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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361800137
Report Date: 11/06/2024
Date Signed: 11/06/2024 11:07:56 AM

Document Has Been Signed on 11/06/2024 11:07 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:SUNRIDGE MANOR INCFACILITY NUMBER:
361800137
ADMINISTRATOR/
DIRECTOR:		LANDICHO, ROBERTFACILITY TYPE:
735
ADDRESS:6800 SUNRIDGE COURTTELEPHONE:
(626) 241-3726
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY: 4CENSUS: 4DATE:
11/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Licensee/Administrator Robert LandichoTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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Licensing Program Analyst (LPAs) Beena Singh and Paola Guerrero arrived unannounced to conduct the required comprehensive annual visit to the facility. LPAs met with Direct Service Professional (DSP) Frederick, introduced self and stated the purpose of the visit. Licensee/Administrator Robert Landicho was contacted and arrived during the visit.

The facility has 5 bedrooms, 2 bathrooms, kitchen, dining room, living room, and attached garage. The facility is vendorized by Inland Regional Center (IRC). LPA Beena Singh completed a walk-through of the facility, review of records, medication audit and P&I audit.

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL), LPA Beena Singh observed four (4) clients. There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 78 degrees Fahrenheit. LPA Beena Singh inspected client bedrooms; they are equipped with required furniture such as: mattresses, night-stands, storage space, chairs, and sufficient lighting. LPA Beena Singh inspected client bathrooms; bathrooms were clean, and appliances were found functional. Water temperatures tested at 110 degrees Fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide detectors, charged fire extinguisher, and first aid kit with first aid book.

Posters such as the personal rights, CCL complaint poster, emergency disaster plan were posted in a common area. Sharps and medications were kept in secure cabinets inaccessible to clients. The facility had emergency kits, emergency food and water. There are no firearms and ammunition in the facility. Overall, the facility is clean, and operates in safe conditions for clients in care.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SUNRIDGE MANOR INC
FACILITY NUMBER: 361800137
VISIT DATE: 11/06/2024
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Yards/Outside: One shaded patio, one (1) side gate(s) with self-latching handle on the right side of the house that leads into the backyard, attached garage observed. The outdoor pathway on the side of the facility was free of obstructions

Food Service: LPA Beena Singh observed two (2) day(s) supply of perishable food and seven (7) day(s) supply of non-perishables food and snacks. Dishes, cups, and utensils were stored properly.


Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week.

Record Review: LPA Beena Singh reviewed client files for admission agreements and needs and services plans and Physician Report (LIC602). LPA also reviewed staff and administrator's file for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. LPA Beena Singh observed that S1 has no updated Administrator Certification. Per LPA Beena Singh's records review, Administrator certificate has been updated on the file, dated 11/28/2025. Fire drill done on 11/02/2024.

LPA Beena Singh reviewed clients files, P&I records and observed no issue.

LPA Beena Singh reviewed medications and observed no issue.

No deficiencies were cited during this visit. An exit interview was conducted where this report was disscussed and provided to Licensee/Administrator Robert Landicho.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
LIC809 (FAS) - (06/04)
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