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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604337
Report Date: 11/12/2020
Date Signed: 12/17/2020 12:28:29 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SUNSET RESIDENTIAL CAREFACILITY NUMBER:
374604337
ADMINISTRATOR:LOPEZ, YANET PUENTESFACILITY TYPE:
740
ADDRESS:6893 RADCLIFFE DRTELEPHONE:
(702) 303-2317
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY:6CENSUS: 5DATE:
11/12/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Yanet Lopez, ApplicantTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Laarni Santiago conducted a Pre-Licensing Virtual Visit, via video conference, due to COVID-19, to observe the facility for compliance with Title 22, Division 6, of California Code of Regulations and Health & Safety Code. The LPA was joined on the video call by Yanet Lopez, Applicant.

LPA and applicant toured the physical plant, and LPA observed the following: resident accommodations, including furnishings, linens, and personal hygiene items; resident bathrooms were equipped with grab bars, non-skid mats, and water temperature measured at 105 degrees Fahrenheit in two bathrooms designated for use by residents; resident and staff records will be located in two locked cabinets; food service, including dishes, utensils, refrigerators, freezers, and adequate food storage and preparation space are present; cleaning and potentially toxic substances are stored in the garage, which is locked and inaccessible to residents; medication are stored in a locked cabinet; a first aid kit and emergency lighting are stored in a locked closet; activities, supplies and sufficient space in which to conduct activities are present; a fire extinguisher was present; smoke and carbon monoxide detectors are present, were recently inspected, and determined to be operable by fire safety inspector; required facility postings are present and visible in the entryway of the facility. According to applicant, there are no guns, weapons, or ammunition stored on the facility property. No swimming pool or body of water was observed on the facility property.

Component III was conducted and completed following the pre-licensing physical inspection.

Items reviewed during the visit are in compliance with Title 22, Division 6, Chapter 8, of California Code of Regulations. The applicant was advised that the application is pending management final review and approval. A copy of this report and Applicant Rights (LIC 9058) were provided to Yanet Lopez via electronic mail. An electronic mail read receipt confirmation was requested to be sent to LPA upon receipt of the documents.
SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 318-5974
LICENSING EVALUATOR NAME: Laarni SantiagoTELEPHONE: (619) 318-5974
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2020
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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