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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347000871
Report Date: 07/10/2024
Date Signed: 07/10/2024 01:55:16 PM

Document Has Been Signed on 07/10/2024 01:55 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:SUNRISE RESIDENTIAL CARE SERVICES, INC. (#1)FACILITY NUMBER:
347000871
ADMINISTRATOR/
DIRECTOR:		DICKEY, MAYE C.FACILITY TYPE:
735
ADDRESS:7880 VISTA RIDGE DRIVETELEPHONE:
(916) 725-6647
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6CENSUS: 5DATE:
07/10/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Maye Dickey, Administrator and Lita Cailing, Co-Administrator TIME VISIT/
INSPECTION COMPLETED:
01:55 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Lita Cailing, Co-Administrator, and explained purpose of inspection. All (5) clients were attending day program at the start of the inspection. LPA observed (2) clients return during the inspection. The facility is an Adult Residential Facility (level 3 home) that is vendorized through Alta California Regional Center. Administrator, Maye Dickey, arrived around 12:45 pm.

LPA and Co-Administrator toured the interior and exterior of the facility including the common areas, (4) private client bedrooms, (1) shared client bedroom, (2) bathrooms, kitchen, (2) staff rooms, laundry area and outside patio. LPA observed the home to be clean, safe and in good repair and to not pose a health and safety risk or personal rights violation. LPA observed locked toxins and sharps in the laundry area and locked medications in a separate cabinet. LPA observed sufficient 2+day perishable/7+day non-perishable food. Bathrooms have soap, paper towels, trash cans with lids and hand-washing posters. There are sufficient PPE supplies and linens/towels. There is a complete First Aid kit. Hot water temperature measured 105*F in the kitchen. Inside temperature measured 72*F. Fire extinguisher last serviced 8/23/23. Fire drills conducted monthly- last conducted June 2024. Smoke/monoxide alarms working.

LPA reviewed (2) of (5) client files and found them to contain current documentation. Medications were reviewed for (1) client- orders match medications being administered and medication documentation is current. P&I funds were reviewed- funds on hand match documentation on file. LPA reviewed (3) of (3) staff files- First Aid/CPR certification is current. Administrator to ensure the third staff is completing annual training- documentation for (8) hours on file for 2024. Administrator certificate #6004281735 (exp 7/10/25) and Administrator certificate #6010165735 (exp 11/25/24). LPA observed various Covid posters throughout as well as other required postings, including House Rules and personal rights. Clients were unavailable or declined to be interviewed. No changes with LIC308 from last year. There are no deficiencies issued in today's report. Exit interview. Copy of report provided to Co-Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2024
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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