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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006015
Report Date: 03/06/2024
Date Signed: 03/06/2024 10:24:29 AM

Document Has Been Signed on 03/06/2024 10:24 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: 2DATE:
03/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Andrew CrawfordTIME COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA met with Program Director (PD) Andrew Crawford and explained the purpose of the inspection.

During the inspection LPA and PD conducted a tour of the inside and outside of the facility, common areas, client rooms, kitchen, garage and observed the following:

This is a one-story home with three client bedrooms, two bathrooms, one staff office, one therapy room, a laundry room, and attached two car garage. All client bedrooms had the required furnishings. LPA observed all client beds had linens and blankets. The back yard has a shaded sitting area. LPA observed two clients present. Clients were observed taking routine morning medication and engaging in therapy sessions. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 118.2-119.1 F degrees. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. Facility has a 2-day supply of perishables and a 7-day supply of non-perishable food. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with service tag dated 7/29/23. Disaster drill log indicated last drill was conducted on 2/07/24. Electric stove, microwave, washer, and dryer were all inspected. Sharps, all and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients. Medication cabinet was observed to be locked in the staff office. LPA reviewed two client files and two staff files. LPA interviewed staff and clients present.

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: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2024
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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