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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 134604417
Report Date: 06/28/2023
Date Signed: 06/28/2023 05:35:19 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/23/2023 and conducted by Evaluator Denise Powell
COMPLAINT CONTROL NUMBER: 08-AS-20230623144824
FACILITY NAME:SONRISA VILLA INC.FACILITY NUMBER:
134604417
ADMINISTRATOR:GUEVARA, ITZELFACILITY TYPE:
740
ADDRESS:708 E. 5TH ST.TELEPHONE:
(760) 756-3285
CITY:HOLTVILLESTATE: CAZIP CODE:
92250
CAPACITY:175CENSUS: 102DATE:
06/28/2023
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Gabriela Zamora, ManagerTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Licensee did not ensure elevator was repaired timely
Residents bathrooms were in disrepair
INVESTIGATION FINDINGS:
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Licensing Program Manager (LPM) Denise Powell conducted an unannounced complaint visit to follow up on the above allegations. LPM met with facility Manager Gabriela Zamora and reviewed basic elements of the complaint. During today's visit, LPM toured facility including resident rooms, elevator areas and stairways and other common areas; interviewed staff and residents and then delivered findings. Elevators were observed as non-operational, with signs posted indicating disrepair. Interviews with staff and residents confirmed elevators have been non-operational for several months, since late 2022 due to needed repairs despite assurances from licensee that contracted work was in place. Outside sources have expressed concerns over impact on residents, potential safety risks and not maintaining a comfortable environment as required. Downstairs bathroom toilet was also observed as non-operational. Based on evidence obtained during visit, both allegations are substantiated. Deficiencies are cited on LIC 9099-D, per CCL Title 22 regulations. Plans of correction were jointly developed with Manager Zamora, and a paper copy of this report was provided along with Licensee Rights, with emailed reports sent for facility records.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Icela Estrada
LICENSING EVALUATOR NAME: Denise Powell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 08-AS-20230623144824
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SONRISA VILLA INC.
FACILITY NUMBER: 134604417
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/31/2023
Section Cited
CCR
87303(a)
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87305(a)- The facility shall be clean, safe, sanitary and in good repair at all times. This requirement was not met, as evidenced by: based on observations and interviews, licensee did not maintain elevator in good repair. This posed a potential safety risk to 37 of 102 residents in care.
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Faclity representative agreed they will submit a written plan for obtaining elevator repair or replacement, with estimated completion dates and cost details, by POC date.

Currently 37 residents are on second floor.
Type B
07/31/2023
Section Cited
CCR
87303(e)(6)
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87303(e)(6)- Maintenance and Operations - Toilet ...facilties shall be maintained in operating condition. This requirement was not met, as evidenced by: based on observations and interviews, one toilet was non-operational. This posed a potential health risk to 102 residents in care.
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Facility representative agreed they will submit proof of toilet repair invoice and photo of repaired toilet in common area downstairs bathroom, by POC date.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Icela Estrada
LICENSING EVALUATOR NAME: Denise Powell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2