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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881358
Report Date: 02/07/2024
Date Signed: 02/07/2024 03:34:20 PM


Document Has Been Signed on 02/07/2024 03:34 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:DIANE DOMINGOFACILITY TYPE:
740
ADDRESS:28500 BRADLEY ROADTELEPHONE:
(951) 679-2391
CITY:SUN CITYSTATE: CAZIP CODE:
92586
CAPACITY:74CENSUS: 69DATE:
02/07/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:ADMINISTRATOR, BITUIN GARCIATIME COMPLETED:
03:50 PM
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On February 07, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced in order to conduct the required annual inspection. LPA Mixson met with Bituin Garcia, introduced self, and stated the purpose of the visit. The File review was conducted in the office and additional forms were requested and reviewed on site.

LPA Mixson toured the facility, along with the Administrator, Bituin Garcia, and inspected the inside and outside of the facility. The facility is a two story building located at 28500 Bradley Road, Sun City CA. 92586. The Facility is licensed for 74 Elderly Adults and is operating at a capacity of 69. The facility phone number is (951)679-2391 and it is operable.
Physical Plant: The physical plant, is in good condition, neat, and orderly. Outdoor and indoor passageways are free of obstruction at the time of this visit. The Facility has several activity rooms and each has the required furniture; such as tables, chairs, storage space, and sufficient lighting. The building temperatures throughout was per regulations. The activity rooms are equipped with the required items, per Title 22. The hot water temperature was tested in several of the restrooms, in which they each tested within the range required for regulations. The restrooms were equipped with liquid soap and paper towels. LPA Mixson toured the kitchen and staff were preparing evening meal. The facility had activity schedules posted and available for review. The Facility has emergency food and water. LPA Mixson inspected the common areas. The fire extinguisher was in the green and the Facility recently had fire inspection. Carbon monoxide alarms, along with smoke detectors were observed. There was a locked and centralized storage area for medications in the nurses station and it was locked. Medications are contained in bubble packs, and supplied by the Pharmacy. The Facility had a designated area for resident and staff files, and it was locked. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There was adequate seating in the common areas and sufficient space for activities. LPA Mixson observed monthly activity calendars, a swimming pool gated and locked. LPA Mixson reviewed staff and resident files, and conducted five staff interviews and resident interviews. There were no regulation violations observed during todays visit. An exit interview was conducted and a copy of this report was provided to Bituin Garcia.
SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus MixsonTELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024
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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