the actual procedure. Chairperson Finerty noted that they could probably have ten or so chairs in the infusion center and if they had three patients having 52 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 sigmoidoscopies and others in the waiting room, she didn't know what all the other rooms were for. She didn't know what any one time was for seven patients. She didn't know if that was at 15-minute intervals. Ms. Taft said they asked the applicant how many patients per hour and she said seven. The clinic is open 8:00 a.m. to 5:00 p.m. and there would be a total of 20 employees. It was closed Saturdays and Sundays. She said there was one doctor that would be onsite and he would see patients before they went in for the sigmoidostopy. But there was only one doctor on staff. Chairperson Finerty asked if that doctor was the one who would be doing the chemotherapy as well or if there could be two doctors. Ms. Taft didn't know. She was told there would just be one doctor and she met that doctor and took him to this site and showed it to him. He was moving in from out of the area. He was new to the area. Chairperson Finerty asked if Ms. Taft would bring up the proposed plan for the commission to look at closer. She noted that the commission didn't receive copies of it. (Ms. Taft brought it forward) Commissioner Jonathan noted that the application said this would be for cancer/chemotherapy/internal medicine medical office and asked what the internal medicine referred to. Ms. Taft explained that was the doctor that performed the procedures, the sigmoidostopy. He was the only doctor that she was aware of that was associated with the clinic. For the infusion clinic, she thought they saw doctors somewhere else and just went there for the treatment of chemotherapy. But the sigmoidostomy she understood required a doctor to be present to do that procedure. Commissioner Jonathan indicated he wasn't an expert in these matters, but to him internal medicine was a broader category. His doctor was an internist. He was a general one, so if his interpretation was accurate, 53 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 then the application was much more broad or general than the specific uses that were being described. Ms. Taft said she was told they would only be doing those two clinics and they looked at several sites. When they started out they were going to do them in opposite locations. They were going to do the infusion clinic, which was the chemotherapy, in 4,00 feet in one clinic and the sigmoidostomy in another area and they were looking in different cities for those. Then this medical group decided to combine them to save people power and to do one check in area and combined them. But they were originally looking at totally separate locations for those two clinics. Chairperson Finerty asked why there were two waiting rooms, one at each end. Ms. Taft didn't think those patients went together. There were to be two separate clinics. Chairperson Finerty asked if there was one doctor for two clinics. Ms. Taft said she didn't know about the chemotherapy and if it took a doctor to administer that. She was assuming that a patient went somewhere, was told they had cancer, and they went for chemotherapy. She thought that practioner types administered what that infusion was. She didn't know that a doctor had to be present. The only doctor she was aware of that she had ever shown the space to was this Dr. Chun who was going to do the sigmoidostopy. So if another doctor comes and checks in, she wasn't aware of it. She had only met Dr. Chun. Mr. Drell asked if Dr. Chun was an internist. Ms. Taft didn't know. She said he specializes in sigmoidoscopies. Mr. Drell said that for some reason on the application there was a description of internal medicine and the question was if a sigmoidostopy was something an internist did. Chairperson Finerty said yes. Mr. Drell said that answered that question. He believed that the application was 54 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 for a very specialized internal medicine procedure. As opposed to chemotherapy, which was something else that was more a part of oncology. But there was no intent for this to be a general practice internal medicine clinic. Ms. Taft said no. These people had those types of clinics at all different cities. She didn't think they had one in Palm Desert, but they had one in Indio and La Quinta. They do urgent care and they do those types of clinics. This was specialized just for the infusion clinic, chemotherapy and sigmoidostopy. This was not a general doctor's office. Chairperson Finerty commented that it might not seem like a general doctor's office, but with all the people having chemo, it might as well be. Commissioner Jonathan said he was coming up with seven doctor's offices, three exam rooms, processing rooms, pretreatment rooms, a bunch of office rooms, medical records rooms, a couple of waiting rooms, a reception area and then the treatment area. He said he was looking at a hospital there. This was going from one doctor with very light activity to something very different. Mr. Drell suggested a continuance to have the actual tenant present to explain the use. Chairperson Finerty asked if staff ever had a copy of the floor plan presented to night. Mr. Smith said no. He was assured that was unavailable. Mr. Young said it just became available. Chairperson Finerty explained that generally the way the procedure worked best was that staff had the time to go over all this before they got to a public hearing. Chairperson Finerty asked if anyone wished to speak in FAVOR or OPPOSITION to the project. There was no one. She left the public hearing open. Commissioner Jonathan said that it might seem harsh, but it seemed they were trying to fit a square peg into a round hole. He would like to hope 55 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 that this development would be successful and to put in 9,500 square feet of medical would end up being an inappropriate use. He said if it was the commission's pleasure to continue, he would go along with that, but he didn't want to drag this on. Commissioner Tschopp noted that Ms. Taft, the representative, was like a lot of them and if they didn't have the medical background, it was pretty difficult to answer the questions. In his mind, he didn't have enough information right now to make an educated guess, but just looking at the plan, it certainly looked like it was a lot more than what had been stated in the staff report as far as doctors, patients and so forth. So he would be in favor of a continuance if the appilcant wanted one. But he also said that if the use came out to be what the plans looked like, he didn't think this was the right spot either. Commissioner Campbell said that if they had more information, they could look at it a lot more closely. She also noted that Ms. Taft made the comment that those plans might have changed. She thought that the other plan might have fewer examining rooms and fewer treatment rooms. She would leave it up to the commission on whether or not to continue it. But right now, it was too big for that area. Mr. Drell said that if they were going to do a denial, they should have all the information. Commissioner Lopez concurred. He said that as difficult as it was for Ms. Taft to answer their questions, it was as difficult for the commission to understand the perspective of the project without having enough information or information received prior to the meeting, i.e., plans and the layout, etc., and not having the medical individual present to give them expertise at the meeting. Mr. Young stated that because they couldn't explain it, they would like a chance to bring him in at a later date to answer the questions. He agreed with a continuance of two weeks. Commissioner Jonathan said that in an abundance of fairness to the applicant, he would move for a continuance. He asked if two weeks to March 4 was enough time. 56 MINUTES PALM DESERT PLANNING COMMISSION FEBRUARY 18, 2003 Mr. Young said yes. Chairperson Finerty noted that the public hearing would remain open. Action: It was moved by Commissioner Jonathan, seconded by Commissioner Campbell, continuing Case No. CUP 03-01 to March 4, 2003. Motion carried 5-0. XI. MISCELLANEOUS None. XII. COMMITTEE MEETING UPDATES A. ART IN PUBLIC PLACES - (No meeting) B. CIVIC CENTER STEERING COMMITTEE - (No meeting) C. DESERT WILLOW COMMITTEE - (No meeting) D. GENERAL PLAN ADVISORY COMMITTEE - (No meeting) E. LANDSCAPE COMMITTEE - (No meeting) F. PROJECT AREA 4 COMMITTEE - (No meeting) G. ZONING ORDINANCE REVIEW COMMITTEE - (No meeting) XIII. ELECTION OF OFFICERS AND COMMITTEE LIAISONS A. Election of Chairperson and Vice Chairperson B. Appointment of an Art in Public Places Representative, a Civic Center Steering Committee Representative, Appointment of a Desert Willow Committee Representative, Appointment of a Project Area 4 Committee Representative, and Appointment of a Zoning Ordinance Review Committee Representative. Action: It was moved by Chairperson Finerty electing Commissioner Campbell as Chairperson and electing Commissioner Jonathan as Vice Chairperson, Commissioner Campbell continue with Art in Public Places, Commissioner Jonathan continue with the Civic Center Steering Committee, delete Desert Willow, Commissioner Finerty continue with Project Area 4 and 57 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 VII. CONSENT CALENDAR None. VIII. PUBLIC HEARINGS Anyone who challenges any hearing matter in court may be limited to raising only those issues he, she or someone else raised at the public hearing described herein, or in written correspondence delivered to the Planning Commission at, or prior to, the public hearing. A. Case No. CUP 03-01 - CARL VOCE, Applicant (Continued from February 18, 2003) Request for approval of a conditional use permit to allow a 9,500 square foot cancer/chemotherapy/internal medicine medical office in the office complex located at 73-712 and 73- 726 Alessandro Drive. Mr. Smith noted that this item was before the Planning Commission at the last meeting. At that time it became clear that they needed additional information to be provided by someone who was more familiar with the actual proposed operation. He informed commission that morning he met with Mr. Voce and the real estate people involved in the project. They provided them with a new floor plan. A copy was distributed to the commission just prior to the meeting and a copy was on display. He said they also had a new parking analysis that was provided by Mr. Voce. Mr. Smith said he was given to understand that this evening the office manager for the project would be able to explain the operation and respond to commission questions. Commissioner Jonathan asked what staffs position was on the application. Mr. Smith said he still had questions as he left the meeting that morning and the applicant was going to be providing additional information, so he was eagerly awaiting their responses as to how the operation would work specifically. As well, on the plan there were several rooms that either weren't labeled or he didn't understand what was going to take place in the room. So he looked forward to hearing that information. 2 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Chairperson Campbell noted that they had the new map that was given to them this evening, but they couldn't compare it to the map given to them at the last meeting. So the commission had no comparison of the two floor plans or if there had been any changes. Commissioner Finerty concurred. She recalled there being many questions about the number of doctors, two waiting rooms, how many patients would be at the facility at any one time, etc. It was her suggestion that they get the answers to those eagerly awaited answers and then come back with a staff report and also request from the applicant the first layout they saw the last time so that they could compare what happened and what their intent was two weeks ago versus what their intent was now. She didn't feel that the commission was in a position to be fully knowledgeable to make a decision tonight when they walked into the meeting without benefit of a staff report and staffs opinion with regard to the new layout since staff just met with the applicant earlier that morning. Commissioner Jonathan concurred. He stated that he wasn't comfortable and that this was premature. It shouldn't be before them until the applicant presented sufficient information for staff to form a comprehensive report, conclusion and recommendation. They were obviously not at that point. He knew they needed to open the public testimony, but he didn't like to be in a position of developing a report, studying material for the first time which they didn't receive with their packets, and trying to absorb all of that to form an opinion, particularly without the benefit of reading and studying staff's analysis. He knew they needed to open the public testimony, but he would be in favor of continuing the matter to give the commission and the applicant adequate opportunity to address all of the issues. Commissioner Lopez concurred. In reviewing the newly received information and trying to compare that to what they previously received in the staff report, it was difficult to do an evaluation. He supported a continuance, although he wanted to have the public testimony. Commissioner Tschopp stated that if the applicant was present, he wouldn't have a problem listening to the changes that he saw in the map compared to the one given to them previously. However, if they weren't going to be able to take any action on it, having the additional information might be helpful. 3 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Chairperson Campbell concurred with her fellow commissioners. Reading the staff report, it was the old report and nothing new. Staff shouldn't have wasted the time to make a copy of it. They could have just said it was the same report. But the public hearing was open from the last meeting and they should hear testimony, but she did feel they should continue it. Chairperson Campbell noted that the public hearing was open and asked the applicant to address the commission. MR. BOB YOUNG of Lyle Commercial, 42-300 Adams Street in Bermuda Dunes, informed commission that he was representing the owner. He said they had three people that would like to contribute tonight. He said Margie Taft represented the tenant and had a very strong understanding now of the flow of how the different procedures worked. Carl Voce was present to talk about the parking requirements and the statistical data information. He said Kay Gillette was also present. She is the Vice President of Operations for the Coachella Valley on the administration side of this company. She could address any questions of use, about flow, about timing issues for the different procedures, and why the rooms were dedicated on this particular plan. He believed only minimal changes had taken place to the plan. One thing they did do was try to isolate from a use perspective what was common area, what was actually a medical location inside the suite, and then they had the business and administration function indicated on the suite. So those things combined along with the following descriptions and information would hopefully clear up some of the questions the commission had last time. He apologized to the commission and staff about not being fully prepared last time. He asked Ms. Taft to address the commission regarding flow. Chairperson Campbell informed the applicant that they had everything in front of them, but they couldn't compare it to the map from last time. As well, receiving it at the last minute before they started the meeting wasn't enough time for them to really make a decision. MS. MARGIE TAFT addressed the commission and said she understood that. She wanted to explain a little bit about the flow of the 4 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 clinic so they could take that back with them and the next time they met, maybe the commission would have a better understanding and could give an opinion on it. Ms. Taft explained that the plan presented at the last meeting was the same as this plan, only they had relabeled some of the rooms as to the use. They moved the doctor's area over to the next building, so they took what was the doctor's suite in the end side (1,250 square feet) and put it at the other end of the next building. Where they saw the doctor's suite was now research area where they might be doing research on some of the drugs that were used in the infusion clinic. They also added a meeting room and an employee lounge. Commissioner Finerty asked for clarification that they were going to be doing research on the chemotherapy that they planned to use on the people. MS. KAY GILLETTE addressed the commission and said no, it would be clinical trial research. They do it quite often, especially for oncology. It wasn't the drugs that the patients were taking, they were non FDA approved drugs, that they do clinical trials on. Traditionally in an oncology center that took place. She said they hadn't gone that far, but they wanted to have the room in the event they did do clinical trials. That would involve having two RN's that would actually monitor the existing patients that would come in for chemo. If they were going to do clinical trials, Commissioner Finerty asked how many people they planned to have in each trial. Ms. Gillette said that all depended on the drug company. She didn't know and said they hadn't looked into it, it was just something in the event that if they did, they had space. But at this point they hadn't even gone into looking at the possibility of doing it. Commissioner Finerty noted that Ms. Gillette said it was a common purpose at these types of facilities to do clinical trials and if they were going to do clinical trials, it generally took a number of people to do those and she was aware that they normally have several trials going on at the same time. Her question was how many people they planned in total in addition to the two RN's that would be required to participate. 5 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Ms. Gillette said that she really couldn't address that honestly because they hadn't looked into any oncology trial studies. So she couldn't say. It could vary by drug. Chairperson Campbell asked Ms. Gillette to state her name and address for the record. Ms. Kay Estell-Gillette, 275 North El Cielo in Palm Springs, with Desert Medical Group. Ms. Taft explained that there were two separate clinics and they colored them on the map to show which part of the space would be medical space and which part would be administrative. As they enter from the lobby, the people that would be coming for the one clinic would be in a waiting room, the sigmoidoscopy/colonoscopy would come through the waiting room and go through the clinic on the other side. The people getting the procedure would be checked in and sedated. There were gurneys there and the gurneys would be wheeled into the procedure room and from the procedure room into the recovery area. So the one patient on the gurney went from checking into the lobby and across into the procedure room and into the recovery room. They estimated two patients per hour. It took half an hour per patient. That would be one whole side of the clinic. Ms. Taft stated that one of the questions asked last time was why there were so many bathrooms. She said it was because patients on one side of the clinic, if they were there for the sigmoidoscopy procedure and one of them needed to use the bathroom (bathroom #5) if that bathroom was full and someone else was in there for the procedure, they had to have a backup restroom for that space. So that would be bathroom #6. A question from the meeting that morning was what the room next to the nurse room and linen room was for and she said it was a storage area. It wasn't labeled. In the other clinic, which was the other waiting room, people that were coming for the infusion therapy usually did not drive and one or two people brought them. It usually took two people to bring them to their therapy. She said they would be in that waiting area. That patient was then taken into the exam room and then taken into the infusion area. 6 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Again, they had two bathrooms. If one of those patients needed to use the restroom, they went into bathroom #2 and it was required that they have an additional bathroom in that space, so that was where bathroom #3 was located. Bathroom #1 was located next to the waiting area and sometimes people waited four or five hours for the patient in the infusion area. The other restroom on the plan was bathroom #4 which was the employee restroom. Another question from the morning meeting was how many chairs would be in the infusion area. She said there would be six. The most that could be in there would be six. MR. CARL VOCE, 545 Via Media in Palos Verdes Estates, addressed the commission. He said there were six chairs, but they could only do three or four patients per hour. Commissioner Finerty noted that there were three procedure rooms and the anticipation was two sigmoidoscopies per hour per procedure room. Ms. Gillette said they were two separate clinics/procedure areas. The area with four beds that was colored yellow. Commissioner Finerty explained commission's copy was not colored. She was assuming it was where they referred to the four gurneys. People come to the waiting room, they go to the changing room, then they go on the gurney, and then they were sedated for a sigmoidoscopy and then they went to the procedure rooms. It was indicated that one doctor would be working doing those and he would be doing two procedures per hour. Ms. Gillette said that was correct. Commissioner Finerty noted that there were three procedure rooms. Ms. Gillette said that a lot of times they would have the room set up with two monitors. Actually the third room would just be like an extra. They had the two and that was all they were planning on doing. The patient, because they were sedated, the nurse would get one to two patients sedated, they would put one in the room and the doctor would start the procedure on that patient and then the nurse would 7 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 take the other patient in to get that patient set up on the monitors. By the time the physician was done with the first procedure, the patient would be taken into the recovery room and he would start the second procedure. Commissioner Finerty asked where the recovery room was located. Ms. Gillette said it was where the six beds were shown on the layout. Commissioner Finerty indicated there would be a six-bed recovery room, even though four patients were going in. They had room for six people. They had an extra procedure room and an extra bathroom. She asked if that was correct. Ms. Gillette said no, they didn't have an extra bathroom. Commissioner Finerty believed what Ms. Taft said was that bathroom#6 was a backup bathroom if#5 was full. With sedated people, she didn't think they would be getting up and going to the bathroom. Ms. Gillette said that when they were coming out of recovery, when they go through a colonoscopy they had to be totally cleaned out. Commissioner Finerty asked for clarification that it was a colonoscopy or sigmoidoscopy. Ms. Gillette said colonoscopy. Commissioner Finerty said that just changed, because they had been talking about a sigmoidoscopy. She was trying to figure out why someone would need to be sedated for a sigmoidoscopy. Ms. Gillette confirmed it was for colonoscopy. She noted that Ms. Taft wasn't a medical person. Commissioner Finerty thanked her. Commissioner Tschopp asked how many doctors there would be and how many employees. 8 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Ms. Gillette said there would be two physicians. One on the G.I. side and one on the chemo side. They were projecting eight employees on each side. Commissioner Tschopp asked how many would be in the research area. Ms. Gillette said there would be two nurses if they chose to do that. Commissioner Tschopp said that would be in addition to the 20 they already talked about. Ms. Gillette said that was correct. Commissioner Lopez noted that one concern was the parking situation. He said it was difficult with what was in front of them to try to figure out if there was enough parking for the facility, especially when they had a clinical trial opportunity and they didn't really know how often that would happen and how many people would be involved in it. Right now they had a surplus of 14 parking spaces dedicated to the facility. He wasn't sure that was going to be enough during certain times when they had clinical trials going on. They didn't want to create a situation where there was an abundance of cars in this area that spilled out into a residential area right next door. That was a concern and it was difficult when trying to figure out the demands on the facility and not have a square peg in a round circle with the information in front of them. He said they needed to have a little more information on what the clinical trials would be, how many people would be involved, and how often that would happen. He asked for her best guess at this point in time based on her knowledge of the data. Ms. Gillette said she does have a clinical trials consultant and she could have that information for the commission at the next meeting. She said it would all be new to them in terms of patients. She said the patients would not be coming in for a long process. It was mainly the nurses that would be following the patients clinically. From the time that the patient sees the oncologist, which was not on their site, it would be an internal medicine physician that would be monitoring that, but she would get more information from the consultant. 9 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Chairperson Campbell stated that it would be an advantage to have that in their packets, even though they might not be able to understand all the wording, at least they would have it in front of them to ask the questions about it. Commissioner Finerty requested that they revisit the portion of the staff report where it said they would have 20 employees, which she now understood could go to 22, and a maximum of seven patients at any one time. She asked how it was that they felt it would only be a maximum of seven. Ms. Gillette said it was with the flow of the patients. They only had two physicians. They had one physician that would be doing the procedure. So he could only do two in one hour. Commissioner Finerty noted that they needed to get the patient prepped and ready, so they wouldn't just show up at that hour. They were going to have to show up ahead of time before the actual appointment with the physician. She asked if that was correct. Ms. Gillette said that was right. Commissioner Finerty also indicated that they would also have those patients go through the procedure while new people were coming in to be prepped and then the patients that just had the procedure were going to the recovery room, and the patients just prepped were going into the procedure room and more were coming in. Ms. Gillette said that the doctor would only be able to do eight procedures per day. That was going to be it. Eight to ten a day was the best she could figure. And on the chemo side, there were six chairs and they varied from one hour infusion up to six hours. She wanted to clarify from the last meeting that in some chemo infusion centers like at Eisenhower, they do everything. They would do just the injections like Lupron and Nupogin where the patient just came in and got a shot in five minutes. They wouldn't do that. They already had two infusion centers. One in Palm Springs and one in Bermuda Dunes. They had that staffed with nurses who would do that. This was strictly going to be infusion which was where the time taking would be. 10 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Commissioner Finerty asked if they would be doing CBC's as a follow-up. Ms. Gillette said yes. Commissioner Finerty asked if the patient needed Nukine or Nupogin, they would be giving them injections? Ms. Gillette said no, they would go to their infusion centers. The other infusion centers in Palm Springs or Bermuda Dunes. Commissioner Finerty said it would also be helpful if they could provide information about the other centers in Palm Springs and Bermuda Dunes, as well as the layout that they saw two weeks ago. Ms. Gillette agreed. Commissioner Jonathan noted that they didn't have the labeling on their plan and asked if the top portion was what they saw at the last meeting. Ms. Taft said yes. Commissioner Jonathan asked if the bottom portion was an addition to what they saw. Ms. Taft said yes. Commissioner Jonathan indicated that they were no longer dealing with one building containing 9,500 square feet, but this application was being spread over two buildings. Chairperson Campbell asked for the total square footage. Mr. Voce addressed the commission and explained that the application was made for the two buildings, 73-712 and 73-726. Mr. Smith said that the parking analysis that was given to staff today showed 10,294 square feet. 11 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Mr. Voce said that was correct. The 1,250 square feet was on the building at 73-712. They moved the doctor from the upper corner to the other building. Commissioner Jonathan indicated that this was now a substantially different application then even the first time. They were looking at different spaces. He noted that at the last meeting they asked the applicant how much more time he needed and he said he wanted to come to this meeting. He came to this meeting and hadn't provided staff with the necessary information for them to prepare a report. They hadn't even met with staff until that morning. He believed they were going to continue this matter and when that happened, that would be the third meeting and he expected it to be the final meeting. He encouraged the applicant to have whatever information they had that they thought would be relevant to their decision-making process to have that information to staff early enough so that they could prepare a comprehensive report which they could get to the commission in time for their review. Otherwise, they would be limited to forming their opinion based on the limited information provided and he wasn't sure that was in the applicant's best interest. He said he had one more question. Most doctors to be successful from what he had seen had two, maybe three or four staff. This ratio was 11 to one. If there were two doctors and seven patients, he asked what 20 employees were doing in that space. Ms. Gillette said there were two people in the business office, one to two in medical records. Where they saw the nursing station in the G.I. area, there would be at least two RN's. And they were prepared to have a third RN if they needed one. And then they had to cleanse the scopes after every procedure, so they would have at least one medical assistant who would be cleaning scopes. Maybe two depending on the equipment they put in and how labor intensive it is. That was the most they would have. It would be the same thing on the other side in the infusion area. The admitting area would be staffed by an LVN who would be doing all the patients' vitals. She would be the one doing the phlebotomy when the patient came in if they needed a CBC. And then they would have no more than three RN's and one MA (medical assistant) in the infusion center. 12 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Commissioner Jonathan asked for confirmation that she was saying seven patients total for this whole operation in both clinics. Ms. Gillette said seven to eight in an hour. Commissioner Jonathan said he would wait for the report. Going through the list there were seven or eight nurses and MA's and a couple of doctors for seven patients. Ms. Gillette said it was not like someone going in to see a family practioner who might spend ten minutes and see six patients an hour because these procedures would take anywhere from 30 to 40 minutes on the G.I. side depending on the patient. So it wasn't like a quick turnaround. It was the same thing in the infusion center. Those patients might be in the chair from one hour to six hours. Commissioner Jonathan thanked her for the information. Mr. Voce said he wanted to clear up something regarding the parking area. In his analysis he showed 20 people working and eight patients, which meant they would need 28 parking spaces. By using the ratio they had at four per 1,000 based on the 10,294 square feet, they had 41.17 parking spaces. Chairperson Campbell noted that the parking requirement for medical uses was six spaces per 1,000 square feet. Mr. Voce said that 41.17 spaces were allocated right now versus the 28 needed. So they already had a surplus. He said he wanted to give them some factual numbers. Commissioner Jonathan noted that the staff report indicated that there weren't 41 , but 34 parking spaces allocated to this suite. Mr. Voce replied that it was based on the new 10,000 square feet. Commissioner Jonathan said it wasn't available spaces, but actually allocated spaces. He asked if there spaces actually allocated to this within the parking lot. 13 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Mr. Voce said yes. The allocation based on 10,294 square feet would be 41.17 minus 8% for the common area. Which would bring it to about 38. So based on 28 that they actually said they were going to use, they still have 10 extra spaces. Besides that, if they looked at actual numbers and not made up numbers, but real numbers right now today, Mason had two employees and they had hardly any visitors. He put one there, but they had maybe one a week. They do designs for homes and once in a while had someone come in. So in that particular area they allocated 9.86 spaces. They were using only three. So he had 6.86 parking spaces from that one. Lorna Ball had a 1,920 square foot tanning salon. They have two employees. He said they really only have one, but he put two. They only had two beds, so they could only have two people at a time. So they had four. They allowed 7.68 spaces. So there was another 3.68. The plastic surgeon has 4,400 square feet. They had right now five employees and he put six for potential growth. Visitors four. The doctor did plastic surgery in the morning for half a day and then he had visitors in the afternoon. So even four might be high. He talked to them about it and they said it was maybe three maximum. But even at that they needed 10 spaces. They have assigned 17.6. So he had another 7.6 extra. He said they just rented to a national insurance business. They were a corporate office and didn't have any visitors. It was strictly employees. They had maybe ten people working and possibly a visitor once in a great while. They need 11 spaces and they have 18.6. Basically right now with the people that were renting he had an extra 25 parking spaces available to anyone. So there was no danger if they allowed this that anyone would park on the streets or anything like that. He said they shouldn't worry about that because he had a lot of parking and it wouldn't get filled up. He had this building for a long time and it had to be rented and this was a good opportunity to do that. They were not going to overflow with patients. He said this was a factual analysis and he hoped the commission would consider that. Chairperson Campbell advised Mr. Voce to work closely with staff so that they could give the commission a very complete report of all of the parking and all of the tenants that they would have in there. 14 MINUTES PALM DESERT PLANNING COMMISSION MARCH 4, 2003 Mr. Voce asked if they had a copy of his analysis. Chairperson Campbell said yes, but they got it at the last minute. For the next report they wanted to have everything in advance. Chairperson Campbell asked if anyone wished to speak in FAVOR or OPPOSITION to this case. There being none, Chairperson Campbell asked how long Mr. Voce needed. Mr. Voce said they would be ready for the next meeting. Mr. Smith said he would need the information by Monday (March 10). Chairperson Campbell suggested that if that information couldn't be provided by that time, that the meeting be continued to April. Mr. Voce concurred. Action: It was moved by Commissioner Jonathan, seconded by Commissioner Lopez, continuing CUP 03-01 to March 18, 2003. Motion carried 5-0. B. Case No. ZOA 02-06 - CITY OF PALM DESERT, Applicant Request for approval of an amendment to the Hillside Planned Residential District, Chapter 25.15, as it relates to permitted density, limit of grading activity and other matters. Commissioner Jonathan informed commission that he would be abstaining from discussion on this matter. He had property near the city in the county, but to avoid the appearance of any conflict of interest, he would be abstaining. Mr. Drell explained that there was a proposed zoning ordinance amendment and three cases which pretty much illustrated all of the applicable impact of that change. What he was suggesting was that the commission first discuss and then introduce to commission the proposed zoning ordinance amendment, open that hearing, take any testimony on that item, keep the hearing open, and then go through each of the specific applications. He thought they would be better able to evaluate the zoning ordinance 15 MINUTES PALM DESERT PLANNING COMMISSION MARCH 18, 2003 Action: It was moved by Commissioner Finerty, seconded by Commissioner Tschopp, by minute motion continuing Case No. HPR 03-01 to April 1, 2003. Motion carried 5-0. B. Case No. CUP 03-01 - CARL VOCE, Applicant (Continued from February 18 and March 4, 2003) Request for approval of a conditional use permit to allow a 9,500 square foot cancer/chemotherapy/internal medicine medical office in the office complex located at 73-712 and 73- 726 Alessandro Drive. Mr. Smith explained that this item was continued from March 4, 2003 to allow the applicant to submit additional information and give staff an opportunity to evaluate that new information. Staff met with the applicant on Monday, March 10, and at that point they provided an original floor plan which was included in the staff report. That plan showed the original proposal as a 9,500 foot medical office facility. The main difference was that plan did not include the research facility that was shown on the plan which was on display. That revised plan occupied 10,294 square feet in two buildings. A doctor's office and two exam rooms had been removed from the main building. That area was replaced with the research center. The doctor's office and two exam rooms had been moved to Suite B-4 in the next building. Staff reviewed the revised floor plan with a view to determining the maximum number of employees that could be expected. The applicant has been saying 20 employees. Mr. Smith said he found space for at least 16 employees, plus in the medical research area one additional investigator for a total of 17. A copy of the letter from the oncologist who would be operating the research center which explained the personnel was included. Next they got into a fairly detailed discussion on the operation of the three facilities at the proposed location. Starting with the infusion area, there would be a maximum of six chairs in that area. The applicant was careful to note that this would not be a daily checkup location. The operator, Desert Medical Group, currently operates six other locations in the valley and they expect those services to be provided in Bermuda Dunes and Palm Springs. 5 MINUTES PALM DESERT PLANNING COMMISSION MARCH 18, 2003 In response to this, staff included in the draft resolution conditions limiting the number of chairs to six and prohibiting the daily checkup operation. The internal medicine area in the facility would be performing colonoscopies and sigmoidoscopies. From the information staff was able to obtain, the limitation on this aspect, in that they were talking about one doctor doing the procedures and limiting them to two per hour, so they had the potential in this portion of the facility for six patients at any one time. Two in prep, two in recovery and two in the procedure itself. Relative to the research operator, they gave staff fairly detailed information. They were talking about four studies with seven patients in each for a total of 28 with an average of 10 visits a year for a total of 280. They expected to have them on hourly appointments, so staff was able to factor that in. The applicant then provided a flow chart showing the operation. The commission received a copy of that in their packets. That confirmed that between 10:00 a.m. and noon on most days would be the peak. That showed 12 patients in the facility with 20 employees for a total of 32. Based on the 10,294 square feet, they have an assumed parking provision of 38 spaces and staff concluded that with proper conditions to assure continued operation consistent with that described, staff recommended approval, subject to the conditions. He said that they came up with one last condition. In the event that parking became a problem in the neighborhood, they wanted the ability to request the appointment books to make sure that they are operating consistent with what they described to staff. Staff understood the names would have to be redacted out, but felt this would give them an opportunity to see if they were operating in accordance with the information given to staff. He asked for any questions. Commissioner Jonathan noted that in the original report going back to February 18, the staff report indicated that the applicant has 34 spaces allocated to them. He asked if there was an agreement for the shared facility that the owner has so that there were only 34 spaces allocated to the applicant. He asked if that was what Mr. Smith meant in the earlier report. Mr. Smith explained that they weren't talking about the same size of building. They were looking at an increase from 9,500 to 10,300 approximately. That took them up to 41 spaces. It was reduced by the unusable area in the building. Commissioner Jonathan clarified that he wasn't referring to the calculation. The staff report indicated that there was different discussion on the computation of how many were required and how many were available. 6 MINUTES PALM DESERT PLANNING COMMISSION MARCH 18, 2003 It was a specific statement indicating that the applicant "has 34 spaces allocated" in the parking lot. He noted that some owners have a parking agreement where there are specific spaces allocated to specific tenants. He was asking if this tenant had 34 specific spaces allocated to them, or any other number. Mr. Smith said no. Commissioner Jonathan asked if he was misinterpreting that statement. Mr. Smith said that statement was an attempt to say that based on the size of the area being leased, of the 128 spaces in the project as a total, they would have an assumed right to 34. Now they were saying that number is 38. Commissioner Tschopp asked if the additional condition was discussed with the applicant and if they agreed with it. Mr. Smith said he hadn't discussed it with them. Commissioner Tschopp said that in reading staffs report, it seemed that a large assumption was made based on the applicant's information that only one doctor would be at the facility. That seemed to correlate into the number of employees and number of customer visits. He suggested that if they were looking at that additional condition, they might want to add in there something about the number of doctors that would be at the facility, working out of the facility, at any one time since that seemed to be the individual that controlled everything else. Mr. Drell said they have a statement of how they would run the business and that includes the one doctor. So they were incorporating as a condition that all the details they describe are the rules. Mr. Smith agreed they should add a condition to limit the number of physicians. Commissioner Tschopp said that the statement was that the quantity of the services that could be performed was limited to two per hour based on one doctor at the facility. If they had two doctors, there would be considerably more employees and more people visiting the facilities. So he thought that would be a good condition. Mr. Drell agreed. He said they needed a very specific exhibit which lists all the details that have been described about the operation. He said they should incorporate the flow chart itself. It said how many employees and how many patients they would be taking at any one time. That flow chart is what they would use to measure against the appointment book to see how many patients they were taking in at any one time. Basically the flow chart should be the measure and should be incorporated as Exhibit A to the conditions. 7 MINUTES PALM DESERT PLANNING COMMISSION MARCH 18, 2003 Commissioner Finerty asked if the flow chart took into consideration the number of trials. Mr. Drell said yes. It has clinical tests and included the people coming in for the clinical tests. Commissioner Finerty asked if the clinical tests were for the research facility. Mr. Drell said yes. Commissioner Finerty said she had done some research into the issue. They were stating that there would be four contracted oncology studies a year. She said that was an extremely low number. Most facilities do many more studies than just four. The average number of participants in each study was between five and ten. In addition, the E-mail the commission had stated that the patients in these studies would be coming in monthly for these visits and that was not necessarily the way it worked. It was usually governed by what they call the American Society of Clinical Oncology which set forth guidelines as to the nationally accepted standards. Some standards said that patients needed to be looked at weekly, some said monthly, and they had no guarantee as to the number of trials nor did they have whether the protocol for that particular trial would necessitate patients going in weekly or monthly. If they came in weekly, that would have a dramatic effect on the parking again. Commissioner Jonathan said he didn't see in the staff report the required number of parking spaces under the ordinance if this was treated as a medical use, which it is. Mr. Smith said that it would be approximately ten more, so instead of 38 they would need 48. Mr. Drell clarified it would be 20 more. It would be six per 1,000 instead of four per 1,000. Mr. Smith concurred. Commissioner Jonathan asked if that was assuming a 15% reduction. Mr. Smith said 8%. Commissioner Jonathan noted that the requirement was for somewhere around 58 and the spaces available were about 38, so they were looking at about a 50% shortage. Mr. Smith said it was 20 or 21 spaces. Chairperson Campbell said she also considered that a medical building and the new ordinance required six per 1,000. She asked if they were going to have the 58 spaces, what business could locate in the remaining vacant space since there would be a shortage of 20 spaces. Mr. Smith said general office use. Mr. Drell said if the applicant had the 58 spaces he wouldn't be before the commission. They would just be entitled to medical use as a matter of right. The reason for the conditional use permit was to see if the character and operation of this particular medical use could fit into the allocated spaces, which was the 38. That's what all this information was about. The conclusion they had to reach to approve this was to say that 38 8 MINUTES PALM DESERT PLANNING COMMISSION MARCH 18, 2003 spaces are adequate for this particular use as described. That is what this process was about. If the commission concluded that he really needs 58 spaces, then they probably wouldn't approve it. If they determined that he could live with 38 based on how it was described, then that would be the basis for approving it subject to the conditions. Chairperson Campbell indicated that the public hearing was still open and asked the applicant to address the commission. MR. LARRY LYLE, 40520 Posada Court in Palm Desert, said his firm was representing the Voce family in the Alessandro Plaza project. He said they have reviewed the report prepared by Mr. Smith and agreed with it. He thought Mr. Smith did a very good job explaining how the tenant was going to use this location. The proposed tenant, Desert Medical Group, had a very good reputation in the valley. As was mentioned, they have six locations. He said that as part of their due diligence as brokers, they called several of their landlords. They didn't get one negative response about this company. Everyone was very positive. He thought that was important because it seemed there was concern that they were really going to do what they said they were going to do. They were. That is the way the company presents itself. That was what the plan said. So the way they wanted to use the facility was the way that would fit the parking requirements as they stated on the flow chart. Mr. Lyle also asked the commission to keep in mind that they do have other locations to do some of the services that might be out of similar types of facilities. The reason they chose their location, Palm Desert being the center of the valley, they have locations in Bermuda Dunes and Palm Springs which could do a lot of the follow-up items that would typically be with these services. So that again should help with the parking situation. He said when they reviewed the items that were on the report, a couple of stipulations that if it was approved, they just brought up a limit on the number of doctors and he didn't know if that was realistic. The way he understood it was that they would have one physician for the infusion area and one for the colonoscopy. But there could be 9 MINUTES PALM DESERT PLANNING COMMISSION MARCH 18, 2003 situations, maybe emergency situations, but he thought the way it was proposed on the limitations was very detailed and he didn't see the tenant doing anything beyond that. But limiting the amount of doctors was a little bit unrealistic. Desert Medical Group would be a very good tenant for their building. They have the space available, they would like to be there, he would like to have them and they were looking for the commission approval. Commissioner Finerty said she would like to respond to Mr. Lyle's statement about limiting the number of doctors and that being unrealistic. She explained that it was very realistic for the job the commission had because if there is a limit on doctors, there would be a limit on patients. When they were dealing with a shortage of parking already, it was very important that it be taken into consideration. She asked if this Desert Medical Group facility would be performing different services than the Desert Medical Group in Palm Springs. Mr. Lyle said the way he understood it they were doing different services. He said that Margie Taft was present and she was representing Desert Medical Group. But the way he understood it, they hired a new physician that was bringing in things they were not able to do before. They were new services here that weren't done specifically at their other locations. Commissioner Finerty asked for clarification that chemotherapy was not done at their other locations. Mr. Lyle didn't think so, not in the way it would be done at this location. But he couldn't answer that specifically. Commissioner Finerty said she was surprised to learn that Desert Medical Group in Palm Springs was really an urgent care and they have four doctors there and primarily deal with HMO patients. They send all of their cancer patients to Comprehensive Cancer. When he raised the issue that they needed more doctors and thought that was an unrealistic condition, it led her to wonder why they would need more doctors and perhaps it would be similar to how the other facilities were run dealing with urgent care and primary care. 10 MINUTES PALM DESERT PLANNING COMMISSION MARCH 18, 2003 Mr. Lyle said it was something he brought up and he couldn't speak for the tenant, but just hearing a limit on doctors, as long as they stayed with the amount of employees, he thought that was the main concern. But he couldn't speak for the tenant on that if they made that a condition. Chairperson Campbell asked if anyone else wished to speak in FAVOR or OPPOSITION. There being no one, the public hearing was closed. Chairperson Campbell asked for commission comments. Commissioner Finerty thought that there was definitely a parking shortage. What the applicant put forth in their flow chart and in the two different layouts was probably the best case scenario one could ever expect. But she didn't think it was anywhere near realistic. She thought the trials would increase, the number of patients would increase and the reality was the number of doctors would increase. She thought it was a great service to offer and was certainly needed, but this wasn't the right location for this application. Commissioner Jonathan concurred. Fundamentally he had two problems with the application. Number one was just a significant parking shortage. The application was for plus or minus 10,000 square feet out of an office complex of plus or minus 33,000 square feet. They weren't talking about making an exception for a small 2000, 3000 or 4000 square foot office that was part of a 33,000 square foot office where they have granted exceptions. They were talking about a really significant portion of the overall office complex. Second to that, the parking shortage was really significant. They weren't talking about a 10% or 15% shortage, they were talking about 38 provided and 58 required. Depending on how they do the math, that was either 30% or 50%. It was a significant shortage for a significant portion of the office complex. If either one of those factors wasn't as significant, then he would tend to be a little more flexible. The second fundamental problem he had was the applicant's request being based on a variety and extensive number of detailed limitations. They were set forth partially in Conditions 6, 7, 8 and 9. He thought they were completely unenforceable. The City wasn't in the business of medicine. He . didn't think they understood what kind of procedures were taking place within those four walls. He also didn't think they should make an attempt to 11 MINUTES PALM DESERT PLANNING COMMISSION MARCH 18, 2003 understand the medical profession. They shouldn't be in there looking to see how many tables there were, how many employees have Ph.D. behind their names, what kind of procedures they were doing, how many patients were coming in per hour. That wasn't the City's business and they shouldn't be granting an approval based on those types of conditions. This was clearly a medical use and it called for an office building that was approved for medical use parked at six per 1,000. There was good reason for that zoning ordinance. It was put in place because of the problems that occurred as a result of not having adequate parking for medical use. He thought this was a perfect example of trying to fit a very square peg into a round hole. He thought it wasn't justified. Commissioner Tschopp said that before the meeting he was considering staff's recommendation, thinking the conditions with the addition on the limitation on the number of doctors, it might be appropriate and might work. However, the more he looked at it and at the past case, he agreed that it was approved as an office professional building. If this use was approved, 42% of the building would be medical and 20 spaces short. The flow chart was very nice, but he could say that sometimes customers didn't work according to flow charts and had a habit of messing things up and making it difficult for staff, so sometimes what looked good on paper didn't normally fit in with people's needs. He also agreed that it wasn't staffs job to monitor something like this or to make it work out later if there was a problem. Additionally, he was confused on how many doctors would be there and since that was the number that generated the number of employees and the number of visits, it seemed like it could grow beyond what was being presented. Relying somewhat on Commissioner Finerty, who has some expertise in that area, her comments had credence, so he was not in favor of the project. Commissioner Lopez said he would have to agree with his fellow commissioners. Especially with regard to Commissioner Jonathan's comments. Looking at the conditions of approval, they were looking at more of a business use than a land use and were trying to dictate how they could conduct their business and how to police it. He wasn't sure that was the right thing for them to be doing. Looking at it at face value, it is a medical use. There was a problem with the shortage of parking. For the staff to have to go look at records, he didn't know if that was something they were supposed to be doing. He thought they were trying to fit this into a situation that wasn't 12 MINUTES PALM DESERT PLANNING COMMISSION MARCH 18, 2003 ideal or the right use of this particular building. He wasn't in favor of the proposal before them. Chairperson Campbell also concurred. She was in the dental field for 20 years and ran two dental offices. There was no way staff or the City could monitor how many doctors would be in an office. They ran an office that started with one doctor and ended up with three. Each three had their own patients and it just multiplies. She didn't think it was appropriate to have a police officer sitting in there making sure there was only one doctor working there. Also, the ordinance stated that this was a medical use and required six spaces per 1,000 and they were short parking spaces. So she wasn't in favor at that location. Commissioner Finerty asked for confirmation that there wasn't a resolution of denial in front of them. Staff said that was correct. Action: It was moved by Commissioner Finerty, seconded by Commissioner Tschopp, by minute motion directing staff to prepare a resolution of denial based on the commission's comments to be adopted on April 1 , 2003. Motion carried 5-0. C. Case No. PP 02-21 - CITY OF PALM DESERT, Applicant Request for approval of a precise plan to allow construction of a 3.3 acre expansion to the City's Corporate Yard, including a 19,398 square foot structure, located on the south side of 42nd Avenue, 180 feet west of Joni Drive. Mr. Joy indicated that this matter was before the commission briefly during the Hovley Gardens project. It was carved out of the 35-acre Hovley Gardens site and was a 3.3 acre site. As part of the development of Hovley Gardens an eight-foot wall was constructed around this expansion area. This use would allow consolidation of city yard uses that were scattered around the city a little bit right now, particularly in the industrial area. He noted that when Joni Drive was extended, it bisected the city yard into two. 13 PLANNING COMMISSION RESOLUTION NO. 2199 A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF PALM DESERT, CALIFORNIA, DENYING A REQUEST FOR A CONDITIONAL USE PERMIT TO ALLOW A 10,294 SQUARE FOOT CANCER/CHEMOTHERAPY/ INTERNAL MEDICINE/RESEARCH FACILITY MEDICAL OFFICE IN THE OFFICE COMPLEX LOCATED AT 73-712 AND 73-726 ALESSANDRO DRIVE. CASE NO. CUP 03-01 WHEREAS, the Planning Commission of the City of Palm Desert, California, did on the 18th day of February, 2003, hold a duly noticed public hearing which was continued to March 4 and March 18, 2003, to consider a request by CARL VOCE, for the above mentioned; and WHEREAS, at said public hearing, upon hearing and considering all testimony and arguments, if any, of all interested persons desiring to be heard, said Planning Commission did find the following facts and reasons to exist to justify denial of said conditional use permit: 1 . The proposed medical office use would amount to 31 % of the complex and when coupled with the previously approved plastic surgery office would total 44.6% of the complex. 2. The proposed medical office would have a parking shortage of 21 spaces when compared with the amount required by code for a medical office use. 3. The conditions necessary to assure compliance with the number of patients to be served as described by the applicant would be burdensome, difficult to enforce, and could result in an invasion of privacy beyond which the City should be engaged. 4. The number of patients is related to the number of doctors working from the complex. Monitoring the number of doctors working from the facility would be difficult. NOW, THEREFORE, BE IT RESOLVED by the Planning Commission of the City of Palm Desert, California, as follows: 1. That the above recitations are true and correct and constitute the findings of the Commission in this case. PLANNING COMMISSION RESOLUTION NO. 2199 2. That Conditional Use Permit 03-01 is hereby denied. PASSED, APPROVED and ADOPTED at a regular meeting of the Palm Desert Planning Commission, held on this 1st day of April, 2003, by the following vote, to wit: AYES: FINERTY, JONATHAN, LOPEZ, TSCHOPP, CAMPBELL NOES: NONE ABSENT: NONE ABSTAIN: NONE ()-1/ n SONIA M. CAMPBELL, Chairperson p ATTEST: PHILIP DRELL,‘t ecretary Palm Desert Planning Commission 2 CITY OF PALM DESERT DEPARTMENT OF COMMUNITY DEVELOPMENT STAFF REPORT TO: Planning Commission DATE: February 18, 2003 CASE NO: CUP 03-01 REQUEST: Approval of a conditional use permit to allow a 9,500 square foot cancer/chemotherapy/internal medicine medical office in the office complex located at 73-712 and 73-726 Alessandro Drive. APPLICANT: Carl Voce 545 Via Media Palos Verdes Estates, CA 90274 I. BACKGROUND: In July 2001 , Commission approved a three (3) building office complex having a total of 33,196 square feet. Construction of the buildings was completed in July of 2002. The project as constructed had an eight space parking surplus (128 spaces provided- 120 spaces required) based on its use for general office purposes. Based on this eight space surplus, staff in July 2002 approved a 4,400 square foot plastic surgery center in the north building adjacent to San Pasqual. Any additional medical use requires approval of a conditional use permit. ADJACENT ZONING AND LAND USE: North: R-1 / Single family residential South: C-1 / Professional offices, general retail East: R-3, R-1 / Verizon parking, single family residential West: R-3, R-1 / Buccino building parking lot, single family residential SITE ZONING: The property is zoned O.P. (office professional). II. CURRENT PROPOSAL / ANALYSIS: The applicant proposes a 9,500 square foot cancer/chemotherapy/internal medicine medical office which will bring the total medical office space in the complex to 13,900 square feet of the total 33,196 square feet in the complex (42%). STAFF REPORT CUP 03-01 FEBRUARY 18, 2003 The issue with medical office uses typically revolves around parking. Medical offices have a parking requirement of six spaces per 1 ,000 square feet versus four spaces per 1 ,000 square feet for general office use. This office complex is for the most part currently unoccupied by tenants so a parking survey would not yield meaningful information. The CUP process allows Planning Commission to evaluate specific use requests and approve acceptable requests subject to conditions. In this instance, staff feels there are extenuating circumstances which should be considered. The existing 4,400 square foot medical office is a plastic surgeon's office (Dr. Ball). This office has six employees and sees 6-8 patients per day. The doctor spends mornings in surgery and consults with patients in the afternoon. The eight patients would be spread out between 1 :00 p.m. and 5:00 p.m. This area of the complex then would have an actual parking demand of 8-9 spaces on any given afternoon. This space has 16 parking spaces allocated in the complex parking lot. The proposed cancer/chemotherapy/internal medicine medical office, according to the applicant, will have twenty employees and see a maximum of seven patients at any one time for a total parking demand of 27 spaces. This space (9,500 square feet - 8,579 square foot net) has 34 spaces allocated in the parking lot. Both medical uses are specialty medical practices which are low traffic generators. According to the applicant's figures both medical uses will have parking demands below that of a general office use. The two medical uses should have surplus parking of 14 spaces (7 + 7). IV. CONCLUSION: The recently completed office complex is an attractive addition to the neighborhood. The complex currently remains basically vacant except for Dr. Ball's office, which recently completed its interior improvements. The CUP process for medical offices was created to address the problem generated by high traffic general medical uses (i.e. dental clinics, urgent care facilities, pediatrician offices, and the like) which attract walk-in patients without appointments. The proposed new medical use and Dr. Ball's plastic surgery center are specialty medical uses which for parking purposes are at the low end of the parking generation spectrum. These uses only accept patients with an appointment. 2 STAFF REPORT CUP 03-01 FEBRUARY 18, 2003 The CUP process allows the City to impose conditions which will limit the medical uses to those described in the application (i.e. cancer/chemotherapy/internal medicine medical office use). The approval will be tenant specific. Additionally, staff is recommending a condition which requires that all employees be required to park on- site. Based on staff's review of the expected tenant mix, number of employees and number of visitors/customers/patients as provided by the applicant, staff concludes that the office complex parking lot can support this medical office proposal. Staff recommends approval of the requested CUP subject to conditions which will limit medical use in the complex to that described in the application. Any future change in the medical office use in the center will require an amendment to the CUP and public hearing before the Planning Commission. Any future medical use including replacing Dr. Ball's space will be comparable low parking demand specialty type medical uses. V. CEQA: The project is a class 5 categorical exemption for purposes of CEQA. No further environmental documentation is necessary. VI. RECOMMENDATION: That CUP 03-01 be approved subject to conditions. Prepared by: Reviewed and Approved by: S ve Smith Phil Drell Planning Manager Director of Community Development /dq G:\Planning\Donna Quaiver\wpdocs\sr\CUP03-01.pc 3 PLANNING COMMISSION RESOLUTION NO. A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF PALM DESERT, CALIFORNIA, APPROVING A REQUEST FOR A CONDITIONAL USE PERMIT TO ALLOW A 9 , 5 0 0 SQUARE FOOT CANCER/CHEMOTHERAPY/INTERNAL MEDICINE MEDICAL OFFICE IN THE OFFICE COMPLEX LOCATED AT 73-712 AND 73-726 ALESSANDRO DRIVE. CASE NO. CUP 03-01 WHEREAS, the Planning Commission of the City of Palm Desert, California, did on the 18th day of February, 2003, hold a duly noticed public hearing to consider a request by CARL VOCE, for the above mentioned; and WHEREAS,said application has complied with the requirements of the"City of Palm Desert Procedure for Implementation of the California Environmental Quality Act, Resolution No. 02-60,"in that the Director of Community Development has determined that the project is a Class 5 Categorical Exemption and no further documentation is necessary; and WHEREAS, at said public hearing, upon hearing and considering all testimony and arguments, if any,of all interested persons desiring to be heard,said Planning Commission did find the following facts and reasons to exist to justify its granting approval of said conditional use permit and parcel map: Findings for Approval of Conditional Use Permit A. The location of the conditional use permit and parcel map is in accord with the objectives of the municipal code and the purpose of the district in which the site is located; B. The proposed location of the conditional use and the conditions under which it would be operated or maintained will not be detrimental to the public health, safety, or welfare, or be materially injurious to properties or improvements in the vicinity; C. The proposed conditional use and conditions under which it will operate will comply with each of the applicable provisions of the zoning ordinance, except for approved variances or adjustments. D. The proposed conditional use complies with the goals, objectives, and policies of the City's general plan. 1 PLANNING COMMISSION RESOLUTION NO. NOW, THEREFORE, BE IT RESOLVED by the Planning Commission of the City of Palm Desert, California, as follows: 1. That the above recitations are true and correct and constitute the findings of the Commission in this case. 2. That approval of Conditional Use Permit 03-01 is hereby granted for reasons subject to the attached conditions. PASSED, APPROVED and ADOPTED at a regular meeting of the Palm Desert Planning Commission, held on this 18th day of February, 2003, by the following vote, to wit: AYES: NOES: ABSENT: ABSTAIN: CYNTHIA FINERTY, Chairperson Palm Desert Planning Commission ATTEST: PHILIP DRELL, Secretary Palm Desert Planning Commission 2 CONDITIONS OF APPROVAL CASE NO. CUP 03-01 Department of Community Development: 1 . The development of the property shall conform substantially with exhibits on file with the Department of Community Development as modified by the following conditions. 2. Construction of tenant improvements of said project shall commence within one year from the date of final approval unless an extension of time is granted; otherwise said approval shall become null, void and of no effect whatsoever. 3. The development of the property described herein shall be subject to the restrictions and limitations set forth herein which are in addition to all municipal ordinances and state and federal statues nor is force, or which hereafter may be in force. 4. That the conditions of approval imposed on Case No. PP 01-13 shall be conditions on this application. 5. That the complex owner shall require that all employees of the complex shall park on site. 6. That the approved medical use under this approval shall be limited to a cancer/chemotherapy/internal medicine practice only. Any change or addition of other medical uses within this 9,500 square foot approved space shall first obtain approval of an amendment to this conditional use permit. i i . . • . , _1(ref2P/ 0 5 A / _.,Q APZ/ •gm/s211WYbid A69(yRya/ .,"pet9a/(7 -i,./ 11/ LI GO" 4, WE i 0415g4=1/74012/e"-,7"/*107 di?a0 71Y95?6. 6 4 , .5. / 6'1 , 0E// _17,1/147Y, - /7,..- -,5-azYd -- . 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FAX: 760 341-7098 • •'•"�=• info@palm-deserr.org CITY OF PALM DESERT LEGAL NOTICE CUP 03-01 NOTICE IS HEREBY GIVEN that a public hearing will be held before the Palm Desert Planning Commission to consider a request by CARL VOCE for approval of a conditional use permit to allow a 9,500 square foot cancer/chemotherapy/internal medicine medical office in the office complex on the north side of Alessandro between San Pascual and San Juan,73-712 and 73-726 Alessandro Drive. I , III �1 , RORro1Amos.•my • � WO i 1 - ' PirI sue.�Me .... r w . 1• O. ORROM %U U7•NZ,11111..1ill. C a !IC IFIN swt•wgs.•kwi R 1DR . M ea. ;•• i. 3 3 3.. iiiirl:' i'Lliti;;; IAA' _ Kim Ki S ' CMG {I13d • ' .owu.. RR e • • ••••••• :if' ?'At ® M VICINITY NO SCALE SAID public hearing will be held on Tuesday,February 18,2003,before the Palm Desert Planning Commission at 7:00 p.m.in the Council Chamber at the Palm Desert City Hall, 73-510 Fred Waring Drive,Palm Desert,California,at which time and place all interested persons are invited to attend and be heard. Written comments concerning all items covered by this public hearing notice shall be accepted up to date of the hearing. Information concerning the proposed project and/or negative declaration is available for review in the department of community development at the above address between the hours of 8:00 a.m. and 5:00 p.m.Monday through Friday. If you challenge the proposed actions in court,you may be limited to raising only those issues you or someone else raised at the public hearing described in this notice,or in written correspondence delivered to the planning commission at,or prior to,the public hearing. 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V ' OVA ri I 1....._11 ,---, 7-- ---- ,,, .ti II),!,MI'll,!.Ehl- '—' 4 1,—) 1 I •\ illi Gurr . 15- Af- K CITY OF PALM DESERT DEPARTMENT OF COMMUNITY DEVELOPMENT STAFF REPORT TO: Planning Commission DATE: March 18, 2003 continued from March 4 and February 18, 2003 CASE NO: CUP 03-01 REQUEST: Approval of a conditional use permit to allow a 9,500 square foot cancer/chemotherapy/internal medicine medical office in the office complex located at 73-712 and 73-726 Alessandro Drive. APPLICANT: Carl Voce 545 Via Media Palos Verdes Estates, CA 90274 BACKGROUND: This matter was continued from the March 4, 2003 meeting to allow the applicant to submit additional information and to allow staff to evaluate the new information and make a recommendation to commission. Staff met with Mr. Voce and various other interested parties Monday, March 10, 2003. The applicant provided a copy of the original floor plan which was shown to commission at its February 18, 2003 meeting (copy enclosed). This plan showed one area with a total of 9,500 square feet. This plan did not include the research facility. The revised floor plan shown to commission March 4, 2003, provides a total area of 10,294 square feet in two buildings. A doctor's office and two exam rooms are removed from the main building and that area is replaced with the research center. The doctor's office and two exam rooms are moved to Suite B-4 in the next building. Staff has reviewed the March 4, 2003 floor plan with a view to determining the maximum number of employees we could expect. The applicant indicates a maximum of 20 employees. Staff concluded there will be at least 16 employees plus those associated with the research facility. A letter dated March 10, 2003 from an oncology research person indicates there will be one principal investigator for a total of 17 employees minimum. We conclude that a maximum of 20 employees is reasonable. Next the applicant explained in detail the operation of the three (3) facilities (chemo facility; internal medicine - colonoscopy/sigmoidoscopy); research center. STAFF REPORT CASE NO. CUP 03-01 MARCH 18, 2003 The infusion area will have a maximum of six chairs. These patients take from two to four hours each. The applicant advised that Desert Medical Group operates six existing facilities across the valley. The goal here is to consolidate its infusion facility. This facility will not be a full service facility. It will be specialized and limited to infusion only. People will not come to this location for daily check-ups. These will be handled at the Palm Springs and Bermuda Dunes locations. At any one time this area will have a maximum of six patients. Conditions limiting the number of chairs to six and prohibiting performing daily check-ups will be included in the draft resolution. The internal medicine area will perform colonoscopies and sigmoidoscopies. The quantity of these services which may be performed is limited to two per hour (based on one doctor at the facility). At any one time this area will have a maximum of six occupied gurneys (two in recovery, two in procedure and two in prep). The research area operator anticipates four contracted oncology studies with seven patients in each study group for a total of 28 patients. These 28 patients would have 10 visits per year each for 280 total visits or about one visit per day. The applicant indicates they would be expected to group appointments by day so we could expect one per hour. Based on this explanation of the operation, a maximum of 12 patients could be expected at the facility at any one time. This count is confirmed by the flow chart the applicant has prepared (copy attached). Staff has been given to understand that this flow chart has been reviewed and concurred with by Kay Esteii-Gillette of Desert Medical Group. The flow chart of operations shows that the peak number of patients and employees at this facility will be at 10:00 a.m. and 1 1 :00 a.m. when 32 people will be onsite (12 patients and 20 employees). Based on a parking requirement of four spaces per 1 ,000 square feet, this area has 41 assigned parking spaces less 8% unusable area = 38 available spaces. The flow chart and the applicant's explanation of the operation shows a maximum parking demand for 32 spaces. Staff concludes that with proper conditions to assure continued operation consistent with that described in this report that the facility will not create a parking problem for the neighborhood and that the conditional use permit can be recommended for approval. 2 STAFF REPORT CASE NO. CUP 03-01 MARCH 18, 2003 Staff will suggest an additional condition which will allow the City, should parking become a problem, to review appointment books to confirm that patients are being scheduled consistent with the flow chart provided. We recognize that patient names will need to be redacted. II. RECOMMENDATION: Staff recommends that Planning Commission adopt Planning Commission Resolution No. approving CUP 03-01 , subject to conditions. III. ATTACHMENTS: A. Draft Resolution B. Plans C. February 1 8, 2003 Prepared by: Reviewed and Approved by: Steve Smith Phil Drell Planning Manager Director of Community Development /tm 3 PLANNING COMMISSION RESOLUTION NO. A RESOLUTION OF THE PLANNING COMMISSION OF THE CITY OF PALM DESERT, CALIFORNIA, APPROVING A REQUEST FOR A CONDITIONAL USE PERMIT TO ALLOW A 10,294 SQUARE FOOT CANCER/CHEMOTHERAPY/ INTERNAL MEDICINE/RESEARCH FACILITY MEDICAL OFFICE IN THE OFFICE COMPLEX LOCATED AT 73-712 AND 73-726 ALESSANDRO DRIVE. CASE NO. CUP 03-01 WHEREAS, the Planning Commission of the City of Palm Desert, California, did on the 18th day of February, 2003, hold a duly noticed public hearing which was continued to March 4, 2003 and March 18, 2003 to consider a request by CARL VOCE, for the above mentioned; and WHEREAS, said application has complied with the requirements of the "City of Palm Desert Procedure for Implementation of the California Environmental Quality Act, Resolution No. 02-60," in that the Director of Community Development has determined that the project is a Class 5 Categorical Exemption and no further documentation is necessary; and WHEREAS, at said public hearing, upon hearing and considering all testimony and arguments, if any, of all interested persons desiring to be heard, said Planning Commission did find the following facts and reasons to exist to justify its granting approval of said conditional use permit and parcel map: Findings for Approval of Conditional Use Permit 1 . The location of the conditional use permit and parcel map is in accord with the objectives of the municipal code and the purpose of the district in which the site is located. 2. The proposed location of the conditional use and the conditions under which it would be operated or maintained will not be detrimental to the public health, safety, or welfare, or be materially injurious to properties or improvements in the vicinity; 3. The proposed conditional use and conditions under which it will operate will comply with each of the applicable provisions of the zoning ordinance, except for approved variances or adjustments. 4. The proposed conditional use complies with the goals, objectives, and policies of the City's general plan. PLANNING COMMISSION RESOLUTION NO. NOW, THEREFORE, BE IT RESOLVED by the Planning Commission of the City of Palm Desert, California, as follows: 1. That the above recitations are true and correct and constitute the findings of the Commission in this case. 2. That approval of Conditional Use Permit 03-01 is hereby granted for reasons subject to the attached conditions. PASSED, APPROVED and ADOPTED at a regular meeting of the Palm Desert Planning Commission, held on this 18th day of March, 2003, by the following vote, to wit: AYES: NOES: ABSENT: ABSTAIN: SONIA M. CAMPBELL, Chairperson ATTEST: PHILIP DRELL, Secretary Palm Desert Planning Commission 2 PLANNING COMMISSION RESOLUTION NO. CONDITIONS OF APPROVAL CASE NO. CUP 03-01 Department of Community Development: 1 . The development of the property shall conform substantially with exhibits on file with the Department of Community Development as modified by the following conditions. 2. Construction of tenant improvements of said project shall commence within one year from the date of final approval unless an extension of time is granted; otherwise, said approval shall become null, void and of no effect whatsoever. 3. The development of the property described herein shall be subject to the restrictions and limitations set forth herein which are in addition to all municipal ordinances and state and federal statues now in force, or which hereafter may be in force. 4. That the conditions of approval imposed on Case No. PP 01-1 3 shall be conditions on this application. 5. That the complex owner shall require that all employees of the complex shall park on site. 6. That the approved medical use under this approval shall be limited to a cancer/ chemotherapy/internal medicine/oncology research practice only. Any change or addition of other medical uses within this 10,294 square foot approved space shall first obtain approval of an amendment to this conditional use permit. 7. That the infusion center shall be limited to a maximum of six (6) chairs. 8. That the infusion center shall not provide daily check-ups. 9. That should parking in the complex become a problem in the future, the operator(s) of the medical facilities approved under this permit agrees to provide the City, upon 15 days notice, copies of current appointment books (names may be redacted) to confirm that patients are being scheduled consisted with the flow chart (copy attached) provided by the applicant. 3 F-Lot,) CIA.QA b r9,414 typos fo r/C Peso,'4/'t. Colonoscopy Infusion Clinical Test Employees Total New arrival current patient New arrival current patient New arrival current patient 7 t, o a o o 1 O t U 8 Z o ( o 0 O zo LB 9 .L Z o Co 1 o z o 3 l , 10 `{ O 9 l 1 Z.0 3 Z Z. 11 Z 1 z Z. I 2.-03 Z. 12 0 Z o 2- 0 I 1 0 lS 1 0 0 ( 0 I o Z 0 -1 2 Z. v e �P I Z o 3 0 3 2_ -z o `1 t 1 Zo 3 4 v t_ v 7_ v t -t___o a C 5 v o 0 p v o I v l ° 6 Die(6>� a (I -,,e.4 )g / Zos15 ace u ej pourcor+ t bus , „4, ` latiowo Arm i war ‘[.... war t---- - j at I of two ( � t ' ro•lc. I `d 61 7 ,O ] I 41 O O ^, O I saws -----. A Liu ! ; 'n7 , .o s L. . to. Qi 8I I-- theis ,... _{ 8° tAilAr 0.--...—..... fj" b ../ ftrliy. OteR Ph "—at >t 0%11 t an Dro * keic *Po — -"---- Rr" , Lii,, _ lD i trn E4,...,t , fLOL() Ckc r Colonoscopy Infusion Clinical Test Employees 'total New arrival current patient New arrival current patient New arrival current patient 7 0 O O V O 0 l0 t0 8 'Z b (.0 o v O Zo ZB 9 z Z O Cc 1 o -Z o 31 10 y O y 1 I -z..., 3a Z 11 Z '-t Z Z. 1 Zo 'S Z. 12 O Z o 2_ 0 I 10 lS 1 0 o O I U z o Al 2 Z. o e I z.o 3 0 3 Z z o `1 -LA) 3 4 v z ° 7- 0 Z� aS 5 0 0 0 0 v o I d ( U 6 FROM FAX NO. Mar. 10 2003 11:53AM P2 MAR-10-2003 MON 1( AM DESERT MED 1 CAL GROUP 7.,,,,1J 1494 P. 01 Kay Et sII-GNiette • From: Fronts(pfrontstaa1hua2000.com) To Maim t0'2003 8;44 AM Kay�8 Ce: Thomas Goodro;Mark Huffing MD,MPH subject: Foracass and Assumptions fot Oncok gy torch V stts Hi ray, It was a pleasure seeing you again last week. AA you requested. below is a forecast and related aaeumptions for oncology research visits in year 1. The start of year 1 will depend on when an oncologist is hired by DMG. Assumptions Year 1: * All research visits completed at new Oncology center * Oncology principal investigator on sit• full time * 4 contracted Oncology studies • 7 patients enrolling in end completing each study - 28 patients total * 10 visits per study per patient - 280 visits total Oncology. Research Visit Etiorscaet. 4 80 of all visite completed in year 1 - 224 visits * 260 work days par years 260/224 = .86 visits/day in year 1 • visit volume expeoted to increase 75% in year 2 - about 392 visits 4t about 1.75 visits per day in year 2 " The net Increase in total visite at the nee, oncology ;enter due to research visits will be leas then the reaearob visit number since a portion of research visits will replace normal care visits (depending on study anyschese from i0b-60%) Kay, please call ape if yov nave any questions. I hope this info helps you with your project. Regards, Pete fronts Pros=dent Altura 949-330-6160 1 FROM FAX NO. Mar. 10 2003 11:52AM P1 MAR-10-2003 MOH 1( AN DESERT MEDICAL GROUP 7 01494 P. 02 f' DESERT 1 1r MEDICAL 4 GROG:Pic. 3/b103 The fbllowing arc aorvicos,injections or infusions performed at the two Desert Medical Group I fbeion Clinics in Palm Springa and Bermuda Dunes: SERVICES INJECTIONS/INFUSIONS Arcdia Inflation AvenextInterferon Hillary Tube Flush Central Line Blood Draw Central Lino Dressing Change Central Line Flush Cerezyme Cortisol Stim/C-Syntropin Culture&Sensitivity Decaduabolin Depo Pmv -a Desferral DTAP Enbrcl Estrogen Fin Vaccine Fa8ladex Hepatima A Hcpatitus B Human Immune Gloubin MI Antibiotic IV Antibiotic IV Hydration IV1ci Iron Injection Iron tnfuaion Lovenox Lupron/nelstar/Zolades Medication Pick up 277S N.131 Clete • Palm Sppringe,California 97762 • Teiephane(760)320-8814 • Fax(760)320.0104 FROM : FAX N0. : Mar. 10 2003 11:53AM P3 MAR-10-2003 MON 10 gill DESERT tED{CAL GROUP 7buset11494 P. 03 Mediport Flush Medipott Lab Draw Maaingacoccs] Methotrcaste 1M Mg So4 Naphrostorny Care Nophrostomy Flush Neupogen Phlebotomy PICC Line Blood Draw PICC Lane Discontinued PICC lino Drcating Change PICC Lino Flush PICC Line Placement/Insertion Polio Vaccine Procrit/Aranscp Pneuumovax PF T/Spaioy PPD PPD with Controls or Read Prevnar Remicade Rocephin IV Rum S nndostin/Ocetrchd.e Skin Test or Read Synsgis Soh Medrol IV Infusion Teaching Tetanus Testosterone Typhoid Urinary Cath_Change Varivax Venipuneturr Viramin K Wound Care &mcta Pulse Ox Ostomy Care