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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920051
Report Date: 10/03/2023
Date Signed: 10/03/2023 12:11:12 PM

Document Has Been Signed on 10/03/2023 12:11 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:SONRISA SENIOR LIVINGFACILITY NUMBER:
315920051
ADMINISTRATOR:GALVEZ, JESSICAFACILITY TYPE:
740
ADDRESS:1041 ROSEVILLE PKWYTELEPHONE:
(520) 797-4000
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 199CENSUS: 0DATE:
10/03/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:TIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility announced on 10/3/23 to conduct a Pre-licensing referencing the CARE inspection tool. LPA met with the Executive Director and explained the purpose of the visit.

LPA toured the interior and exterior of the facility together with the Maintenance Director to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, bathroom, kitchen, laundry room, outdoor areas and The Gardens (memory Care) area, In the areas toured no immediate health, safety concerns observed.

The licensee is waiting for delivery of 2 stairwell evac chairs that are anticipated to be delivered before opening.

There are currently no residents or staff present.

Component III review is waived as the applicant has other facilities.

The facility is in significant compliance.

License pending approval.

Exit interview conducted and copy of report left at the facility.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2023
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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