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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005738
Report Date: 02/01/2024
Date Signed: 02/01/2024 11:46:05 AM

Document Has Been Signed on 02/01/2024 11:46 AM - 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: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:
02/01/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Hong Lei Wang aka "Kobe" - CaregiverTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Dwayne Mason Jr. 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. Caregiver Hong Lei Wang also known as "Kobe" took lead during LPA's inspection as the facility representative. LPA Mason discussed the purpose of the inspection.

This is a two-story house with three bedrooms and three bathrooms. LPA confirmed the facility currently does not have any clients in care. Kobe 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 provided.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Dwayne L Mason
LICENSING EVALUATOR SIGNATURE: DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2024
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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