405802274-8-11-2026-29-AS-KBUY-DYEM8S-20260930092336

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405802274
Report Date: 07/30/2026
Date Signed: 08/11/2026 02:15:16 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/30/2026 and conducted by Evaluator Garrett Haner-Tomasko

COMPLAINT CONTROL NUMBER: 29-AS-20260730114026

FACILITY NAME:	SUNRISE TERRACE RCFE I		FACILITY NUMBER:	405802274
ADMINISTRATOR:	INGAN, EDWIN		FACILITY TYPE:	740
ADDRESS:	1135 OCEANAIRE DRIVE		TELEPHONE:	(805) 544-0982
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93405
CAPACITY:	6	CENSUS: 5	DATE:	07/30/2026
		UNANNOUNCED	TIME BEGAN:	03:48 PM
MET WITH:	Administrator - Edwin Ingan		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff do not ensure cleaning supplies, knives, and other similar items that can pose danger to residents are in a locked storage.

INVESTIGATION FINDINGS:

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On 7/30/2026 at 2:00pm Licensing Program Analyst (LPA) Haner-Tomasko arrived unannounced at the facility to investigate the above allegation to this complaint. LPA met with Licensee Albert Gregorio and explained the purpose of the visit.

Licensee and LPA conducted a full tour of the facility. LPA also collected relevant documentation and conducted interviews. When Administrator Edwin Ingan arrived he took over and the Licensee left.

On the allegation, Staff do not ensure cleaning supplies, knives, and other similar items that can pose danger to residents are in a locked storage; it was alleged that on a day this month in the hallway bathroom, the cabinets with cleaning supplies was left unlocked and the knife drawer in the kitchen was unlocked with keys left in the lock.

(Continued on LIC9099-C)

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20260730114026

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNRISE TERRACE RCFE I	FACILITY NUMBER: 405802274
	VISIT DATE: 07/30/2026

NARRATIVE

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While touring the facility during today's visit, at 2:05pm LPA noted the cabinet under the kitchen sink unlocked and unattended with a can of aerosol Easy Off oven spray. At 2:12pm the drawer that is not lockable to the left of the stove/oven containing a steak knife and at 2:13pm a butcher knife in the drawer that is not lockable to the left of the dishwasher underneath the utensil container with the handle visibly sticking out. At 2:18pm LPA observed a bottle of glass cleaner in the east side yard and at 2:20pm LPA noted the shed in the backyard was unlocked and unattended. The shed contained multiple sharp landscaping tools, three tubs of grout compound, a plastic basin with a steak knife in it, and eleven (11) paint/sealant cans.

During today's visit LPA noted the kitchen knife drawer and hallway bathroom cabinet to be locked. Staff stated that the knife drawer lock was recently fixed but before it was fixed the keys would get stuck in the lock. Staff stated the hallway bathroom cabinet was left unlocked this month because they had just pulled something out of it to use in another room and admitted that they did leave the cabinet unattended.

Resident record review determined three of five residents are at risk if given access to knives and cleaning chemicals.

Based on all interviews conducted and documents obtained, at this time the above allegation was found to be substantiated, there is a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted, deficiency cited on LIC809-D page, report signed, appeal rights and report provided to the Administrator.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2026

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20260730114026

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNRISE TERRACE RCFE I	FACILITY NUMBER: 405802274
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/30/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/31/2026 Section Cited CCR 87309(a)	1 2 3 4 5 6 7	(a) ... the licensee shall ensure that disinfectants, cleaning solutions,... knives,... tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.	1 2 3 4 5 6 7	Staff locked up the items when they were discovered during the tour. Administrator states they will conduct training with the staff and email LPA the staff training summary and signed staff roster on or before 8/6/2026.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on observation, interview, and record review, the licensee did not ensure items that could pose a danger to residents were locked when unattended which poses an immediate health and safety risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2026

LIC9099 (FAS) - (06/04)

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