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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
345002828
Report Date:
08/30/2021
Date Signed:
08/30/2021 01:16:46 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 CARE
FACILITY NUMBER:
345002828
ADMINISTRATOR:
HEYDON, ANITA
FACILITY TYPE:
740
ADDRESS:
6729 SUGAR MAPLE WAY
TELEPHONE:
(916) 200-8447
CITY:
CITRUS HEIGHTS
STATE:
CA
ZIP CODE:
95610
CAPACITY:
6
CENSUS:
3
DATE:
08/30/2021
TYPE OF VISIT:
Prelicensing
UNANNOUNCED
TIME BEGAN:
12:00 PM
MET WITH:
Steve Heydon, Adminsitrator
TIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to complete pre-licensing inspection. LPA met with administrator Steve Heydon during today's inspection. LPA met with fire inspector to review floor plan and fire clearance. Currently there are 3 residents at the facility.
LPA observed facility has corrected the following:
The facility has locked kitchen cabinet which stores the kitchen knives.
Cleaning supplies in the garage are locked.
Resident needs and service plan is completed.
This report will be forwarded to the centralized application unit for continued processing.
Exit Interview conducted.
SUPERVISOR'S NAME:
Troy Ordonez
TELEPHONE:
(916) 263-4832
LICENSING EVALUATOR NAME:
Bethany Mirlohi
TELEPHONE:
(916) 591-1072
LICENSING EVALUATOR SIGNATURE:
DATE:
08/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/30/2021
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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