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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005223
Report Date: 06/30/2021
Date Signed: 07/01/2021 10:58:23 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:SUNNYCREST SENIOR LIVINGFACILITY NUMBER:
306005223
ADMINISTRATOR:HEATHER YOSTFACILITY TYPE:
740
ADDRESS:1925 SUNNY CREST DRIVETELEPHONE:
(714) 992-1999
CITY:FULLERTONSTATE: CAZIP CODE:
92835
CAPACITY:210CENSUS: 79DATE:
06/30/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Heather YostTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Michelle Reed made an unannounced visit to the facility to conduct an Annual visit. Upon arrival LPA met with Administrator Heather Yost and explained the purpose of the visit. Ms. Yost provided LPA with a copy of the Covid Preparedness and Response Plan.

During the visit, LPA toured the facility. LPA observed Covid signage as well as a sanitization station. Facility has required Department postings and there will be 1 entrance in and out. LPA toured the activity and dining areas of the facility and they were clean and sanitary with Covid precautions in place. Hand sanitizer was observed throughout the facility. Gloves were also readily available. Restrooms observed contained soap and paper towels. Residents were observed playing Bingo and enjoying the courtyard. Licensee has required Mitigation plan and Emergency Disaster Plan. LPA also observed a 30 day plus supply of PPE. Facility has a secured location for resident medications and files.

During the visit, LPA reminded staff of the importance of maintaining a 30 day supply of PPE on site. Additionally, LPA discussed sign in and screening procedures for visitors as well as residents and staff. LPA advised the importance of mask wearing and handwashing for staff at all times.

No deficiencies noted during visit. An exit interview was conducted with and a copy of this report was provided to Heather Yost.

SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: Michelle ReedTELEPHONE: (714) 743-4958
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021
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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