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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603280
Report Date: 01/13/2023
Date Signed: 02/03/2023 01:55:26 PM

Document Has Been Signed on 02/03/2023 01:55 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:SUNBRIGHT HOMECAREFACILITY NUMBER:
198603280
ADMINISTRATOR:TUASON, CYNTHIAFACILITY TYPE:
735
ADDRESS:1744 STORRS PLTELEPHONE:
(909) 988-8396
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY: 6CENSUS: 6DATE:
01/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Gerard Liwanag and Cynthia Tuason TIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Required-1 year visit focusing on COVID-19 Infection Control Practices. LPA met with Gerard Liwanag and explained the purpose of today's visit. LPA toured the facility grounds. Cynthia Tuason (Facility Administrator) arrived at approximately 8:45 AM.

This home consists of (5) bedrooms (3 of which are client occupied), (2) bathrooms, living room, kitchen, dinning area, recreation room, laundry set-up is inside the attached garage. All Clients residing at this facility receive case management services provided by San Gabriel Pomona Regional Center.

The following were observed/inspected: .
  • COVID-19 Infection Control Practices (including signs) were observed at the entrance of this facility and throughout the facility.
  • Signs are posted to promote hand washing, cough/sneeze etiquette, and physical distancing were observed. Bathrooms have hand washing signs promoting hand washing etiquette.
  • Clients were be socially distanced according to local public health guidelines.
  • Client medications reviewed for Client#1 (C-1) through Client #6 (C-6).
  • PPE supplies observed. Additional PPE supplies are stored inside the garage.
  • Hygiene supplies observed.
  • Incontinence supplies observed (stored inside the garage).
  • Restrooms have hand soap, hand sanitizer and paper towels.
  • Common areas have hand sanitizers.
  • Sufficient supply of perishable for 2 days and non-perishable foods for 7 days were observed. Additional food supply and water is stored inside the garage.

Exit interview conducted, a copy of this report and Appeal Rights were provided to Cynthia Tuason
SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Elizabeth Irra
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2023
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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