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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001314
Report Date: 09/16/2022
Date Signed: 09/16/2022 05:00:49 PM

Document Has Been Signed on 09/16/2022 05:00 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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:SUNRISE RESIDENTIAL CARE SERVICES, INC. (#2)FACILITY NUMBER:
347001314
ADMINISTRATOR:DICKEY, MAYEFACILITY TYPE:
735
ADDRESS:8139 WACHTEL WAYTELEPHONE:
(916) 725-6647
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6CENSUS: 6DATE:
09/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Maye Dickey, Administrator TIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Erlinda Cailing, DSP and explained purpose of inspection. Luzviminda "Mindy" Graganta, Co-Administrator and Elizabeth Lucas, DSP, arrived at approximately 3:15 pm. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols and confirmed the facility does not currently have any positive Covid-19 diagnoses. LPA was screened per Covid-19 precautionary measures upon entering the facility. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. The facility is a licensed 4B home that is vendorized through Alta California Regional Center. There are (6) clients who reside at the home. LPA observed (5) clients in the common area and (1) client return later during the inspection from an interview.

LPA and Co-Administrator toured the interior and exterior of the facility including the common areas, (4) client bedrooms, (2) bathrooms, kitchen, and laundry area. 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 various Covid posters throughout as well as other required postings, including House Rules and personal rights. Administrator certificate #6010165740- exp 2/3/2024 and Certificate #6037524735- exp 10/9/2023 posted.. Inside temperature was observed to be 70* F. Fire extinguisher last serviced 8/31/2022. Facility conducts monthly fire drills- documentation observed. The facility has a large back yard area with seating. LPA observed locked toxins, medications and sharps and sufficient 2+day perishable/7+day non-perishable food. LPA observed paper towels, soap, sanitizer, trash cans with lids and hand-washing posters in the bathrooms. LPA observed grab bars and non-skid flooring in the bathrooms and sufficient PPE supply on hand. LPA provided (1) package of gowns and (6) individual sanitizers from Department. Discussed resident and staff vaccination status and eligibility for booster shot. LPA provided booster flyer. Discussed visitation protocols. LPA observed organized binders with staff and resident documentation as well as several binders containing the Covid-19 Mitigation Plan, Monkey Pox and Infection Control plans.
There were no deficiencies observed.
Exit interview. Copy of report left at facility.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/16/2022
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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