<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006015
Report Date: 08/16/2023
Date Signed: 08/16/2023 10:34:41 AM

Document Has Been Signed on 08/16/2023 10:34 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:SOUTHERN CALIFORNIA SUNRISE RECOVERY CENTER, LLCFACILITY NUMBER:
306006015
ADMINISTRATOR:VILLARREAL, MICHAELFACILITY TYPE:
772
ADDRESS:24751 ARGUS DRTELEPHONE:
(949) 533-4025
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 6CENSUS: 4DATE:
08/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:02 AM
MET WITH:Andrew Crawford- Program DirectorTIME COMPLETED:
10:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose to issue a Technical Violation (TV) in conjunction with the delivery of findings for complaint control number: 22-AS-20230808150304.

On August 14, 2023 approximately 1:31pm, LPA verified upon entry that Staff #1 (S1) who was employed effective August 9, 2023 was not associated to the facility per the Licensing Information System (LIS) Facility Personnel Report Summary dated August 9, 2023. LPA also verified at 2:39pm, that S1's criminal record clearance was not transferred to the facility per review of the Department's Guardian Background Check System. At 2:46pm, LPA was informed by Administrator Michael that S1 was associated. LPA verified S1 to be associated effective August 14, 2023. On today's date, clearance transfer was not completed for Staff #3 (S3) and was associated on today's date.

LPA provided consultation on 80019(e)(1) & (2) Criminal Record Clearance and offered guidance to ensure that future violations to the said regulation will result in a Type A citation and immediate civil penalty.

Based on the observations and interviews which were conducted, an Advisory Note Technical Violation (LIC9102 TV) was issued on today's date. No citations were issued.

An exit interview was conducted via a conference call with Administrator Michael Villarreal who consented Program Director Andrew Crawford to sign this report on his behalf. A copy of this report along with the LIC811 and LIC9102 TV were provided via email to both individuals.




SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1