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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
197607506
Report Date:
06/15/2021
Date Signed:
06/15/2021 12:03:51 PM
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
21731 VENTURA BLVD., STE. 250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
SUNSHINE'S PLACE II
FACILITY NUMBER:
197607506
ADMINISTRATOR:
ROSARIO SORIANO
FACILITY TYPE:
740
ADDRESS:
7328 QUARTZ AVE.
TELEPHONE:
(818) 739-0492
CITY:
WINNETKA
STATE:
CA
ZIP CODE:
91306
CAPACITY:
6
CENSUS:
5
DATE:
06/15/2021
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
09:30 AM
MET WITH:
Rosario Soriano
TIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Wendell Smith conducted a required annual visit. LPA met with the administrator and explained the reason for this visit.
LPA toured the physical plant area of the facility. There was one resident on hospice at the time of the visit.
All the required postings were posted regarding Covid-19. LPA's temperature was taken and a questionnaire was filled out before entering the facility.
Kitchen:
The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Cleaning supplies are stored in the cabinet under the kitchen sink. Properly labeled medications were locked in a cabinet in the kitchen.
Bedrooms:
There were five bedrooms designated for residents' use. All bedrooms were properly furnished and had sufficient lighting. There was appropriate bedding and linens. There is a staff room attached to the garage. Smoke signal system is hard wired throughout the facility. Carbon monoxide detector was observed.
Bathrooms:
There were three bathrooms designated for residents' use. All bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 111 degrees F.
Common Areas
: These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit.
Surrounding Grounds
: Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The laundry area and detergents are located in the garage which is kept secured from residents.
No deficiencies cited during this visit. Exit Interview conducted.
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
06/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/15/2021
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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