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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001314
Report Date: 09/20/2023
Date Signed: 09/20/2023 05:06:19 PM

Document Has Been Signed on 09/20/2023 05:06 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. (#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:
09/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Maye Dickey, Administrator TIME COMPLETED:
05:10 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Luzviminda "Mindy" Graganta, Administrator and Maye Dickey, Administrator, and explained purpose of inspection. LPA observed (6) clients present. 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 and Administrators toured the interior and exterior of the facility including the common areas, (4) client bedrooms, (2) bathrooms, (2) staff rooms, 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- renewal pending. Inside temperature was observed to be 72* F. Fire extinguisher last serviced 8/23/23. Facility conducts monthly fire drills- last conducted Aug 2023. The facility has a large back yard area with seating. LPA observed locked toxins, medications and sharps and sufficient 2+day perishable with fresh fruit and 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 observed newly installed locks on each client door, pursuant to the Regional Center's request. (4) of (6) clients chose to safeguard their own key. Hot water temperature measured 108*F in the kitchen. LPA reviewed (2) resident files and observed them to contain complete/current documentation. Medications were reviewed for (1) client and P&I funds were reviewed for (2) clients - no discrepancies were found. LPA reviewed staff files for (4). All staff completed First Aid/CPR in August 2022 and training is being conducted as required. Medication training was recently conducted by a local pharmacy.All clients had a flu shot earlier this week. LPA reviewed the Infection Control Plan, Monkey Pox Plan and Emergency Disaster Plan.

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: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2023
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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