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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003502
Report Date: 07/22/2024
Date Signed: 07/22/2024 02:09:28 PM


Document Has Been Signed on 07/22/2024 02:09 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
ORANGE COUNTY ASC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:SUNNY CREST GUEST HOME #3FACILITY NUMBER:
306003502
ADMINISTRATOR:KENNETH/MARIA HUNTERFACILITY TYPE:
740
ADDRESS:5174 FOX HILLSTELEPHONE:
(714) 562-1082
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:6CENSUS: 4DATE:
07/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Kenneth Hunter - Licensee/AdministratorTIME COMPLETED:
02:24 PM
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Licensing Program Analyst (LPA) Dwayne Mason Jr. arrived at the facility unannounced for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into facility by facility staff Hyacinth Talaban. Administrator/Licensee Kenneth Hunter joined the inspection approximately 30 minutes after LPA's arrival.

The facility is a one-story home with three resident bedrooms, one staff bedroom, two resident bathrooms, one staff bathroom, kitchen, dining room, living room, family room, backyard, laundry room and attached 2-car garage. All resident rooms had required elements, including bed, chair, closet space and ample lighting. Facility has extra linens for residents in the hallway closet. Restrooms are stocked with soap and paper towels. LPA measured water in resident bathrooms to be between 105 and 120 degrees Fahrenheit. LPA noted Fire Extinguishers were last serviced on 04/19/2024 according to the service tag on them. LPA observed the smoke/carbon monoxide detectors to be operational. Facility keeps emergency water and emergency disaster supplies in the garage.

LPA observed hazardous items such as knives, chemicals and cleaners to be locked up in cabinets. Knives are locked up separate from toxic chemicals. Medication for each resident is kept locked in a closet in the hallway. The backyard has a shaded sitting/lounging area. Exit gate is unlocked. LPA observed exit gates to be unobstructed. LPA observed a sample menu and activity calendar in the facility. LPA reviewed four of the four resident files and four staff files. LPA also reviewed medication for two out of four residents. LPA interviewed one resident and one staff.

Based on today's inspection, no deficiencies are being issued. An exit interview was conducted and a copy of this report was provided to the facility.
SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Dwayne L MasonTELEPHONE: () -
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2024
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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