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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015601387
Report Date: 07/26/2024
Date Signed: 07/26/2024 10:49:20 AM

Document Has Been Signed on 07/26/2024 10:49 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:SUNRISE HOME CAREFACILITY NUMBER:
015601387
ADMINISTRATOR/
DIRECTOR:		PASCUT, MIHAELAFACILITY TYPE:
740
ADDRESS:7254 ELBA COURTTELEPHONE:
(510) 754-8122
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 6CENSUS: 0DATE:
07/26/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Mihaela Pascut, AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On 7/26/2024 at 9:25 AM , Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with owner and Administrator, Mihaela Pascut and explained the purpose of the visit. During the visit LPAs observed that there are currently no resident residing at the facility.

LPA inspected the facility inside and out including but not limited to bedrooms, bathrooms, kitchen, dining area, living room and backyard. Room temperature is observed to be 77 F. Hot water temperature measured at 110 degrees Fahrenheit. LPA observed the presence of smoke detectors and carbon monoxide. Fire Extinguisher was last serviced on 7/26/2024. First aid kit was found complete.

Currently, there are no residents living at the facility. Facility serves as primary residence for the Administrator and her family.

Administrator's files were reviewed.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Ardalan Gharachorloo
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2024
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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