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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700816
Report Date: 11/17/2020
Date Signed: 11/17/2020 11:03:37 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:SUNSET HILL SENIOR LIVINGFACILITY NUMBER:
312700816
ADMINISTRATOR:POPESCU, DANIELFACILITY TYPE:
740
ADDRESS:2552 OLD KENMARE RDTELEPHONE:
(916) 253-9925
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY:6CENSUS: 0DATE:
11/17/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Daniel PopescuTIME COMPLETED:
11:30 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 Analysts Melissa Lusby arrived to conduct a prelicensing inspection. Due to Covid-19 precautions, LPA wore N95 respirators upon entering the property. LPA was greeted with Administrator Daniel and allowed entry in to the facility.

LPA toured the facility with Daniel. This facility has a fire clearance for 6 nonambulatory residents.There are 5 bedrooms and 3 bathrooms. All bedrooms contain the required furniture. Bathroom water temperatures are recorded at 114.6, 118.0, and 112. Showers and bathtub have required nonskid mats. Kitchen is clean and organized. All knives and sharp objects are kept locked and inaccessible to clients. All appliances in the kitchen are observed to be clean and operational. Toxins and cleaning supplies are locked under the kitchen sink. Medications will be kept locked in kitchen cabinets. Wash and dryer are located in separate room by the garage and are clean and noted to be operational. There are locked cabinets in the laundry room for detergent and additional cleaning supplies. Backyard was clear of debris and hazards.

Administrator tested fire alarms and are in working order. Facility has two fire extinguishers which have current inspections. Facility has a fully stocked first aid kit.

Component III has been completed at this time with Administrator Daniel.

The facility appears to be in substantial compliance and ready for licensure. The license will be granted upon completion of a final review and approval from the Licensing Program Manager and the Central Applications Bureau. An exit interview was conducted with Administrator and a copy of this report will be left at the facility.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Melissa LusbyTELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2020
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