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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700891
Report Date: 11/04/2020
Date Signed: 11/04/2020 03:51:23 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:SUNGARDEN VILLA IFACILITY NUMBER:
342700891
ADMINISTRATOR:TAKHAR, ARMINDERFACILITY TYPE:
740
ADDRESS:7523 FIREWEED CIRCLETELEPHONE:
(916) 904-0221
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:6CENSUS: 6DATE:
11/04/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Arminder Takhar, AdministratorTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Bethany Huusfeldt conducted a pre-licensing inspection. LPA met with Administrator Arminder Takhar during today's inspection over the phone. Currently there are 6 residents residing within the facility. Fire clearance was granted on 9/04/20 for 5 non-ambulatory in rooms #2-6 and 1 bedridden in room #1.

Facility was inspected both indoors and outdoors. LPA inspected resident bedrooms, bathrooms, common living areas, and garage. Outdoor area is free from hazardous debris. Outdoor exits are clear and accessible. The emergency exiting plan, Resident rights, and licensing complaint poster is posted. First aid kit was present in the facility. Centrally stored medications are locked in office area. The facility has adequate lighting throughout. LPA inspected resident bedrooms and the bedroom had appropriate furnishings, chair, adequate lighting and storage. Bathrooms are clean, sanitary, and in good repair. Smoke detectors and carbon monoxide detectors were checked and operational. Fire extinguisher indicator revealed a full charge. Kitchen is clean, sanitary, and in good repair. There is a locked area for cleaning supplies and toxins. LPA observed 7-day non-perishable and 2 perishable amount of food. A working telephone is provided to residents. Water temperature was measured at 108 degrees. There is an upstairs area utilized by staff.

Component III was completed on 10/22/20. This report will be forwarded to the centralized application unit for continued processing.

Exit Interview conducted. Administrator to sign and return a signed copy by 11/06/20.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany HuusfeldtTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2020
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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