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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700765
Report Date: 04/26/2021
Date Signed: 04/26/2021 01:20:07 PM

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 SENIOR CAREFACILITY NUMBER:
342700765
ADMINISTRATOR:HEYDON, ANITAFACILITY TYPE:
740
ADDRESS:6729 SUGAR MAPLE WAYTELEPHONE:
(916) 560-8903
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:6CENSUS: 2DATE:
04/26/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Urmilla Debi, CaregiverTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Bethany Huusfeldt-Mirlohi arrived unannounced to facility. Upon arrival LPA met caregiver Urmilla Debi. LPA called administrator Anita Heydon to inform of facility visit.

LPA toured the facility observing resident rooms and bathrooms, common living space, and kitchen area. LPA observed the facility to be clean and sanitary. LPA observed sufficient food for residents. Both residents appeared to be comfortable and had finished lunch upon arrival. LPA reviewed resident files.

No deficiencies at this time. Report emailed to administrator.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany HuusfeldtTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2021
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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