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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107203333
Report Date: 01/09/2025
Date Signed: 01/09/2025 04:05:37 PM

Document Has Been Signed on 01/09/2025 04:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:SUNSHINE BOARD AND CARE IIFACILITY NUMBER:
107203333
ADMINISTRATOR/
DIRECTOR:		RIGON, AURORAFACILITY TYPE:
735
ADDRESS:1642 W. ROBINSON AVENUETELEPHONE:
(559) 225-6432
CITY:FRESNOSTATE: CAZIP CODE:
93705
CAPACITY: 6CENSUS: 6DATE:
01/09/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:25 PM
MET WITH:Aurora RigonTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
NARRATIVE
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On 01/09/25, Licensing Program Analysts (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA introduced self stated purpose of visit and allowed entrance by Direct Care Staff. Licensee contacted by telephone and arrived a short time later to conduct facility inspection. Facility tour conducted with Administrator, Aurora Rigon.

Facility observed to be well lit and a comfortable temperature. Resident bedrooms toured, all bedrooms observed to have required furnishings. All common areas observed to have adequate seating available for residents in care. Resident bathroom toured, fixtures observed operational at time of visit. LPA observed non-skid surface and grab bars. Water temperature measured at 120 degrees F. Kitchen toured, all knives observed locked and secured. LPA observed a 2-day supply of perishable and a 7-day supply of non-perishable available. Medications observed to be locked and secured in kitchen cabinet. All medications observed to have original labels and to be administered as prescribed.

All cleaning supplies observed to be locked and secured in hallway closet. Smoke detectors and carbon monoxide detectors observed operational during today's inspection. Fire extinguisher present with a purchase date of 2/13/24. Last fire drill conducted 2/14/24 and facility has no record of disaster drills.

Outside of facility toured. All exits open free of obstruction. No hazards observed.

Staff and resident files reviewed.

Deficiencies cited on the attached 809-D

Exit interview conducted. A copy of report provided to Administrator for facility records.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2025
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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Document Has Been Signed on 01/09/2025 04:05 PM - It Cannot Be Edited


Created By: Melinda Medina On 01/09/2025 at 03:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: SUNSHINE BOARD AND CARE II
FACILITY NUMBER: 107203333

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/09/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80020(c)
Fire Clearance
(c) A licensee of an Adult Residential Facility or Group Home utilizing secured perimeters shall conduct fire and earthquake drills pursuant to Health and Safety Code section 1531.15(h).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above facility has no record of conducting disaster drills and the last fire drill was conduted on 2/14/24, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/24/2025
Plan of Correction
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Licensee to conduct both a fire drill and an emergency disaster drill and submit paperwork to Fresno Regional Office prior to the POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Melinda Hoffmann
LICENSING EVALUATOR NAME:Melinda Medina
LICENSING EVALUATOR SIGNATURE:
DATE: 01/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2025


LIC809 (FAS) - (06/04)
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