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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361880793
Report Date: 12/05/2023
Date Signed: 12/05/2023 01:27:43 PM


Document Has Been Signed on 12/05/2023 01:27 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
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507



FACILITY NAME:SUNLIT GARDENS ASSISTED LIVINGFACILITY NUMBER:
361880793
ADMINISTRATOR:STEVENSON, CHERYLFACILITY TYPE:
740
ADDRESS:9428 19TH STREETTELEPHONE:
(909) 481-2600
CITY:ALTA LOMASTATE: CAZIP CODE:
91701
CAPACITY:100CENSUS: 68DATE:
12/05/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Missy Rivera, Wellness Director & Tirso Del JuncoTIME COMPLETED:
01:30 PM
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Licensing Program Analyst, Amber Coleman, (LPA) arrived at Sunlit Gardens unannounced to conduct a case management visit. This case management visit is in response to an incident report submitted to the Community Care Licensing Office on 11/21/23. LPA met with Executive Director, Tirso Del Junco, introduced self and state purpose of the visit.

The Special/Unusual Incident Report, (SIR) reported that on 11/8/23, the Executive Director received a call from family member of R1 reporting that staff laughed at R1 on the floor. R1 later complained about the food service. Food Service was scheduled to deliver a meal, R1 made request for an alternative. Staff's response was, "We don't have that."

According to staff interviews, on 11/8/23 R1 needed assistance transferring. When staff arrived to assist R1. Staff had trouble completing the task and required more assistance. During this time, it was reported that there was an unfavorable verbal exchange. Later during that day, (11/8/23) R1 made request for an alternative meal. This alternative meal was not provided by staff. LPA interviewed R1 and learned that the unfavorable verbal exchange could not be recalled. Executive Director expressed that staff conducted their own investigation. This investigation resulted in S1's termination from the facility. R1 denies having seen or worked with S1 again.
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Amber ColemanTELEPHONE: 951-248-0338
LICENSING EVALUATOR SIGNATURE:
DATE: 12/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/05/2023
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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