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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005701
Report Date: 07/24/2024
Date Signed: 07/24/2024 01:35:53 PM

Document Has Been Signed on 07/24/2024 01:35 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 RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:SOUTHERN CALIFORNIA SUNRISE RECOVERY CENTERFACILITY NUMBER:
306005701
ADMINISTRATOR/
DIRECTOR:		MICHAEL VILLARREALFACILITY TYPE:
772
ADDRESS:25481 GLORIOSA DRIVETELEPHONE:
(949) 533-3046
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 6CENSUS: 5DATE:
07/24/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:47 AM
MET WITH:Michael Villarreal- AdministratorTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of initiating the 10-day complaint investigation at another facility, Southern California Sunrise Recovery Center LLC, #306005879, located at 24372 Augustin St. Mission Viejo. LPA was greeted and granted entry by Behavioral Technician Tracy Graham and explained the reason for the visit. Administrator Michael Villarreal arrived on premise approximately 12:18pm.

During today's visit, LPA observed the food supply. Facility maintains 7 day supply of non-perishables and 2 day supply of perishables. There was a census of five clients and six staff. All staff were cleared and associated upon review of the Licensing Information System Personnel Report Summary. LPA interviewed Administrator Michael Villarreal in connection to the complaint at the Augustin facility, Complaint Control Number: 22-AS-20240718133612. LPA also requested copies of records to LPA via email by Monday, July 29, 2024.

An exit interview was conducted, and a copy of this report was provided at the end of the visit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2024
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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