Inspection visit

Routine inspectionAugust 7, 2024

SUNNYBRAE HOMELicense 19760968429 citations on this visit

29 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA met with staff Josephine Espiritu was explained the reason for the visit. At 1:00 PM Jeffrey Savella who is the licensee arrived and met with LPA, was explained the reason for the visit. At 11:37 AM, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the kitchen. The charge date is 1/2/2024. During the visit the facility is at 74 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents; one (1) bedridden; hospice waiver for six (6). Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked cabinet under the sink of the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away under the kitchen sink. Bedrooms: There were six (6) bedrooms designated for residents' and staff use. Room #2, room #3, room #5 and bedroom #6 are all private. Bedroom #4 is shared. Room #1 is for staff used. Residents bedroom are properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Continue to LIC 809-C Bathrooms: There are four (4) bathroom designated for residents' and staff use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 105.1 degrees Fahrenheit for bathroom #1 located in the hallway in between room #2 and room #3. Bathroom #2 is inside bedroom #4. Hot water temperature was measured at 105.8 degrees Fahrenheit. Bathroom #3 is located beside the laundry area that is only use for staff. Bathroom #4 is beside bedroom #5 is under renovation, it is lock, closed and non-operational. There was enough clean linen available in the cabinets in the hallway. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control : Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds : Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or body of water. The garage detached. Laundry service: There is enough linen available to change weekly or more if need. Cleaning supplies are being stored in a locked cabinet under the kitchen sink. Staff Files : LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Office space is beside the kitchen. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. The administrator file was reviewed for current first aid, fingerprint clearance, administrator certificate, and HIV/AIDS and TB training. S3 missing TB test and health screening. Deficiency will be cited on LIC 809-D. Continue to LIC 809-C Medications are in a centrally stored and locked place, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has NOT been logged in the medications log with proper documentation from the clients’ doctor. Staff last log medication was back on 8.5.2024 for all residents. Deficiency will be cited on LIC 809-D. Proper medication dispensing instruction are followed and checked for contamination. First-aid has all proper items and is current. Resident records were reviewed for requirements and legibility: LPA reviewed client’s files for current appraisal R1, R2, R3, R4 and R6, no appraisal was seen R1, R2, R3, R4 and R6, LIC 601, no functional capability R1, R2, R3, R4 and R6; no admission agreement for R5. Deficiency will be cited on LIC 809-D. Planned activities are offered. Facility is within CA code of Regulations Title 22 or Health and Safety Code. Deficiencies were found and cited on LIC 809-D, exit interview conducted, copy of report has been issued and discussed.

Citations

29 citations recorded^*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

87457(c)(1)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents appraisal is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87463(a)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents appraisal is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87464(c)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87464(d)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission appraisal agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87465(d)(2)Type A
Based on record review, the licensee did not comply with the section cited above in 6 out of 6 MAR log was not filled-in, log stop at 8.5.2024 which poses an immediate health, safety or personal rights risk to persons in care.
1569.885(c)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents functional capability is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
1569.886(d)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87411(a)(11)Type B
Personnel Records/Staff Training - Personnel Records Section 87412(a)(11) - Domain Focused(11) A health screening as specified in Section 87411, Personnel Requirements - General.
87456(a)(2)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents is missing pre-admission which poses/posed a potential health, safety or personal rights risk to persons in care.
87457(c)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents needs and service plan is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87467(a)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87506(b)(13)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents functional capability is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87506(b)(17)(A)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents pre-admission appraisal is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87506(b)(17)(B)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents functional capability is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87506(b)(17)(D)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents social factor is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87507(a)(1)(A)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87507(a)(1)(B)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission appraisal agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87507(b)Type B
Based on record review, the licensee did not comply with the section cited above in 6 out of 6 residents admission appraisal agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87507(c)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission appraisal agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87507(g)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission appraisal agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care
87507(g)(3)(A)1Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission appraisal agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care
87507(l)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87508(a)(3)Type B
Based on record review, the licensee did not comply with the section cited above in 3 out of 6 residents identity and emergency information and emergency is missing which poses/posed a potential health, safety or personal rights risk to persons in care
87608(a)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents appraisal. emergency is missing which poses/posed a potential health, safety or personal rights risk to persons in care
1569.885(a)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87465(e)Type A
Based on record review, the licensee did not comply with the section cited above in 1 out of 1 MAR, incomplete log of MAR, which poses an immediate health, safety or personal rights risk to persons in care.
87506(b)(15)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents appraisal is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87506(b)(17)(C)Type B
Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents mental condition is missing which poses/posed a potential health, safety or personal rights risk to persons in care.
87507(d)Type B
Based on record review, the licensee did not comply with the section cited above in 1 out of 6 residents admission appraisal agreement is missing which poses/posed a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the August 7, 2024 inspection of SUNNYBRAE HOME?

This was a inspection inspection of SUNNYBRAE HOME on August 7, 2024. 29 citations were issued: 2 Type A (serious) and 27 Type B.

Were any citations issued to SUNNYBRAE HOME on August 7, 2024?

Yes, 29 citations were issued (2 Type A, 27 Type B). The first citation was for: "Based on record review, the licensee did not comply with the section cited above in 5 out of 6 residents appraisal is mi..."

What type of inspection was this?

This was a inspection inspection. inspection inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLD View original report

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Data from CCLD public records. Last updated May 25, 2026. If you believe any information is inaccurate, report it here.

Routine inspection·August 7, 2024