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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608474
Report Date: 08/09/2023
Date Signed: 08/30/2023 03:49:15 PM


Document Has Been Signed on 08/30/2023 03:49 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
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364



FACILITY NAME:SUN CARE HOMESFACILITY NUMBER:
197608474
ADMINISTRATOR:STEPHANIE FLORESFACILITY TYPE:
740
ADDRESS:18725 SHOENBORN STREETTELEPHONE:
(818) 384-7456
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY:6CENSUS: 6DATE:
08/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Chita TIME COMPLETED:
02:30 PM
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On 8/09/2023 Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. Upon arrival, LPA was greeted by staff member. Shortly after, LPA met with Administrator Chita Beltran and explained the reason for the visit. A tour of the physical plant was conducted at 10:00 AM.
Bedrooms: There were three bedrooms designated for residents' use. All bedrooms were clean, properly furnished and had sufficient lighting.
Bathrooms: There were two bathrooms designated for residents' use. Both bathrooms were clean, properly supplied and had functional fixtures. Hot water temperature was 112.3 degrees Fahrenheit. Cleaning supplies were kept in locked cabinets.
Hallway: There was a large closet full of extra towels and linens that were readily available.
Temperature: Facility maintains a comfortable temperature of 75 degrees Fahrenheit.
Common Areas: These included the living room and dining area. The common areas appeared clean and were properly furnished.
Surrounding Grounds: Entry/exits were observed to be locked. The outdoor area was clean and free of hazards. There is a clean covered shaded area in the back yard and there is a pool which has a gate and is kept locked and inaccessible to residents in care.
Smoke alarms and carbon monoxide: detectors were tested and function properly. There were 2 fire extinguishers at the facility and they were purchased on 08-09-2023.
Kitchen: The kitchen appeared clean and the appliances and fixtures functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives and detergents were stored in locked drawers and cabinets. Properly labeled medications were locked in a cabinet near the kitchen.
Garage/Laundry area: LPA observed the garage and laundry are to be locked and not accessible to residents.

SUPERVISOR'S NAME: Eva MillerTELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Mariana AgbanTELEPHONE: 818-738-4525
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: SUN CARE HOMES
FACILITY NUMBER: 197608474
VISIT DATE: 08/09/2023
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No deficiencies issued during today’s visit. Report was signed and delivered and an exit interview was conducted.
SUPERVISOR'S NAME: Eva MillerTELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Mariana AgbanTELEPHONE: 818-738-4525
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023
LIC809 (FAS) - (06/04)
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