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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374601134
Report Date: 03/12/2025
Date Signed: 03/12/2025 04:38:20 PM

Document Has Been Signed on 03/12/2025 04:38 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 DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SUNRISE AT LA COSTAFACILITY NUMBER:
374601134
ADMINISTRATOR/
DIRECTOR:
HERNANDEZ, MARLENFACILITY TYPE:
740
ADDRESS:7020 MANZANITA STTELEPHONE:
(760) 930-0060
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY: 120TOTAL ENROLLED CHILDREN: 0CENSUS: 90DATE:
03/12/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Executive Director Jennifer OrtegaTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA), Hannah Rodgers conducted a Case Management - Incident visit. LPA identified themselves and met with Executive Director Jennifer Ortega, to discuss the purpose of the visit.

The facility self reported an incident that occurred on February 18, 2025 involving Resident #1(R1), Resident #2(R2), Resident #3(R3), Resident #4(R4) and Staff #1(S1) [See LIC811 Confidential Name List for identification of select person identifiers used in this report]. The incident report indicated S1 was rough with R1, R2, R3, and R4 while providing care. S1 was placed on suspension and their last day worked was February 18, 2025. S1 officially resigned from the facility February 25, 2025. LPA conducted interviews with residents and staff.

Staff interviews provided conflicting information. Per interviews, S1 was designated to the memory care floor primarily on the right wing. Per staff interviews, the right wing is challenging as there are eight residents who require total assistance with transfers from and to wheelchairs, including R1, R2, R3, and R4. LPA attempted to interview R1, R2, R3, R4, and a sample of their floor mates, but due to their baseline memory loss, each was unable to be qualified as a reliable historian for this case. Interview with S1 did not reveal they had been rough with residents and denied the allegations.

Based on interviews and records review, there did not yield a preponderance of evidence to conclude that S1 was rough with residents. No deficiencies were cited during the visit. An exit interview was conducted with Executive Director Ortega, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

Lizzette TellezTELEPHONE: (619) 767-2351
Hannah RodgersTELEPHONE: (619) 417-3928
DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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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