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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315001968
Report Date: 12/10/2021
Date Signed: 12/10/2021 12:04:39 PM

Document Has Been Signed on 12/10/2021 12:04 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, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:SUNRISE OF ROCKLINFACILITY NUMBER:
315001968
ADMINISTRATOR:MORADHASEL, ROUZBEHFACILITY TYPE:
740
ADDRESS:6100 SIERRA COLLEGE BLVDTELEPHONE:
(916) 632-3003
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY: 82CENSUS: 55DATE:
12/10/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Caroline Frangieh, Senior Executive DirectorTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 12/10/2021 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Senior Executive Director, Caroline Frangieh, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms, and contacted facility to complete a facility risk assessment. LPA ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N-95 Masks.

LPA toured the facility to ensure the health and safety of residents in care. Areas toured include but are not limited to: first and second floor of Assisted Living Unit, Memory Care Unit, dining rooms, kitchen, outdoor area, lobby, PPE storage, and main restrooms. Fire extinguishers are ready for emergency use and all stairwells have evacuation chairs. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Senior Executive Director completed the infection control domain and facility was found to be in substantial compliance at this time.

No deficiencies are being cited. Exit interview conducted and copy of report left at the facility.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE: DATE: 12/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2021
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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