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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002828
Report Date: 08/24/2021
Date Signed: 08/24/2021 01:50:44 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:
345002828
ADMINISTRATOR:HEYDON, ANITAFACILITY TYPE:
740
ADDRESS:6729 SUGAR MAPLE WAYTELEPHONE:
(916) 200-8447
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:6CENSUS: 3DATE:
08/24/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Anita Heydon, AdministratorTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Bethany Huusfeldt-Mirlohi conducted a pre-licensing inspection. LPA met with Administrator Anita Heydon during today's inspection. Currently there are 3 residents residing within the facility. Fire clearance was granted on 7/20/21 for 5 non-ambulatory and 1 bedridden resident.

Facility was inspected both indoors and outdoors. LPA inspected 4 resident bedrooms, 1 staff room, bathrooms, common living areas, and kitchen. Outdoor area is free from hazardous debris. Outdoor exits are clear and accessible. The emergency exiting plan was posted. First aid kit was present in the facility. Centrally stored medications will be locked in the hallway closet. 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. Kitchen is clean, sanitary, and in good repair. A working telephone will be provided upon time of admission of residents.

LPA observed the following corrections need to be completed:
  • Kitchen cabinet which stores the kitchen knives needs to be fixed and locked.
  • Cleaning supplies in the garage need to be locked and inaccessible.
  • Resident needs and service needs to be completed.

Administrator agrees to correct listed items. Component III was waived.

LPA will return on a later date to finish pre-licensing once corrections have been made. Exit interview conducted.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany MirlohiTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021
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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