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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600990
Report Date: 12/02/2020
Date Signed: 12/29/2020 09:36:15 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SUNRISE OF BURLINGAMEFACILITY NUMBER:
415600990
ADMINISTRATOR:ABBIE APOLINARIOFACILITY TYPE:
740
ADDRESS:1818 TROUSDALE DRTELEPHONE:
(650) 692-2805
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY:97CENSUS: 64DATE:
12/02/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Abbie ApolinarioTIME COMPLETED:
12:45 PM
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On this day, Licensing Program Analyst (LPA) Michael Garcia conducted a Case Management continuation visit to provide Technical Assistance to the facility regarding COVID-19. Due to the pandemic, the visit was conducted remotely via video call. The visit was conducted with Abbie Apolinario, executive director/administrator, and Barbara Elenteny, Department of Social Services Nurse.

The facility's COVID-19 protocol was discussed. Parts of the facility were toured, including the facility's COVID-19 screening area. Plenty of PPE supplies observed. Hand washing stations and hand sanitizers available throughout the facility. Staff and residents practicing physical distancing.

According to Administrator, the facility currently has no active COVID-19 cases at the facility. The last known active case was on November 11, 2020. The facility has completed two rounds of mass testing for all facility staff and residents and all tested negative. The facility has resumed surveillance testing of 25% of its staff every 7 days.

No recommendation needed at this time regarding the facility COVID-19 protocol.

Report was discussed with Administrator. An electronic copy of the report was emailed to Administrator for signature.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Michael GarciaTELEPHONE: (650) 380-4608
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2020
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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