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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843025
Report Date: 05/03/2019
Date Signed: 05/03/2019 09:37:21 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:SUNRISE CHILDREN'S CENTERFACILITY NUMBER:
334843025
ADMINISTRATOR:MASS AMITHFACILITY TYPE:
840
ADDRESS:1421 RIMPAU AVENUETELEPHONE:
(951) 272-2022
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY:48CENSUS: 2DATE:
05/03/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Assistant Director/Designee Angila AhmadyarTIME COMPLETED:
09:50 AM
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Licensing Program Analysts (LPAs) Samuel Lopez and Destinee Hogue arrived at the facility to amend a report that was previously issued on 3/14/19. Prior to conducting today's visit/inspection, on 4/19/19, LPA Lopez discussed, with Director Mass Amith, the reason for amending the report. LPA Lopez then emailed the amended version of the report to Mass Amith on 4/19/19 and 5/1/19, requesting her to sign and return. Mass Amith verified receipt of emails and attached report. As of 5/3/19, LPA Lopez had not received the signed report, as requested. During today's visit, LPAs Lopez and Hogue met with Assistant Director/Designee Angila Ahmadyar and obtained a signature on the amended report and provided a copy to her.

An exit interview was conducted with Assistant Director/Designee Angila Ahmadyar and a copy of this report was also provided to her.

This report must be made available to the public, upon their request, for a period of 3 years.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 782-4116
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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