445202756-1-15-2026-26-AS-CKAI-DQK3B6-20260121170550

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 445202756
Report Date: 01/15/2026
Date Signed: 01/15/2026 03:56:09 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/07/2025 and conducted by Evaluator Marcella Tarin

COMPLAINT CONTROL NUMBER: 26-AS-20250707103827

FACILITY NAME:	SUNSHINE VILLA ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	445202756
ADMINISTRATOR:	BOLIN, CANDACE		FACILITY TYPE:	740
ADDRESS:	80 FRONT STREET		TELEPHONE:	(831) 459-8400
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95060
CAPACITY:	132	CENSUS: 102	DATE:	01/15/2026
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	General Manager (GM) Candace Bolin		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff do not permit resident to have visitors.
Staff do not permit resident to leave the facility.
Staff did not assist resident with obtaining medical care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marcella Tarin arrived unannounced to conduct a complaint investigation visit to deliver the complaint findings. LPA met with General Manager (GM) Candace Bolin and stated the purpose of the visit.

On 7/7/2025 the Department received a complaint with the above allegations.

On 7/11/2025, 9/17/2025, 10/3/2025, and 10/7/2025 the Department conducted complaint investigation visits and interviewed 6 Staff (S1 to S6), 2 Residents (R1 to R2), and 3 Witnesses (W1-W3).

The Department interviewed Reporting Party (RP) on 7/11/2025. RP states on 6/23/2025 the facility did not allow him/her to visit a resident (Referred to as R1). RP states he/she was allowed to visit on 6/23/2025 to 6/25/2025. RP states the facility only allowed him/her to visit with R1 within the facility.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026

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 26-AS-20250707103827

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: SUNSHINE VILLA ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 445202756
	VISIT DATE: 01/15/2026

NARRATIVE

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The Department interviewed 6 Staff (S1 to S6). 6 Out of 6 staff state there has never been a time a visitor was not permitted to visit with his/her loved one.

The Department interviewed 2 Residents (R1 to R2). 1 Out of 2 residents state there has never been a time his/her visitors were not permitted to visit with him/her. R2 did not respond to questions due to neurocognitive disorder.

The Department interviewed 3 Witnesses (W1 to W3). 3 Out of 3 Witnesses state he/she has no concerns about the care his/her loved one is receiving at the facility.

Staff do not permit resident to leave the facility.
The Department interviewed 6 Staff (S1 to S6). 6 Out of 6 staff state there has never been a time a resident was not permitted to leave the facility.

The Department interviewed 2 Residents (R1 to R2). 1 Out of 2 residents states there has never been a time when the facility did not allow him/her to leave. R2 did not respond to questions due to neurocognitive disorder.

The Department interviewed 3 Witnesses (W1 to W3). 3 Out of 3 Witnesses state he/she has no concerns about the care his/her loved one is receiving at the facility.

Based on review of R1's physician's report dated 4/26/2024, R1 cannot leave the facility unassisted.

Staff did not assist resident with obtaining medical care.
It has been alleged by RP that the facility did not obtain care for R1's cracked lens on a pair of eyeglasses on 6/23/2025 to 6/25/2025 when RP visited with his/her loved one.

The Department interviewed 6 Staff (S1 to S6). 6 Out of 6 staff state there has never been a time a resident was not assisted with obtaining medical care.

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SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 26-AS-20250707103827

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: SUNSHINE VILLA ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 445202756
	VISIT DATE: 01/15/2026

NARRATIVE

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The Department interviewed 3 Witnesses (W1 to W3). 3 Out of 3 Witnesses state he/she has no concerns about the care his/her loved one is receiving at the facility. W3 states the facility communicates when his/her loved one needs anything at the facility.

This agency has investigated the complaint alleging staff do not permit resident to have visitors, staff do not permit resident to leave the facility, staff did not assist resident with obtaining medical care. We have found that the complaint was UNFOUNDED meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

No deficiencies were cited during today's visit per California Code of Regulations, Title 22. An exit interview was conducted with GM Candace Bolin and a signed copy of this report was provided.

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END OF REPORT

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026

LIC9099 (FAS) - (06/04)

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