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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881358
Report Date: 11/15/2022
Date Signed: 11/15/2022 04:12:37 PM


Document Has Been Signed on 11/15/2022 04:12 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:SUN CITY GARDENSFACILITY NUMBER:
331881358
ADMINISTRATOR:BITUIN, GARCIAFACILITY TYPE:
740
ADDRESS:28500 BRADLEY ROADTELEPHONE:
(951) 679-2391
CITY:SUN CITYSTATE: CAZIP CODE:
92586
CAPACITY:74CENSUS: 39DATE:
11/15/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:42 PM
MET WITH:ADMINISTRATOR, BITUIN GARCIATIME COMPLETED:
04:33 PM
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On November 15, 2022, Licensing Program Analyst (LPA), Venus Mixson conducted a scheduled visit to complete a Pre-licensing inspection. LPA Mixson met with Bituin Garcia, Administrator, and toured the facility.

LPA Mixson toured the facility inside and outside. The facility is a two story facility with 74 single resident living quarters with restrooms. There are two dinning areas one per floor, and two activity rooms for residents activities. LPA Mixson observed sufficient food supply, and the overall facility to be in clean condition with a comfortable temperature. LPA Mixson observed passageways to be free from obstruction. Water temperature was tested and found to be within regulation limitations. There were grab bars and nonskid mats and/or strips in the bathrooms.
LPA Mixson observed a pool with a gate and lock installed. Medications were kept locked and inaccessible. LPA observed smoke alarms in working condition, fire extinguishers charged and an operable carbon monoxide detector installed. The Menifee Fire Department gave the all clear on 09/21/2022.
LPA Mixson conducted a Pre-licensing audit of the signal system. LPA Mixson activated the pendant alarms in 2 different rooms. Staff did respond within the allotted amount of time. It was revealed the signal system is operable. It was also determined that there are 6 caregivers total for all residents. This information was obtained from the Administrator revealed this is a sufficient number of staff to meet the needs of the residents.
An exit interview was conducted and a copy of this report was reviewed and given to the Administrator. COMP III reviewed.
SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus MixsonTELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022
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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