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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001314
Report Date: 09/05/2024
Date Signed: 09/05/2024 01:44:15 PM

Document Has Been Signed on 09/05/2024 01:44 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/
DIRECTOR:		DICKEY, MAYEFACILITY TYPE:
735
ADDRESS:8139 WACHTEL WAYTELEPHONE:
(916) 725-6647
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6CENSUS: 6DATE:
09/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Mindy Gragants, Co-Administrator TIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Luzviminda "Mindy" Graganta, Co-Administrator, and explained purpose of inspection. Also present were staff, Marilyn Pascual and Encarnacion Carmen. LPA observed (2) clients present and was informed (4) other clients were attending day program. The facility is a licensed 4B home that is vendorized through Alta California Regional Center.

LPA and Co-Administrator 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. All bathrooms have the required grab bars and non-skid flooring, as well as paper towels, soap, sanitizer, trash cans with lids and hand-washing posters. There are sufficient linens, blankets, towels, PPE supplies, and a complete First Aid kit. Hot water measured 108*F in the bathroom. Inside temperature measured 72*F. Fire extinguisher was last serviced 7/31/24 and smoke/monoxide alarms are in working order. There is sufficient 2+day perishable and 7+ day non-perishable supply of food, and sharps are locked in the kitchen. Toxins are locked in the laundry area and medications are locked in a separate cabinet. Each client door has a locking mechanism (per Title 17), and there are alarms on each exit door. There is an open back-yard area with a vegetable garden and picnic tables. There is no pool/pond.

LPA reviewed (3) client files and observed them to contain complete/current documentation. Medications and P&I funds were reviewed for (2) clients- no discrepancies were noted. Documentation is complete and current. LPA reviewed (4) staff files. All staff have current First Aid/CPR certifications and have completed initial/continuing training, as required. Administrator certificate #6010165735- exp 11/25/24 and Co-Administrator's certificate #6037524735 is pending renewal. Required postings are in common area.
The Infection Control and Emergency Disaster Plans were reviewed. LPA obtained updated land/mobile phone contacts.
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: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2024
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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