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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005738
Report Date: 02/10/2023
Date Signed: 02/10/2023 02:48:33 PM

Document Has Been Signed on 02/10/2023 02:48 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:SUNFLOWER HOMEFACILITY NUMBER:
306005738
ADMINISTRATOR:WHITE, DAVID E.FACILITY TYPE:
735
ADDRESS:1161 ORLANDO STTELEPHONE:
(949) 612-9883
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: 4CENSUS: 0DATE:
02/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Ruth HunterTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA arrived at the facility and was greeted and granted entry by mother of Administrator Ruth Hunter, who stated they are currently residing in the home with no clients in care. LPA Gutierrez discussed the purpose of the inspection. During the inspection LPA Gutierrez conducted a tour of the inside and outside of the facility, common areas, bedrooms, kitchen, garage and observed the following:

This is a two-story house with three bedrooms and two bathrooms. LPA confirmed the facility currently does not have any clients in care. Ruth stated they wish to maintain the license at this time and Administrator David White will notify Community Care Licensing when they admit a client into the facility, a physical inspection will also be completed at that time.

Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was left at the facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2023
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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