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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 445202756
Report Date: 09/02/2020
Date Signed: 09/02/2020 04:15:28 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:SUNSHINE VILLA ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
445202756
ADMINISTRATOR:MCKIE, JAMESFACILITY TYPE:
740
ADDRESS:80 FRONT STREETTELEPHONE:
(831) 459-8400
CITY:SANTA CRUZSTATE: CAZIP CODE:
95060
CAPACITY:132CENSUS: 95DATE:
09/02/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Craig Cady, Health Services DirectorTIME COMPLETED:
04:15 PM
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Licensing Program Analysts (LPA) Anna Bui and Jackie Jin conducted an unannounced Case Management visit. This case management visit is to conduct a health and safety check and ensure the facility is adhering to health protocols. LPAs met with Craig Cady, Health Services Director, via facetime.

During today's visit, LPAs toured the facility inside and outside, including the resident bedrooms, bathrooms, and living room. Bedrooms and living rooms were observed with furnishings that are in good repair. Bathrooms were observed to be clean and with hygiene supplies and toiletries. The facility has lighting in the bedrooms and common areas. Residents have a 30 days supply of medications. First aid kits have sufficient supplies. 2 days worth of perishables and 7 days worth of nonperishable were observed. Hot water temperature is available for the residents to use. Facility temperature is maintained at 73 degrees Fahrenheit. LPAs observed no damage from the Santa Cruz County fire.

Residents were observed and interviewed. Residents were clean, groomed, and with no serious injuries.

Facility is still following health protocols during this pandemic.

No deficiencies cited during today's visit.

This report was reviewed with Craig Cady, Health Services Director. A copy of this report was emailed on 9/2/2020 for signature.
SUPERVISOR'S NAME: Sarah YipTELEPHONE: (408) 324-2131
LICENSING EVALUATOR NAME: Anna BuiTELEPHONE: 650-269-7419
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2020
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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